Panel, Fireside Chat
Gun Violence as a Public Health Crisis: An Update | Milken Institute Future of Health Summit 2022
Milken InstituteElisabeth Rosenthal, Georges C. Benjamin, Kris Brown, Babak Sarani, Mallory Williams, Bob Axarani
- Demographic and Cultural Trends: Younger generations (millennials and Gen Z) are expected to consistently drive an increase in candidates running and winning on gun violence prevention platforms, though a cultural shift regarding home firearm safety is predicted to take "a very very long time" to fully materialize, similar to the decades-long norm change for smoking. The "lockdown generation" is anticipated to suffer long-term mental health impacts, including increased blood pressure and higher infant mortality rates due to cumulative trauma from living in a fear-based culture where children are taught to run, hide, or fight.
- Market and Supply Dynamics: Gun-related injuries at specific hospitals, which rose from 10–12% to 35% in one year during the pandemic, are predicted to never return to pre-pandemic levels (12%) due to a market flooded with firearms; this is viewed as one of the longest-lasting negative consequences of the pandemic. The supply of crime guns is concentrated in a specific demographic: 5% of federally licensed dealers are responsible for 90% of guns recovered in crime, while 1 in 5 guns are sold annually via private sellers without background checks, a loophole that prevented the Bipartisan Safer Communities Act from being comprehensive.
- Legislative and Enforcement Outlook: The current Supreme Court is characterized as hostile to balancing Second Amendment rights with public safety, making an Australian-style model of removing guns "not even a pipe dream" under the existing amendment. While the Bipartisan Safer Communities Act passed with 12 Republican votes, it is viewed as incremental change because it did not close the Brady loophole for private sales; however, the speaker anticipates continued legislative pushes for closing these loopholes and an assault weapons ban in the upcoming "lame duck session." Enforcement is expected to rely heavily on executive action by President Biden to redefine "selling firearms" and targeting the 5% of dealers responsible for the majority of crime guns, though the ATF currently lacks the capacity to inspect more than one dealer every seven years out of 80,000.
- Public Health and Prevention Statistics: Gun violence prevention is projected to require multimillion-dollar research funding beyond the current $25 million annual allocation to address gun violence, which is the number one killer of children under 19. Data indicates that 60–64% of gun deaths could be prevented by safe storage alone, with 90% of suicide attempts using a firearm resulting in death compared to a 3% or less completion rate for other methods. Additionally, 55–60% of firearm deaths are suicides (impulse acts), and 75% of school shooters obtain their weapons from unsecured homes, where nine kids a day are killed or injured with loaded guns.
- State-Level and Policy Barriers: States with robust permitting systems and expanded background checks are noted to have materially less gun violence, with 19 states and the District of Columbia having passed extreme risk protection laws. However, state-level preemption laws are expected to continue preventing local communities from protecting themselves through elected officials without federal intervention. The Brady Law, active for 30 years, has stopped over 4 million sales, but the "guy with a gun" myth persists despite evidence that armed civilians do not outweigh armed bad guys.
- Industry and Social Norms: The firearm industry's marketing strategy, which mimics the tobacco industry's approach to "flood the market," is expected to continue driving sales and addiction among younger customers, while social media influencers and corporations are considered essential for shifting social norms. The demand side of violence in urban areas is driven by the perception that "everyone else has one," necessitating supply-side enforcement to be effective. The speaker expects that focusing on the 5% of dealers responsible for 90% of crime guns, if targeted and shut down, will have a material impact and save lives.