Researchers join forces to expand evidence base on gun violence
Brown
University
According
to data from the Centers for Disease Control and Prevention, firearm-related
fatalities are now the second leading cause of death among children in the
United States.
In
recognition of the need for substantially increased research and training in
the field of firearm injury prevention, the National Institute of Child Health
and Human Development (NICHD) recently awarded $5 million to the University of Michigan to
lead a research capacity building grant that includes more than 20 researchers
at 12 universities and health systems across the nation, including Brown.
The
award represents the largest funding commitment from the National Institutes of
Health (of which NICHD is a part) in the past 20 years to reduce firearm
injury.
The
new Firearm Safety Among Children and Teens Consortium (FACTS) will bring
together expertise from scientists from public health, emergency medicine,
pediatrics, criminal justice, psychiatry, psychology, data science and trauma
surgery, among other fields.
Dr.
Megan Ranney, an associate professor of emergency medicine at
Brown's Warren Alpert Medical School, is leading the Brown arm of the study. A
longtime emergency physician and researcher, she was also appointed
in April by Rhode Island Gov. Gina Raimondo to co-chair a gun
safety working group for the state.
We
asked Ranney about the need to address gun violence based on evidence and facts
and how these new efforts can contribute to creating solutions.
Q: As an emergency physician, you see firsthand the effects of firearm injury. How have those experiences informed your perspective in thinking about solutions to prevent gun violence?
Injuries
caused by guns are different from any other type of injury. If I take care of a
stabbing victim in the emergency department, or if I take care of someone who
tried to commit suicide by taking pills, I can almost always save them. The
fatality rate from guns, in comparison, is much higher: 30 percent of gun
assault victims and 90 percent of gun suicide attempts die. As a doctor, it's
really upsetting to not be able to save a patient's life — especially when it's
a young life and a senseless death.
Firearm
injuries also have a unique impact on patients' families and communities. The
possibility of gun violence creates fear and despair in a way that few other
injuries do. Since I have limited ability to help these patients or their
families after the gunshot wound happens, I am determined to try to stop as
many of the injuries as I can from happening in the first place.
Q:
Why do we need to research firearm injury? Don't we already know what to do?
Injury
prevention, like any other field of research, is a science. We have used the
science of injury prevention to reduce car injuries and deaths by developing
multifaceted interventions that have good evidence behind them. And we have
achieved these successes without taking
cars off the road.
Unfortunately, due to a lack of federal funding over the
last 20 years, we have made little progress in addressing firearm injury. I
could easily list three dozen scientifically valid questions, on both sides of
the political spectrum, that need answers.
Q:
Why is this NIH grant so significant?
Federal
funding for firearm injury research is less than 2 percent of what it should
be, based on the number of deaths. In the last 20 years, less than a dozen
researchers have published more than an article or two about firearms. Few
young researchers are going into the field. Who would want to create a career
around something that you can't get funding to study?
This
grant is a big deal because it is helping us to jump-start the science of
firearm injury prevention for kids. It allows us to unite existing researchers
and to attract new ones. The hope is that through this grant, the best and
brightest minds will be motivated to address this problem.
I'm
confident that it will make a big difference for the field.
That
said, it is a drop in the bucket. Last year, the NIH spent $500 million on
opioid research alone. So, this $5 million, five-year grant for pediatric
firearm injury prevention is terrific, and is necessary... but it's not
sufficient. What would be sufficient is to have enough money to fund studies to
answer every one of the key questions that our workgroups are identifying and to fund studies addressing adult firearm
injury prevention, too.
Q:
Can you share some details about the workgroup that you're leading as part of
the NIH study?
I
am leading the workgroup focused on "secondary prevention and longitudinal
consequences" of firearm injury. In other words, we are identifying and
addressing the consequences of pediatric firearm injury. Some of our topics
include exploring how to reduce mental health disorders, addiction and future
injury among youth affected by gun violence; and how to reduce the impact of
firearm injury (including mass shootings) on kids' families and communities.
Q:
What other research are you conducting focused on gun violence?
I
have a number of research projects focused on youth violence in general. I have
a new five-year grant from NICHD that is examining the efficacy of an automated
text-message program to reduce violence and depression among at-risk youth. I
also have a grant from NICHD through which I'm developing an innovative new
mobile phone-based cyberbullying prevention program. I am hopeful that both of
these projects will reduce gun violence by addressing the underlying causes.
I
also represent Rhode Island on a multi-state research consortium, established
by the governors of Rhode Island, Massachusetts, Connecticut, New York, New
Jersey, Delaware and Puerto Rico.
Finally,
I am serving as the chief research officer for a great new collective of public
health and medical researchers and medical societies — the American
Foundation for Firearm Injury Reduction in Medicine. Through this
cooperative effort (which the FACTS consortium is part of) we hope to further
spur the use of science to reduce firearm injury.
Q:
The FACTS consortium mentions "capacity building" and includes a
focus on training postdocs and graduate students. Can you talk about the need
for training new researchers? Will any of that work happen at Brown?
As
I mentioned, the field desperately needs restarting. To attract young
researchers, they need to feel assured that they can develop a career in
firearm injury research. This grant helps to show that they can do that. I have
already taken on two trainees here at Brown and hope to train more.