NEW YORK, N.Y. - Amid the bloodbaths of 21st-century America, you might think that there would be a lot of research into the causes of gun violence, and which policies work best against it.
You would be wrong.
Gun interests, wary of any possible limits on weaponry, have successfully lobbied for limitations on government research and funding, and private sources have not filled the breach. So funding for basic gun violence research and data collection remains minuscule — the annual sum total for all gun violence research projects appears to be well under $5 million. A grant for a single study in areas like autism, cancer or HIV can be more than twice that much.
There are public health students who want to better understand rising gun-related suicide rates, recent explosions in firearm murders in many U.S. cities, and mass murders like the one this month at an Oregon community college, where a lone gunman killed nine people.
But many young researchers are staying away from the field. Some believe there's little hope Congress will do anything substantive to reduce gun violence, regardless of what scientists find. And the work is stressful — many who study gun violence report receiving angry emails and death threats from believers in unrestricted gun ownership.
Most importantly, there's simply not enough money.
Gregory Tung is a sharp young scientist who trained at Johns Hopkins University with some of the nation's leading gun violence researchers. He's fascinated by gun violence, and the mountain of unanswered questions about why it may be surging and how to prevent it.
But he's not becoming a gun violence researcher himself.
"From a self-preservation standpoint, I think about, is there enough funding to support this kind of work? And there's just not," said Tung, who is now an assistant professor at the Colorado School of Public Health in Denver whose emphasis is issues like youth violence and child abuse.
How did this happen?
U.S. health researchers began to take a hard look at gun violence about 30 years ago, when firearm homicide rates were climbing to what were described as epidemic proportions. During 1986 and 1987, more than 66,000 Americans died from gunshot wounds — a greater toll than what U.S. forces suffered during the entire Vietnam War.
Gun homicides had always been treated as a criminal justice issue, and gun suicides as a mental health issue. But starting in the late 1970s, researchers increasingly saw it as fair game for public health. Scientist had tamed polio, yellow fever and other infectious diseases that had once ranked among the nation's leading causes of death. They also were making strides against heart disease and cancer, thanks to treatment advances and anti-smoking campaigns. They even were having success against another leading killer, automobile accidents. So it was natural to turn next to gun-related homicide and suicide — consistently ranked among the nation's 15 leading causes of death.
Currently, gun-inflicted injuries rank among the top five killers of people ages 1 to 64. In an average year, they account for far more deaths than traditional public health targets like influenza and food poisoning.
"The line is: 'If it's not a public health issue, why are so many people dying?'" said Philip Cook, a Duke University economist who in the 1970s began studying the impact of guns on society.
The Centers for Disease Control, the federal government's lead agency for the detection and prevention of health threats, took an early leading role in fostering more research into violence.
In 1992, CDC received the congressional go-ahead for establishing a National Center for Injury Prevention and Control, where gun violence was an important emphasis. Private philanthropies like the Joyce Foundation and the California Wellness Foundation also began putting money into research aimed at understanding and preventing gun violence.
The number of researchers committed to gun violence rose from a dozen or so in the late 1980s to more 25 or 30 by the mid-1990. And interest was growing not only among public health researchers, but also among scholars in fields like anthropology, criminology, education and sociology, said Dr. Mark Rosenberg, the CDC injury centre's director back then.
CDC-funded research — some of it published in the nation's most prestigious medical journals — implicitly questioned the wisdom of having a gun. Studies found that having a gun in the home tripled the risk that someone there would be murdered, and dramatically increased the chance of a suicide occurring as well.
Beginning in the 1980s, the National Rifle Association tried to discredit such studies, accusing the CDC and the researchers the agency funded of incompetence and falsifying data.
In 1995, the NRA and sympathetic lawmakers pushed for the elimination of the CDC injury centre, claiming it had embarked on a political agenda against gun ownership. That bid failed. But the next year, Congress took the $2.6 million CDC had budgeted for firearm injury research and earmarked it for traumatic brain injury. Congressional Republicans also included language directing that no CDC injury research funding could go to research that might be used, in whole or in part, to advocate or promote gun control.
Exactly what that language meant wasn't clear. But CDC officials, aware of how vulnerable their injury research centre was becoming, ultimately adopted a conservative interpretation. "They fired a big shot across our bow" that was seen as saying "any hint that you are crossing the line we will take as an invitation to come and take away the rest of your funding," Rosenberg recalled.
