Why Biden’s gun policy doesn’t go far enough

The United States is tackling the challenges of the pandemic with substantial resources: emergency authorization of vaccines, collection and access to high-quality data, and lead agencies that monitor untoward effects of new vaccines with the power to pause. But there is another epidemic plaguing the U.S. that deserves the same steely resolve: gun violence. In the U.S., 300 people are shot and more than 100 people die each day, and yet we have not allocated sufficient resources to stop it. While we applaud President Biden for his will and courage to act to reduce the toll of gun violence, the evidence-based policy changes he proposes do not go far enough.

President Biden’s proposed steps are thoughtful, doable, and use policy as a lever to improve the health and safety of the nation. They address policy holes, authorize the first study on gun trafficking in 20 years, provide resources through the Department of Justice to address gun violence at the community level, and more. Additionally, Attorney General Merrick Garland outlined a commitment for how he would enact these steps with specific strategies and timelines. Yes, they are showing the will and courage to act — but we need to do more.

As trauma clinicians, we have witnessed firsthand the impact of gun violence on individuals, families and communities. As researchers at the Penn Injury Science Center, we have worked with colleagues and communities to stop gun violence, treat it, and help people live on — in a climate marked by adversarial stands, limited funding and politicization of evidence.

To address this public health epidemic, we must move beyond solely using the tools of the criminal justice system. Although important, they are insufficient. We now need to wisely expand efforts in the health and public health sector to open more avenues of intervention — avenues that can directly address the physical, social, economic and cultural environments in which gun violence occurs. Indeed, it is impossible to disentangle interpersonal gun violence from structural determinants of health, social justice and systemic racism. Violence is no one’s first choice. When people have access to education, opportunities, support and security, the conditions that lead to gun violence are attenuated.

Wise people learn from the past. In Reader’s Digest in 1936, President Franklin D. Roosevelt called on the American people to make motor vehicle safety a priority and a social duty because automobile accidents were a grave national problem. He had the will and courage to act. By the end of the 20th century, motor vehicle safety was identified as one of the top 10 public health successes. There were six key elements leading to this success: 1) a surveillance system; 2) a lead agency; 3) robust and stable funding; 4) data accessible to researchers; 5) interdisciplinary approaches; and 6) a focus on all possible points of intervention. 

President Biden can mirror this success by taking three additional actions:

• First, dedicate $1 billion each year to fund rigorous and transparent research through the National Institutes of Health and Centers for Disease Control and Prevention. In the past 2 years, only $25 million annually was dedicated to gun violence across these two agencies, for a disease that costs $280 billion a year.
• Second, provide researchers needed access to all relevant data, with appropriate privacy precautions, by removing restrictions put in place by the 2003 Tiahrt Amendment. Even the most basic data on gun violence are difficult or impossible to obtain.

• Third, improve data. Simple counts of how many people are injured each year are estimates, and even less is known about the shooters and weapons involved. AG Garland announced a new firearm trace study for the Federal Bureau of Alcohol, Firearms and Tobacco — these data are sorely needed, not just once, but continuously. The FBI is updating its national crime reporting system but is missing the opportunity to clearly delineate nonfatal shootings in these data. Health data such as the National Electronic Injury Surveillance System need to be expanded and strengthened to overcome key statistical flaws that limit its use for monitoring gun injury.

Let us mirror the lessons learned from the pandemic and motor vehicle safety. In our national quest to reduce gun violence, each of us must have the will and courage to act. This is a shared responsibility that cuts across national, state, tribal and community levels, and includes public, private and not-for-profit sectors. We will be successful only if we all take action, and if our actions are informed by the wisdom of the past and the lessons we will learn along the way.

Expanding the approach to gun violence as a health issue is not only wise, it is essential. 

Drs. Therese S. Richmond and Elinore J. Kaufman are senior fellows at the Leonard Davis Institute of Health Economics at the University of Pennsylvania and are affiliated with Penn Nursing and Penn Medicine, respectively. Richmond is professor and associate dean for research and innovation, and Kaufman is assistant professor of surgery.