A Public Health Response

I've written here about firearms a few times and I'm not going to repeat myself at length. The problem of firearm violence obviously has three dimensions. The first is epidemiological/etiological -- what are the patterns of its occurrence, and can we identify causes? The second is prescriptive -- if we can identify causes, are there policies that would effectively prevent it? The third, of course, is political -- is it possible to implement effective policies?

I won't bother to link to statistics because the exact numbers aren't important. Qualitatively, mass shootings, however you want to define them -- four or more deaths in one incident is a common operationalization, but it's arbitrary -- account for a pretty small minority of firearm deaths in the U.S. We do see more and more AR15 style weapons used in these, but handguns are far more commonly the instrument of death, including in many mass shootings.

The mass shootings get a lot more attention than the daily toll of more isolated deaths. That's just human nature. And they do in some ways have repercussions beyond the sheer numbers of dead. They devastate communities and have an emotional impact on people who aren't so directly affected. In some cases, they are intended as terrorist intimidation or assaults on particular groups of people, such as African Americans, Latinos, or sexual minorities, so those cases can affect the emotional well-being of millions of people. So yes, we'd like to stop them. Let's talk about that first.

Mental illness and video games, along with all the other explanations so-called gun rights defenders like to put forth, obviously exist all over the world. But only in the U.S. do we have routine massacres, barring conditions of war or social collapse. (The Mexican drug wars I would classify as an example of the latter.) That guns are much more easily obtained in the U.S. than most other countries is a ready explanation, but it isn't sufficient. Almost every household in Switzerland has a gun, but it's a very peaceful country. One important difference is that everyone has been trained in use of those weapons and weapon safety, and I suspect another is that people who are disturbed and evidently dangerous get weeded out in compulsory military training. On the other hand countries that have experienced devastating massacres, such as the UK and Australia, have taken measures to drastically reduce gun ownership and they haven't seen similar incidents since. So outside of the Swiss context it does seem to matter.

 

Another difference is that every affluent country other than the United States, and some less affluent, has universal comprehensive health care and people with psycho-emotional problems get identified and helped. Another is that there is less social and economic inequality in other affluent countries, and hence fewer people who build up toxic resentment. But I would  say that one essential problem is cultural. There's a strain of toxic masculinity in the U.S. that's less powerful elsewhere, and it is strongly associated with the culture of firearm fanaticism. At the same time, we have a lot of socio-cultural diversity and a lot of Americans are infected by one or another form of bigotry. Young men who need to prove that they are powerful and manly may conflate that with one or more such resentments and we get the racist massacres. 

 

There have been a couple of incidents perpetrated by Islamic Jihadists, of course. The U.S. isn't uniquely vulnerable, but I'm hoping that movement is in decline. (I don't put the Pulse nightclub massacre in that category because the perpetrator was very confused about religion, did not identify with any specific ideology, and his actions were most likely the result of psycho-sexual torment.)

But all of those considerations can't account for all of these incidents. For example there is no compelling explanation for the actions of Stephen Paddock. I will say that his attack would not have been a fraction as deadly had he not been able to make his weapons mimic fully automatic fire by the use of bump stocks. If those had not been obtainable dozens of lives might have been saved. So that seems a no-brainer although this was a unique case.

So, these incidents are diverse in etiology, and they involve profound problems in U.S. society. Given that complexity and our seeming inability to solve our problems of inequality, division, cultural toxicity and inadequate social welfare, it tempting to say we should go the way of Australia and just round up all the guns. But we know that isn't going to happen.  

I will say that these military-style rifles have no purpose other than to kill humans. That is what they are designed for. There is also no reason to allow large-capacity magazines. Getting rid of them wouldn't prevent these tragedies, but it could make them less deadly. But the mass killing problem aside, there are possibly achievable ways to reduce the overall toll of firearm violence. I'll get to that next.