NRA officials in Washington did not respond to repeated AP requests for comment for this story.
The CDC ceased to be the main engine driving gun violence research, and the agency's next director dismissed Rosenberg. The agency also began giving a heads-up phone call to the NRA any time a report was coming out that discussed guns — a practice that lasted about a decade until about 2010, CDC officials say. But there haven't been many, mostly reports on injuries or deaths in which gun numbers are packed among the statistics for car crashes, drownings and poisonings.
Quietly, there is some gun-specific research still going on at CDC. In June, the journal Preventive Medicine published a paper from CDC researchers that went into depth on recent gun injury statistics. It noted deaths from gunfire have been holding steady at about 32,000 a year, with nearly half of them occurring in the South. But while the rates for gun murders and unintentional shooting deaths have been falling, firearm suicides — which account for 60 per cent of gun deaths — have been rising. And nonfatal shooting injuries have reached their highest level since 1995.
Another CDC effort: At the invitation of Delaware officials, CDC scientists have been researching a gun violence prevention project in homicide-plagued Wilmington. One scientist presented preliminary results last fall at a CDC seminar in Atlanta. But CDC has yet to release the research publicly. The work remains under internal review; the CDC has not yet approved it to be submitted to a scientific journal.
CDC officials say gun violence research is important. "We're ready, if we can get the (Congressional) support to do it," said Jim Mercy, director of violence prevention at the CDC injury centre.
But Linda Degutis, who was head of the CDC's national injury centre from 2010 until early last year, said she left because she wanted to work on increasing funding for injury and violence research — including projects that might involve looking at firearms. A focus on gun violence research is "not something I ever saw as an option" at CDC, Degutis said.
With the CDC largely out of the picture, gun violence researchers turned to other sources. But there wasn't much. The field withered, with limited funding and not much new blood. In the last decade, funding for gun violence grew so tight that Dr. Garen Wintemute, a long-time national leader in gun violence based at the University of California at Davis, spent more than $1 million of his own money to keep different gun violence research projects going.
Much of the research that has been done has had to be relatively simple — based on small surveys or on what limited federal or state data has been collected on guns and on gun-related injuries and deaths. Wintemute said some of it has over-reached. He noted one study that suggested the more firearms laws a state has, the lower the rate of gun deaths. But there wasn't enough information or analysis to say whether certain law made more difference than others, or to account for other factors, he said.
As state and federal officials debate gun laws or violence prevention programs, it's often not clear how well they'll work. To answer such questions, researchers ideally would like to know the exact number, type, and distribution of guns, as well as who owns them and where people got them. They'd like to know how and where they're stored, and to track what happens after people take different types of gun safety courses.
That's all key data for determining actual risk and what measures best reduce gun injuries and deaths.
But no agency tracks U.S. gun ownership. No one really knows how many guns there are in the United States.
There isn't even a comprehensive data base on victims. In 2004, the CDC started building a national violent death data base that marries information from death certificates with data from sources like medical examiner and crime lab reports. The idea is to give a more complete understanding of each shooting death and the firearms involved. But due to insufficient federal funding, only 32 states are currently in the system.
Researchers have hoped for a turning point; some development that might cause more people to advocate for gun violence prevention research. There were such turning points regarding cigarette smoking and automobile safety in the 1960s, thanks to galvanizing reports from — respectively — the U.S. Surgeon General and consumer advocate Ralph Nader.
But there has been no such galvanizing book or scientific report to hit the gun violence debate. Because there's been limited data and research on the topic, public health experts have wondered if there can be such a turning point where guns are concerned.
Then came the carnage at Sandy Hook Elementary School in Newtown, Connecticut.
One Friday morning in December 2012, an armed 20-year-old man entered the school and used a semiautomatic rifle to slay 20 first graders and six adult school staff members before killing himself. It was the deadliest mass slaying at a school in U.S. history.
"If you were some kind of futurist operating a number of years ago, and you said; 'You know what would be the tipping point for changing gun policy? Someone walking into a school and shooting 20 little kids,' I would have agreed," said Stephen Teret of Johns Hopkins, who is something of a godfather to the field of U.S. gun violence research.
Advocacy organizations focused on stopping gun violence saw a boom in donors and volunteers. And after the urging for more gun violence research from more than 100 scientists, the White House issued 23 executive orders in reaction to Newtown, including one directing the CDC to research the causes and prevention of gun violence. The actions included a call for Congress to provide $10 million to the CDC for gun violence research. The CDC's Degutis asked the prestigious Institute of Medicine to convene a special committee of experts to develop the research agenda.
