When NRA members attend their convention, ER doctors see fewer patients with gun injuries, study says

A man examines a weapon at the National Rifle Assn.'s annual meeting in Indianapolis in 2014. A new study finds that gun injuries drop 20% while the NRA is holding its convention.
(Karen Bleier / AFP/Getty Images)

For all the fiery rhetoric issued during annual meetings of the National Rifle Assn., new research suggests that life gets a bit more peaceful in hospital emergency departments when the country’s most ardent gun-rights advocates attend their yearly confab.

The rate at which Americans head to ERs seeking treatment for gun injuries dips during the days that the NRA typically holds its annual convention compared with three- and four-day periods just before and after the meeting, a new study shows.

The size of the downturn in gun-related injuries was small, largely because firearms injuries account for a tiny fraction of the ills that bring patients to hospital emergency departments.


During the non-meeting days included in the study, the rate of ER visits for firearm injuries was 1.49 per 100,000 total visits. During the NRA conventions, which are typically held for three or four days in April or early May, that rate fell to 1.19 per 100,000.

The results, published Wednesday in the New England Journal of Medicine, were based on private insurance claims for emergency department visits across the country. The findings fit with mounting research suggesting that increasing rates of gun ownership and use are accompanied by increasing rates of firearm injury, even when guns are purchased legally.

Both rates reported in the study are small. But the authors — Dr. Anupam B. Jena of Harvard Medical School and Andrew R. Olenski of Columbia University — insist they are meaningful.

The difference between them amounts to a 20% reduction in firearms-injury risk, a magnitude that’s on a par with the decreases in gun-related deaths seen after states have adopted some firearms restrictions, the authors wrote.

The researchers did not find a corresponding downturn in gun-related crimes during NRA conventions. That suggests that the missing ER patients were mainly legal gun owners who were either at the convention or taking a break from their usual hunting or sport shooting because their hunting buddies or the gun range operators were off at the convention.

It is a reminder that guns are dangerous, even in the hands of legal owners affiliated with an organization that teaches gun-safety courses and preaches the virtues of responsible firearms ownership, Jena said.


“Even among experienced gun owners — who might be more likely to attend NRA annual conventions — the rate of firearm injury directly relates to the amount of firearm use,” Jena and Olenski wrote.

The people and places that experienced the most pronounced downturns were not entirely random, either.

Reductions in firearm injuries were highest among men, and across the nation’s South and West in states that rank among the highest in gun ownership. And over the nine annual meetings studied, the declines in ER visits for gun injuries were sharpest in the state that hosted the convention in a given year.

Those findings lend further credence to the idea that the NRA convention effect is real. Of the roughly 80,000 NRA members who attend any given yearly meeting, close to 85% are men. And attendance is typically highest among members who live in the state where the convention is being held.

To detect that small but significant trend, Jena and Olenski sifted through more than 75 million private health insurance claims for ER visits due to firearms injuries. They scoured those records first to establish the rate of such visits during the exact dates of the annual NRA meetings between 2007 and 2015. Then, they compared that rate with the rate seen in emergency departments during two other three-day periods — exactly three weeks before the convention and three weeks after the meetings. (That way, all of the periods had the same number of weekdays and weekends.)

None of this is to say that NRA members leave their weapons at home. A notice on the NRA’s annual meeting website says that, in accordance with Texas law, “lawfully carried firearms will be permitted” in Dallas’ Kay Bailey Hutchison Convention Center and the Omni Dallas Hotel, where the 2018 annual meeting and exhibits are to be held May 3 through 6.


“When carrying your firearm remember to follow all federal, state and local laws,” the NRA website cautions attendees.

Dr. Garen Wintemute, an emergency department physician and firearms injury researcher at UC Davis, said the new study should have examined whether the population studied — people with private health insurance — really reflects those most likely to attend NRA annual meetings, and whether other events that occurred during the time periods studied might account for the differences seen.

For instance, Wintemute said that crime rates tend to drop during major sporting events — evidence that a range of activities might temporarily drive down gun injuries.

Wintemute mused that future studies should explore whether ER visits for firearms injuries change during NASCAR events, which are attended by many gun owners, or during annual meetings of AARP, an organization whose aims are entirely unrelated to guns.

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