More mass shootings spark outrage — but don’t forget the daily deaths, either

Another community was in shock and grieving on May 26, after a shooting at a railyard in San Jose, California left at least nine dead, including the suspect. This tragedy came on the heels of a May weekend with mass shootings in eight states that led to at least 11 deaths and 69 injuries. In all of these events, investigations are ongoing, so full details about the perpetrators — and their motives — are unclear.

It is possible that you heard about one of these, but few of us heard about all of them. What do these mass shootings’ occurrence — and their coverage — mean about larger trends in violence? We know that 2020 and 2021 saw record firearm sales, as well as significant socioeconomic, political and emotional stressors. As COVID-19 vaccination rates rise and case numbers drop, more and more Americans are emerging from their pandemic isolation. Are these events a sign of increasing community danger, some kind of extreme result of rusty social skills or stress and anxiety about returning to pre-pandemic activities? Have we all become both doomed and numb?

The short answer: No, mass shootings aren’t occurring more often.

The longer answer: gun violence in America was already a public health crisis, with approximately five firearm deaths per hour in 2020. The first step to controlling and reversing this crisis is acknowledging the full scope of violence.

“Mass shooting” is variably defined as an event where three or four people are killed or injured; these definitions may, or may not, include the shooter in the count. Because of the variability in how “mass shooting” is defined, one could report that there were between six and 503 mass shootings in 2019.

For understanding and preventing mass shootings, more important than victim count is the type of mass shooting: events may involve the general public, domestic partners or criminal activity.

Public mass shootings are those where a shooter injures or kills members of the general public — examples from my home state of Colorado include the recent Boulder grocery store shooting, the 2012 Aurora theater shooting, or the 1999 Columbine school shooting. These public events are relatively rare, accounting for less than 0.5 percent of all homicides and approximately 19 percent of mass shootings in the United States, but they have significant impact on community mental health and sense of safety. These public mass shootings generally get the most attention from the media, politicians and the general public.

The remaining mass shootings — approximately 80 percent — are connected with domestic violence or criminal activity. Yet these events, and these victims, are noticed significantly less by the media. One example among many: on Mother’s Day, 2021, a Colorado gunman killed his girlfriend, five of her family members, and himself. This horrific domestic violence attack received far less attention than the Boulder shooting from weeks earlier, nevermind the daily drumbeat of firearm deaths in Denver itself.

Indeed, a focus on mass shootings obscures the tremendously higher daily toll of firearm deaths and injuries involving only one or two people. In 2020, the United States saw a significant increase in firearm injuries and homicides. Homicide — including mass shootings and interpersonal violence — and police-involved shootings account for 37 percent of firearm deaths in the United States. A staggering 60 percent of gun deaths are suicide, a fact too often ignored by public discourse. We know that these deaths are preventable, and they are worth preventing. And, as in the years preceding it, this daily toll of firearm injuries and deaths disproportionately affects communities of color. Based on analysis of 2019 national data, Black men are almost eight times more likely to die by firearm homicide compared to the general population (across all ages), and 14 times more likely than White men.

Because behind each of these statistics is a person, a life lost, a family and community grieving. Collectively, as Americans, we share a common goal of health and safety for our families. None of us wants these deaths to occur, even if we disagree on how to prevent them.

So, what do we do? First, we need to recognize there’s not a single, easy answer. While these forms of violence — mass shootings, domestic violence, interpersonal violence, and suicide — share some risk factors, they need different approaches to prevention. No one law or program will fix America’s gun violence problem.

But we shouldn’t lose hope. For each type of violence, there are promising approaches — albeit with a need for significantly more research and evaluation. These include hospital- and community-based violence intervention programs, community partnerships for firearm suicide prevention, and structural changes. We need a comprehensive, multi-faceted, collaborative, “public health” approach, meaning one that uses data and science to investigate which interventions work, and in what populations, and then helps get those interventions to all communities that need them. And one in which communities’ voices and needs are integrally included. This kind of approach will take financial investment and — perhaps even more importantly — leadership and willingness to work together towards our common goal.

Enough is enough. None of us wants to be the next person to mourn a lost family member or friend.

Emmy Betz, MD, MPH, is an emergency physician and researcher at the University of Colorado School of Medicine, where she directs the Firearm Injury Prevention Initiative. She also co-founded the Colorado Firearm Safety Coalition and gave a TEDx talk on firearm suicide prevention. This piece reflects her views, not those of her employers. Follow her on Twitter: @EmmyBetz

Megan Ranney, MD, MPH, is an emergency physician, associate dean of Strategy and Innovation at the School of Public Health of Brown University, and director of the Brown-Lifespan Center for Digital Health. She is also the co-founder of AFFIRM Research and GetUSPPE. Follow her on Twitter: @meganranney