THE BIG BANG THEORY: EVIDENCE-BASED STRATEGIES

TO REDUCE GUN VIOLENCE

@bicmay#PolicyRx16

DisclosureThe Following Presenters Have Disclosed Relevant Financial Relationships:Cedric Dark, MD MPH FAAEM FACEPCommunity Health Choice, Event Sponsorship; Schumacher Clinical Partners, Event Sponsorship Seth Trueger, MD MPHEmergency Physicians Monthly, Employee, Salary The Following Presenters Have Disclosed No Financial Relationships:Megan Douglas, JDElena M. Marks, JD MPHLaura Medford-Davis, MDBich-May Nguyen, MD MPH The Following Planners Have Disclosed Relevant Financial Relationships:Cedric Dark, MD MPH FAAEM FACEPCommunity Health Choice, Event Sponsorship; Schumacher Clinical Partners, Event Sponsorship The Following Planning Committee Members and Staff Have DisclosedNo Relevant Financial Relationships:Emily DeVillers, CAEKay Whalen, MBA CAEJanet Wilson, CAE

The Second Amendment

A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.

LoGiurato, Andy Kiersz and Brett. "Here's Where You're Most Likely to Own a Gun." Business Insider. 03 July 2015.Kalesan B, Villarreal MD, Keyes KM, Galea S. Gun Ownership and Social Gun Culture. Inj Prev. 2015;22(3):216–220.

Fleegler EW, Lee LK, Monuteaux MC, Hemenway D, Mannix R. Firearm Legislation and Firearm-Related Fatalities in the United States. JAMA Intern Med. 2013;173(9):732–740.

Objectives

• Identify three evidence-based policies to reduce gun violence

• Identify barriers to potential policies• Identify strategies to promote evidence-

based policies

BACKGROUND CHECKS

Which person cannot buy a gun under federal law?

A. A man who has been convicted of a violent or firearm-related misdemeanor

B. A woman with a history of alcohol abuseC. A person who has renounced his or her

U.S. citizenshipD. A teenager convicted of juvenile offenses

Guns, Public Health, and Mental Illness: An Evidence-Based Approach for State Policy; 2013.Vittes KA, Vernick JS, Webster DW. Legal Status and Source of Offenders’ Firearms in States with the Least Stringent Criteria for Gun Ownership. Inj Prev. 2013;19(1):26–31.

Universal Background Check Laws

• Bans for mental health conditions associated with fewer homicides

• Reductions in firearm-related homicides• Local checks associated with lower

suicide rates• Decreased intimate partner homicides

Teret SP, Wintemute GJ. Policies to prevent firearm injuries. Health Aff. 1993;12(4):96–108.Ruddell R, Mays GL. State background checks and firearms homicides. J Crim Just. 2005;33(2):127–136.Sumner SA, Layde PM, Guse CE. Firearm death rates and association with level of firearm purchase background check. Am J Prev Med. 2008;35(1):1–6.Vigdor ER, Mercy JA. Do laws restricting access to firearms by domestic violence offenders prevent intimate partner homicide? Eval Rev. 2006;30(3):313–346.Rodríguez Andres A, Hempstead K. Gun control and suicide: the impact of state firearm regulations in the United States, 1995–2004. Health Policy. 2011;101(1):95–103.Sen B, Panjamapirom A. State background checks for gun purchase and firearm deaths: an exploratory study. Prev Med. 2012;55(4):346–350.

"The Cost of Eliminating Background Checks." Everytown for Gun Safety Support Fund. 16 Apr. 2015.Bureau of Alcohol, Tobacco, Firearms and Explosives, “Missouri,” Firearms Trace Data - 2013, accessed April 10, 2015.

"The Cost of Eliminating Background Checks." Everytown for Gun Safety Support Fund. 16 Apr. 2015.Bureau of Alcohol, Tobacco, Firearms and Explosives, “Missouri,” Firearms Trace Data - 2013, accessed April 10, 2015.

"The Cost of Eliminating Background Checks." Everytown for Gun Safety Support Fund. 16 Apr. 2015.Webster D, Crifasi CK, Vernick JS. Effects of the Repeal of Missouri’s Handgun Purchaser Licensing Law on Homicides. J Urban Heal. 2014;91(2):293–302.

"Universal Background Checks & the “Private” Sale Loophole Policy Summary." Law Center to Prevent Gun Violence. 10 Sept. 2015. Barry CL, McGinty EE, Vernick JS, Webster DW. After Newtown - Public Opinion on Gun Policy and Mental Illness. N Engl J Med. 2013;368(12):1077–81.

"Universal Background Checks & the “Private” Sale Loophole Policy Summary." Law Center to Prevent Gun Violence. 10 Sept. 2015. Barry CL, McGinty EE, Vernick JS, Webster DW. After Newtown - Public Opinion on Gun Policy and Mental Illness. N Engl J Med. 2013;368(12):1077–81.

CHILD ACCESS PREVENTION

What percent of children know where their parents’ guns are?

A. 73%B. 39%C. 36%D. 22%

Baxley F, Miller M. Parental Misperceptions about Children and Firearms. Arch Pediatr Adolesc Med. 2006;160(5):542–547.

Ingraham, Christopher. "Toddlers Have Shot at Least 23 People This Year." Wonkblog. The Washington Post. May 2016.

Murray, Rheana. "Idaho Woman Shot by Son at Walmart Remembered as Scientist, Loving Mom." ABC News. N.p., 31 Dec. 2014.

Wagner, Meg. "Pro-gun Florida Mom Accidentally Shot by 4-year-old Son after Leaving Loaded Weapon in Car, Bragging about How Tot Gets 'gets Jacked Up' for Target Practice." New York Daily News. 9 Mar. 2016.

