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The vacuum in gun violence research in America is slowly being filled by independent organizations.

Michael Hiltzik

Michael Hiltzik, Los Angeles Times

The latest to accept the responsibility for studying one of our most pressing public health crises is Kaiser Permanente, the giant health-care system, which last week announced a $2 million program to study how to prevent gun injuries and deaths.

With more than 12 million members and a presence in communities with 65 million residents, says Bechara Choucair, the organization’s chief community health officer, “we feel a responsibility to address public health issues, and gun violence is one of those issues.”

Firearm-related injuries caused 30,000 deaths in 2016, the latest year for which statistics are available. Kaiser Permanente physicians treated 11,000 gunshot injuries in 2016 and 2017 combined.

“Whether firearm-related injuries and deaths are coming from suicides, homicides or accidents,” Choucair told me, “we feel we’re particularly well-positioned to understand what role health-care systems can play to help prevent them.”

Kaiser Permanente’s effort appears to be unique among nonacademic medical institutions. But it may be uniquely situated to perform the sort of clinical studies that have been sorely lacking in U.S. gun violence research. The system is known for its ability to conduct clinical research among its huge patient base, including research into cardiac and cancer treatment.

In turning its sights on firearms violence, Kaiser Permanente will be helping to fill a gap created by federal agencies’ fears of the National Rifle Association. In 1996, the NRA strong-armed Congress into eliminating the $2.6 million it had appropriated for gun violence research by the Centers for Disease Control and Prevention. Congress then passed a measure drafted by then-Rep. Jay Dickey (R-Ark.) forbidding the CDC to spend funds “to advocate or promote gun control.” (Dickey later would publicly regret his amendment.)

The Dickey Amendment didn’t technically ban any federally funded gun violence research. The real blow was delivered by a succession of pusillanimous CDC directors, who decided that the safest course bureaucratically was simply to zero out the whole field. The result was to reduce gun violence research to an uncharted desert.

Non-federal institutions have recently moved to fill in the blanks. One is UC Davis, which has established the Firearm Violence Research Center with a five-year, $5-million grant.

The center’s director, Garen Wintemute, welcomes Kaiser Permanente’s initiative. “In this field, a $2 million research commitment will make a difference,” he told me by email. “One possibility that I find particularly exciting: Kaiser would be an ideal setting for research on how best to integrate firearm violence prevention into patient care.”

The $2 million may be just a start — a “down payment,” says David Grossman, a physician and expert in gun injury prevention at Kaiser Permanente in Washington state who will be co-leader, with Choucair, of the system’s task force on firearm injury prevention. Physicians know how to treat firearm injuries when they present at the hospital and have a good idea of which groups are most at risk. Therefore, Grossman said, the research will focus on interventions that physicians can perform for patients in high-risk groups, such as those vulnerable to abuse by intimate partners where “there is a firearm in the picture.”

“As clinicians, we’re seeing those folks,” Grossman told me. “We have an opportunity to help and intervene, and we’d like to know how we can be most effective.”

Grossman already has some experience in learning how intervention can reduce injury and death. In 2011, before joining Kaiser Permanente, he studied what happened after gun safes were installed in rural native Alaskan households, 95 percent of which owned guns. The study found that the ratio of homes with unlocked guns fell from 93 percent to 35 percent in a year, a trend the study team conjectured would lead to reduced gun-related injuries and deaths in the community.

The system’s doctors also have experience intervening to address chronic conditions such as alcoholism or motor vehicle injuries. “As a family physician, I’ve counseled thousands of patients over the years how to quit smoking or prevent car accidents,” Choucair says.

“There are decades’ worth of research that tell us how to screen for these issues, who to screen for these issues, what type of questions to ask, and if somebody screens positive, what are the types of interventions you need to do to address these issues. The reality is that when it comes to firearm injuries, we don’t have that body of research. We’re hoping that $2 million will start to fill in the gaps.”

One other difference: the political component. Few areas of American life are as touchy as gun ownership. It’s not unheard of for gun-happy state legislators to try to limit doctors’ abilities even to ask patients about guns in the home, an example of how politics can infiltrate the clinical office.

The system’s initiative will step lightly around politics, Choucair says. “It’s really, really important that we are leaving the policy debates to policymakers,” he says. “This is truly about science; this is not about politics.”

Michael Hiltzik is a columnist for the Los Angeles Times.


(21) comments


Several areas that need study is why liberals have no problem with illegals entering our country, but have a problem with law abiding citizens legaling owning guns of their choice. Why do liberals say it’s ok for illegal felons some of whom rape and kill Americans to be given refuge in sanctuary cities, but want to disarm the law abiding American. Liberals have no problem allowing immigrants from terror sponsoring countries, but want to take my gun even though I’ve never committed a crime, much less a crime with my gun. Why is it ok for Odummy to release over a thousand criminals early with no regard for their past victims or future ones, but people who’ve committed NO CRIMES at all, and NO CRIMES with guns may be forced to give up their constitutional right. Does this make any intelligent sense at all??????


