FIVE GUN UNKNOWNS

After yet another spate of multiple mass shootings, it is only natural to feel despondent. At times, I share those emotions. As both a practicing emergency physician and a researcher focusing on firearm injury prevention, I see the damage caused by our uniquely American epidemic every day.

But I also have hope. Congress appropriated funds to the National Institutes of Health and the Centers for Disease Control and Prevention to invest in firearm injury prevention research in the 2020 budget for the first time in 24 years. Private organizations such as Kaiser Permanente and the National Collaborative on Gun Violence Research are also committing funds, and President Biden has dedicated resources to evaluating community violence interventions.

Thanks to these relatively small but momentous investments, we have growing proof that solutions exist. Some, such as laws to prevent children from accessing guns without supervision, require legislative action. Many simpler solutions do not. For example, repairing abandoned houses and planting gardens in vacant lots are tremendously effective at reducing gun shots and homicides. These require nothing more than community will and a small amount of funding.

But more research is needed. Here are five research questions that could help lead to solutions for the gun epidemic in the United States.

1. How often do firearm injuries happen, and to whom?

It might seem odd, but we don’t have an accurate count of such injuries in a given year, much less the number of shots fired. We have no accurate counts of defensive gun use. And we have little data on stolen or trafficked firearms, the costs of a gunshot wound or other key statistics. We know even less about longterm individual or community outcomes after a shooting. Without these basic facts, we can neither assess the scope of the problem, nor accurately decide what works.

2. Can we know who is at risk before they pull the trigger?

Of the roughly 400 million firearms in private hands, about 100,000 are used to hurt someone in a given year. What distinguishes the people who pull the trigger to hurt someone from those who don’t?

Some researchers have created databases to describe mass shooters. But this is descriptive data, not a predictive model. What is it about a school kid, a lonely elderly man or a young adult that makes them shoot themselves or someone else? Are there environmental signals that we can act on? How do we identify these signs, whether in social media or personal interactions, without violating privacy rights and without bias?

3. How do we act effectively once we know who is at risk?

There are already many laws in place to keep firearms out of the wrong hands, such as limitations on purchases by people with a history of domestic violence convictions. But they are often unenforced, and the risk of injury can change after a gun is purchased.

Moreover, some of the best prevention occurs outside of law enforcement. How do we empower communities and individuals to recognize risk and act to prevent a shooting? Gun shops, health care providers, families, schools and workplaces all have a role to play. We need data on how to help them help others, in a way that’s respectful, safe and effective.

4. How can we change firearms themselves?

It is engineering, as well

Most gun owners don’t shoot people. What spurs those who do?

as changes in individual behavior, that helped reduce car crash deaths in previous decades. We created crumple zones, changed road designs and implemented air bags. Over the past decade, nearly two-thirds of gun deaths have been suicides; a significant portion of gun crimes are committed with stolen or trafficked firearms. Nothing but the bounds of creativity and the will of manufacturers stops us from developing guns that people cannot use on themselves or when they are stolen. This problem is too important not to solve with feats of engineering.

5. How do we create and sustain leadership in communities most familiar with firearms and firearm injury?

From urban neighborhoods affected by structural racism to economically depressed rural hamlets to veterans’ organizations, we must elevate the voices of people who own firearms, understand the reasons for firearm ownership or have been hurt by firearms. Their lived experience can both provide solutions that public health researchers might never think of and can provide more successful paths to implementation.

At the end of the day, no one wants their child, parent or friend to be on the wrong end of a gun. This is a moment to do more. We must renew our commitment to asking — and funding — the paradigm-shifting questions about firearm injury. The answers could transform not just rates of injury and death, but also our country’s ability to believe in a safer tomorrow.

Ranney is deputy dean at Brown University’s School of Public Health. This first appeared in The Washington Post.