The 5 L’s

• Is it loaded?• Is it locked? • Are little children present? • Is the operator feeling low? • Is the operator learned?

Pinholt EM, Mitchell JD, Butler JH, Kumar H. “Is There a Gun in the Home?” Assessing the Risks of Gun Ownership in Older Adults. J Am Geriatr Soc. 2014;62(6):1142–1146.

FIREARM SAFETY

Which products are not regulated?

A. Hair dryersB. Teddy bearsC. GunsD. AspirinE. All of the above

15 U.S.C. § 2052(a)(1)(ii)(E), referencing 26 U.S.C. § 4181.

RESEARCH

“…we are in strong agreement now that scientific research should be conducted into preventing firearm injuries and that ways to prevent firearm deaths can be found without encroaching on the rights of legitimate gun owners.”

Dickey J, Rosenberg M. We won’t know the cause of gun violence until we look for it. The Washington Post. Published July 27, 2012.

BALLOT MEASURES

Question 1

Background Checks for Gun Sales Initiatives

Summary

• Evidence-based policies: – Universal background checks– Child access prevention– Improve firearm safety

• Barrier:– NRA leadership

• Strategies:– Research– Ballot measures

Giffords, Gabrielle. "Gun Violence Is a Full-Blown National Crisis." Vogue. 02 June 2016. Web. 04 June 2016.

References• Accidental Shootings: Many Deaths and Injuries Caused by Firearms Could Be

Prevented. Washington, D.C.; 1991.• Albright TL, Burge SK. Improving Firearm Storage Habits: Impact of Brief Office

Counseling by Family Physicians. J Am Board Fam Pract. 2003;16(1):40–46. • Barry CL, McGinty EE, Vernick JS, Webster DW. After Newtown - Public Opinion

on Gun Policy and Mental Illness. N Engl J Med. 2013;368(12):1077–81. • Baxley F, Miller M. Parental Misperceptions about Children and Firearms. Arch

Pediatr Adolesc Med. 2006;160(5):542–547. • Bureau of Alcohol, Tobacco, Firearms and Explosives, “Missouri,” Firearms

Trace Data - 2013, accessed April 10, 2015.• Fleegler EW, Lee LK, Monuteaux MC, Hemenway D, Mannix R. Firearm

Legislation and Firearm-Related Fatalities in the United States. JAMA Intern Med. 2013;173(9):732–740.

• Gostin LO. 4 Simple Reforms to Address Mass Shootings and Other Firearm Violence. JAMA J Am Med Assoc. 2016;315(5):453–454.

References• Grossman DC, Mueller BA, Riedy C, et al. Gun Storage Practices and Risk of

Youth Suicide and Unintentional Firearm Injuries. JAMA J Am Med Assoc. 2005;293(6):707–714.

• Guns, Public Health, and Mental Illness: An Evidence-Based Approach for State Policy; 2013.

• Kalesan B, Villarreal MD, Keyes KM, Galea S. Gun Ownership and Social Gun Culture. Inj Prev. 2015;22(3):216–220.

• Kellermann AL, Rivara FP, Rushforth NB, et al. Gun Ownership as a Risk Factor for Homicide in the Home. N Engl J Med. 1993;329(15):1084–91.

• Leventhal JM, Gaither JR, Sege R. Hospitalizations Due to Firearm Injuries in Children and Adolescents. Pediatrics. 2014;133(2):219–25.

• Naureckas SM, Galanter C, Naureckas ET, Donovan M, Christoffel KK. Children’s and Women's Ability to Fire Handguns. Arch Pediatr Adolesc Med. 1995;149(12):1318–1322.

• Pinholt EM, Mitchell JD, Butler JH, Kumar H. “is There a Gun in the Home?” Assessing the Risks of Gun Ownership in Older Adults. J Am Geriatr Soc. 2014;62(6):1142–1146.

References• Santaella-Tenorio J, Cerdá M, Villaveces A, Galea S. What Do We

Know About the Association Between Firearm Legislation and Firearm-Related Injuries? Epidemiol Rev. 2016;38:140–157.

• Schuster MA, Franke TM, Bastian AM, Sor S, Halfon N. Firearm Storage Patterns in US Homes with Children. Am J Public Health. 2000;90(4):588–94.

• Sen B, Panjamapirom A. State background checks for gun purchase and firearm deaths: an exploratory study. Prev Med. 2012;55(4):346–350.

• Rodríguez Andres A, Hempstead K. Gun control and suicide: the impact of state firearm regulations in the United States, 1995–2004. Health Policy. 2011;101(1):95–103.

• Ruddell R, Mays GL. State background checks and firearms homicides. J Crim Just. 2005;33(2):127–136.

References• Sumner SA, Layde PM, Guse CE. Firearm death rates and

association with level of firearm purchase background check. Am J Prev Med. 2008;35(1):1–6.

• Teret SP, Wintemute GJ. Policies to prevent firearm injuries. Health Aff (Millwood). 1993;12(4):96–108.

• Vittes KA, Vernick JS, Webster DW. Legal Status and Source of Offenders’ Firearms in States with the Least Stringent Criteria for Gun Ownership. Inj Prev. 2013;19(1):26–31.

• Vigdor ER, Mercy JA. Do laws restricting access to firearms by domestic violence offenders prevent intimate partner homicide? Eval Rev. 2006;30(3):313–346.

• Webster D, Crifasi CK, Vernick JS. Effects of the Repeal of Missouri’s Handgun Purchaser Licensing Law on Homicides. J Urban Heal. 2014;91(2):293–302.