Climate asks for intelligent sense? I think intelligent sense might encompass letting out prisoners who no longer pose a threat to society, thus saving us millions of tax payer dollars. I wonder if Climate could point out how many of the prisoners released early by Obama's directive have since committed crimes. THAT would be intelligent sense, wouldn't it? Of course we already knew Climate lacks that. It would also make intelligent sense, Climate, for you to compare the rape and murder statistics among illegal immigrants compared to the general U.S. population. It is far, far lower, but that would be too much for Climate to understand, as he lacks intelligent sense. I wonder if Climate could come up with some evidence that there is a big push to disarm all Americans. That would make intelligent sense, but of course Climate lacks that and thus is unable to back up that accusation. Americans can continue to own arms, but it would make extremely intelligent sense to get rid of all military-style assault weapons from private ownership. They are designed for one thing: to kill other human beings. They are not hunting rifles, nor are they target rifles. They are designed to spray a maximum amount of ammo in a minimum amount of time, so they are extremely attractive to the mentally ill who are seduced by America's insane gun culture. Getting rid of those weapons would be a good first step in throwing cold water on that gun romance. We did it in the 1800s, making it unacceptable for people to stroll in public with weapons strapped to their hips, and we can do it again. You can keep your weapons -- acceptable weapons for self-defense and hunting -- but keep them at home, where you can have them to protect you and your family, as you wish.


Facts simply don't matter to the Hoaxer. No amount of facts or reasoned thinking will sway him from his belligerent ignorance.

kingman10 Here is great piece on smart guns.


one area that needs more research is the use of smart guns. Technology has made it possible for guns that fire for only the owner, not some thief or kid. It is possible it would save many lives, especially suicides or even mass shootings. Of course the NRA has not endorsed this yet, not enough killing for them I guess. What effect this would have on gun violence in our society is a good place to do research.


So you’re saying most people who commit suicide don’t own their own guns? Show me the proof, the facts.


man hoaxer you are a special type, too scared to think outside the box. Read the articles or have someone read them to you. I never said "most" people who commit suicide don't own their own gun. But it might stop some people, how many we don't know thats why we need "research". Who said a smart gun can only have one owner? Read the ARTICLE!


If a smart gun only shoots for its owner, how is that going to save many suicidal lives? I presume most suicides are killed with their own gun.


So you have a home invasion, you’ll have to pass the gun around to the registrant before the thug can be shot? What if the wife is home alone and the gun is registered to her husband, she’s expected to take one to appease the liberal anti gun idiots.? Not so smart. But it would increase gun ownership because everyone would have to own one. Maybe it is a good idea.


You don't understand basic logic, do you, Climate? king is a secret agent of the NRA, and these personalized guns would mean that the Mrs. would have to have a second piece registered in HER name, thus doubling sales of handguns per household. With Donald Trump's households, he'd need a huge arsenal to arm himself, his wife, ex-wives and uncounted mistresses, not to mention stocking each of many different homes that where he and they maintain pillows.


its like dog attack stats. most are german shepards, but they're police dogs and that gets thrown in the mix. how many of these shootings are trigger happy rookie cops?


I have to guess the head-in-the-sand attitude from congressional slaves to the NRA is what drives such effective measures as placing 5 gallon buckets of rocks in classrooms and handing out tiny baseball bats to teachers. You go 'Merica! Ignorance is your God now.

Buggs Raplin

Most gun deaths are suicides. Most of the rest are gang-bangers killing each other over drugs. No real need for any research considering those facts.


spoken like a true NRA patriot buggs. No need for research, or science or facts or even reality. Just do like buggs and roam the web sites, google anything you want, and whala, you are an automatic expert on whatever. NO need to listen to anyone else, just your own narcissistic mind.

Buggs Raplin

Why is there a need for research when the facts of gun deaths are already known?


I guess you never even bothered to read the column buggs, shame on you! Here let me help you out. Its about gun violence and injuries, not just deaths. The writer puts it perfectly. "“Whether firearm-related injuries and deaths are coming from suicides, homicides or accidents,” Choucair told me, “we feel we’re particularly well-positioned to understand what role health-care systems can play to help prevent them.”

Buggs Raplin

kingman (below) you're not able to sift through the bullsh*t of this opinion piece. You just like it cause it criticizes the NRA. Fact: most gun deaths are suicides; most others are gangbangers killing themselves over drugs. Case closed. No need for any further investigations or 'research', such as this one aimed at the NRA, in a subtle attempt to undermine the 2nd Amendment.


No buggsy, I am saying there is a need for research, and you are just afraid what might be revealed by such science, so you want to squash it. Staying ignorant might be the path you choose in this life, but others want to research and learn and discover ways to improve life. Where the likes of you just want to maintain the status quo, and fear change and knowledge. If it were up to you we would still be middle ages where some people then also thought they knew it all, nothing more to learn.


Buggs, I would guess out of your contrarian sense of duty that you also dispute the connection of cancer with smoking. Of course you would be wrong there, too. And this position you now take, that a large percentage of shooting deaths are due to suicide, so there is no need for any research about the social and psychological connections of firearms with firearm deaths is like saying "we already know smoking causes cancer, so why spend money researching cancer?"


Of COURSE Chippy is opposed to research. Like nearly every other subject he comments on, he'd rather NOT have any facts get in the way of his pre-conceived notions.


Chippy is content with "alternative facts" and opposes any research that might unveil what is actually happening.

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