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Firearm Violence
April 8, 2024

Strengthening the Role of the NIH in the Firearm Violence Epidemic: A Modest Proposal

Author Affiliations
  • 1School of Nursing, Penn Injury Science Center, and the Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia
  • 2Department of Emergency Medicine and Comprehensive Injury Center, Medical College of Wisconsin, Milwaukee
  • 3Firearm Injury & Policy Research Program, University of Washington, Seattle
JAMA Intern Med. 2024;184(6):595-596. doi:10.1001/jamainternmed.2024.0337

The National Institutes of Health (NIH) is the largest biomedical research entity in the world. It has near-universal support from Congress and has a current budget of $47.683 billion. The funding provided by NIH is the mainstay of research programs in universities and academic health centers across the country. NIH funds research that seeks to reduce current morbidity and mortality from major public health threats, such as the COVID-19 pandemic and the epidemic of opioid overdoses. Yet, the near-universal political support of NIH has not extended historically to research on firearm injury and death. The NIH Reporter indicates NIH funded no firearm research before 2002. Congress did appropriate $12.5 million to NIH and Centers for Disease Control and Prevention each in fiscal year 2023 and the nongovernmental National Consortium for Gun Violence Research has funded $22 million in grants between 2019 and 2022. According to the NIH Reporter, there were only 31 active grants on firearm violence in fiscal year 2023. The mismatch of public health burden and funding is the result of the polarized politics around firearms in the US, which has resulted in decades of limited funding and restrictive language on what federal agencies could fund.

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4 Comments for this article
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Integrity required when lives are at stake
Andrew Johnstone, MD,RPh | Independent Practitioner
Unless we do better than in the past, our lack of honesty and integrity when it comes to 'guns and public health' will cause us to lose even more credibility.

Even liberal (and award-winning) criminologist Don Kates and his physician co-authors published a 'citique of overt mendacity' thoroughly documenting the fact that "... unfortunately, CDC and other health advocate sages build their case not only by suppressing facts, but by overt fraud, fabricating statistics, and falsifying references to support them ..." "Guns and Public Health - epidemic of violence, or pandemic of propaganda?" 61 Tenn. L.
Rev. 513-596 (1994). https://guncite.com/journals/tennmed.html

Until we are willing to be honest and apply the same objectivity the medical community is usually known for when it comes to issues of Public Health, nobody is going to take our recommendations seriously.

Andrew Johnstone, RPh/MD
CONFLICT OF INTEREST: None Reported
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Painful Truths
Steven Reid, MD, FAANS | Doctor Lifeline, Incorporated
We need to begin with an honest, objective, analysis of the data, untainted by political narratives. We need to follow the data, wherever it leads, even against the headwinds of biases and cognitive dissonance. I suspect that many of the truths we find will be disruptive to prevailing dogma. We must deal with our sociological world as it is, not as how we wish it to be.
CONFLICT OF INTEREST: None Reported
It will be an uphill battle!
David Hartman, BSEE | retired
You can expect the NRA, the disorganized 2nd amendment militia, most of the Republicans, the police forces, and the entire gun lobby to fight any form of disclosure of firearm ownership, injury, and fatality raw data.

Don't settle for statistics because statistics can be bent and distorted to say anything.

There are liars, damn liars, and statisticians, and these days the Republicans seem to be adept liars.
CONFLICT OF INTEREST: None Reported
Research What and Why?
Edward Powell, Ph.D., Astrophysics | Independent
The author asks for additional funding and the establishment of a research institute to study questions the answers to which have been known for decades. The NIH was until recently banned from this line of research because a) the NIH previously showed political bias in both its research and recommendations, and b) firearms violence (any violence really) is not a health-related issue. Studying the causes and possible interventions for mental health issues that lead to suicide is a worthy goal. But since in 2021, 50.4% of suicides were done using firearms, what's the point of studying only those 50.4%? Why not study suicide prevention techniques rather than the use of guns in suicide? Suicide prevention is a health-related issue; firearms use is not.

Similarly, the murder rate in the United States jumped from about 5.0/100,000 in 2019 to about 6.5/100,000 in 2020. Why did this occur? One hint is that the jump occurred in June 2020 after the BLM riots and the "defund the police" movement became popular. It jumped to 6.9 in 2021 after all the covid lockdowns went away. Most of these murders were with firearms. Why did they happen? Because policing high-crime areas greatly decreased. It does not take an institute and millions of dollars to figure this out. And there are plenty of both public and private institutes that study crime and criminals anyway, including the FBI, the National Institutes of Justice, the Manhattan Institute, and numerous others.

The NIH has not covered itself in glory during the covid pandemic, when it advocated the exact opposite of what it had written down as pandemic response measures in studies beforehand. In fact, many of the NIH's recommendations (which became mandates) such as "six foot" social distances, masking children, closing schools, using ventilators, and not recommending Vitamin D supplements were utterly arbitrary, lacking all evidence, and caused insuperable harm and even death to many vulnerable Americans. The NIH needs to regain what little credibility it had before the pandemic before it ventures into other highly politicized areas of research, which are well covered by existing public and private research.
CONFLICT OF INTEREST: None Reported
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