But Congress did not budget money to the CDC for gun violence research. It didn't strip away the legislative language that had chilled CDC activity on guns, either. The research agenda was not formally adopted by anybody.
Some new funding has emerged, including from advocacy organizations. Everytown for Gun Safety, funded by philanthropist/former New York City Mayor Michael Bloomberg, which this year made grants of more than $500,000 to independent scientists.
But such money has a potential downside. Critics — including the gun lobby — might raise questions about how objective research is when it's funded by an advocacy organization, acknowledged Ted Alcorn, Everytown's research director. "To delegitimize researchers," he added.
Perhaps the greatest ray of hope comes from the National Institutes of Health, the federal government's lead medical research agency. In September 2013, NIH announced three new funding opportunities for violence research, including for projects that focus specifically on firearms. The NIH has a budget more than four times greater than the CDC, and some in the gun violence research field are excited. "It's a sea change that the NIH would do this," said Charles Branas, director of the University of Pennsylvania's Injury Science Center.
But so far the NIH announcement has not exactly led to a flood of new funding. Since the violence research announcements, the agency received 136 applications for that funding. The NIH has made nine awards, including only two — together totalling about $600,000 paid out this year — that specifically focus on guns.
Researchers say they've found some encouragement on the state and local level. In August, Seattle's city council approved a tax in gun and ammunition sales in the city to raise hundreds of thousands of dollars annual for gun violence prevention research and programs. The tax is scheduled to take effect Jan. 1, but the NRA and other gun rights groups have sued to stop it, saying Washington state law pre-empts municipalities from enacting such ordinances.
It's tough sledding, said Dr. Frederick Rivara, a University of Washington researcher who co-authored several influential gun violence studies through the years. Among all the topics a public health researcher can go into, "I think this is probably the most challenging one," he said.
One month after the Newtown shootings, John Hopkins held a summit on reducing gun violence in America. It got wide notice — Bloomberg was a speaker — and it was webcast and part of it was broadcast on C-SPAN. Daniel Webster, the gun centre's director, was about to stand up to give concluding remarks when he glanced at his Blackberry and read a threatening, anonymous email .
"It was very specific about what he intended to do to me. I got up to the podium and I was literally shaking," Webster recalled. There was a voicemail, too.
More than a decade ago, Webster's mentor, Stephen Teret, was so alarmed by a menacing letter he received from a man in the Indianapolis area that he contacted university security. They contacted law enforcement officials in Indiana who told the man not to contact Teret again. Years later, Teret was speaking at a conference at an Indianapolis hotel. Teret had advised conference organizers about the earlier threat, and they had arranged heavy security. In the middle of Teret's talk, the letter writer stood up and started screaming at him from the audience. Security quickly rushed Teret off the stage.
Death threats are relatively rare, but angry phone calls are not. The University of Pennsylvania's Branas told a story about being at a baseball game with a younger researcher shortly after a high-profile gun violence study was released. Someone angered by the paper got Branas' cellphone number and called him during the game.
"Wow," the younger man said. "That's pretty crazy." He's since gone on to study other topics, in part to avoid that kind of vitriol, Branas said.
Other young researchers are put off by the frustration of working in a field where their findings would likely be politicized, and have little impact.
"You can provide some people with evidence until you're blue in the face, present them with the best and fanciest models you can come up with, and they're not going to care," said Cassandra Crifasi, a 32-year-old gun violence policy researcher at Johns Hopkins who owns firearms herself.
Meanwhile, the longtime leaders in gun violence research aren't getting any younger; many are in their 60s and 70s. Younger researchers who are intrigued by gun violence — but worried about ensuring a flow of funding — have to spend much of their time pursuing other topics.
Some, worried that the field may soon shrink through attrition, are working hard to recruit successors.
Dr. Michael Levas, a 35-year-old researcher in Milwaukee, has been working on a grant-funded project to evaluate where a Welsh violence surveillance and intervention system would work in the United States. He's drawn to the field of gun violence, and fascinated by its potential. But he won't commit to it.
"If the climate was right and the funding was there, it would make sense to focus on gun violence prevention. I probably would be tempted to pursue that," he said.
"But right now, it would be a dead end."