“An awful lot of untouched questions.” The state of U.S. gun violence research

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In the past two weeks, the United States has seen two horrific high-profile mass shootings: A racially motivated attack at a Buffalo grocery store left 10 dead on 14 May, and a shooter at an elementary school in Uvalde, Texas, killed 2 adults and 19 children on 24 May. Guns are now the number one cause of death in U.S. children, overtaking automobile accidents, according to data from the Centers for Disease Control and Prevention (CDC).

For years, researchers including Rebecca Cunningham, an emergency room physician and gun violence researcher at the University of Michigan, have been sounding the alarm on the need for more scientific study of the causes of gun violence and ways to prevent it. But “historically, funding was very kneecapped,” says Cunningham, because beginning in 1996 Congress barred the CDC from spending money “to advocate or promote gun control.” In 2020, however, lawmakers set aside $25 million for the CDC and National Institutes of Health (NIH) to study the issue.

“Now, there is some money for this research — but it’s still massively underfunded,” Cunningham says, especially compared with research for cancer or other diseases that kill children. ScienceInsider recently spoke with Cunningham about the current state of U.S. gun violence research and what she thinks is needed. The conversation has been edited for length and clarity.

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Are child deaths from guns increasing in the United States?


Yes. We recently published a letter to the editor in the New England Journal of Medicine demonstrating that, indeed, this is now the number one cause of death among children who lived through infancy. Several years ago it was the number two cause of death, and since then the country has continued to take this turn. From a number standpoint, we’re certainly not in a better place.

Are more scientists studying gun violence?

The field of firearm injury prevention has grown a lot in the past couple of years. Three, four or five years ago, we had very few scientists studying this. People were so nervous — it was difficult to get scholars to be comfortable studying it. We now have a bubbling up of scholars pivoting their careers towards this pressing problem, and we’ve now had national conferences where scientists can come together and talked about the science of gun violence. From a scientific standpoint, I think there is hope and progress.

Is the funding available to match that interest?

The more difficult news is we still are really massively underfunded. Compared to cancer, or any other serious cause of death among kids, it’s still exponentially underfunded, and we’re not even talking about the underfunding of gun deaths among the rest of our population. The $25 million [for] the CDC and the NIH is [a] great commitment and focus. But to apply the best thinking and theory in the fields and make a movement forward — those things cost money.

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Rebecca Cunningham inside an operating room Melanie Maxwell

What could you and other researchers study with more funding?

There are many pieces of this issue that need to be examined. We need to address communities, we need to address individuals and families, we need to address policies, we have to address how we manage post-injury for people who survive gunshots. We need to study how we store guns – how do we reduce access for youth who are at risk for suicide? We need to better understand how Extreme Risk Protection Order laws [or red flag laws, which restrict gun possession or purchase in an at-risk individual] are being used, which parts of them may be working, and what happens when [the temporary restriction period] runs out. And, for example, with the tragic shooting this week in Texas, we need to understand how that will impact the community going forward. There’s an awful lot of untouched questions right now.

What does research say is the most effective way to prevent gun deaths in children?

There’s not one best method, and we’re not talking about one issue — gun violence is heterogeneous. We have mass shootings like this week, and then we have the daily, very high levels of violence in our communities, both from suicide and from homicides. Those have different ideologies and different mechanisms. Concepts like safe storage [of guns] are shown to be important, and there’s an increasing scientific literature around how we do threat assessments with youth that have raised red flags in schools or in communities, and provide them the right resources for prevention.

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Is this a particularly urgent moment for researchers who study gun violence?

The shooting [in Uvalde] will hark our national consciousness back to [the] Parkland and Sandy Hook [mass school shootings], which had impact on the collective conscious of our nation – as it should. [It can’t] be lost in the daily urgency that our overall rates of gun violence, every day, are also exceedingly high. We’re failing our kids. Our children are overwhelmingly dying, and so are our communities and our grandmothers and people who want to shop at grocery stores or walk down their streets and in hang around their neighborhoods. We can’t look away anymore.



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