"If car seats are so great, then why don't they stop drunk drivers from killing people? Just more stupid traffic laws getting in the way of freedom."
The above statement is dumb and irrational, right? Car seats and the laws requiring parents to use them for their children are not intended to stop drunk driving. When evaluating car seats and the laws surrounding them, we are focusing on a specific issue of child safety within the larger public health problem of traffic fatalities. We use various policies like vehicle registration, seatbelt mandates, and intoxicated driving laws to address a range of traffic safety issues. No single law or device can protect all of us when we are in traffic. Furthermore, all of our regulations and technologies were developed over time and continue to change as we learn more and as challenges arise. There are hundreds and hundreds of laws, devices, and behaviors that work together to keep us safe on the road.
This is exactly the approach we need to take with the public health crisis of gun violence. We can not expect every policy or technological innovation to stop every incident of gun violence. For example, about 31 percent of unintentional firearm deaths might be prevented if owners used both a childproof safety lock and a loading indicator showing whether a firearm is loaded. Would these devices stop an elderly person from committing suicide with a gun, or an enraged homophobe from shooting dozens of people? Probably not, but that is hardly an apples-to-apples question. Stopping gun suicides will require a range of policies, system changes, and cultural shifts that may or may not overlap with the approaches we use to stop homicides. And those approaches may not be enough to stop unintentional shootings (which are not accidents). One-size-fits-all does not work in any other area of public health, so why do we demand that now?
Since 1975, traffic fatalities have declined. There is nothing simple about that trend. It is the complex result of public health research, automotive engineering developments, cultural changes, policymaking at state and federal levels, and so on. Most importantly, we are safer on the road today than we were over 40 years ago because of a willingness among Americans to learn, adapt, and look out for each other. We are hardly perfect: drunk driving is still a challenge, and crashes are disproportionately high for teenagers. Over 32,000 motor vehicle deaths in 2014 is not an indication that traffic safety is a lost cause. On the contrary, we still have our work cut out for us in our homes, state legislatures, media networks, public health research labs, schools, police stations, and so on.
For gun safety policies, we are likely to face similar challenges. Last week, we learned from Everytown for Gun Safety that in 2009, many states failed to submit records to the FBI regarding people with severe mental illness who should not be purchasing guns. Since then, the number of records submitted by states has more than tripled because of laws and funding to improve record-sharing systems. There continue to be fatal gaps in the background check system, but upgrades in state-submitted records are still accomplishments. We must continue our efforts to pass universal background checks; connect those systems to the FBI's knowledge of suspicious individuals; stop people convicted of hate crime misdemeanors from owning weapons; and close the "boyfriend loophole" for domestic abusers.
Whether the public is healthier or safer under these or other policies are important questions. If Congress allowed the CDC and National Institutions of Health (NIH) to research gun violence, we could develop a better understanding of what kinds of gun and ammunition technologies raise or reduce the risk of injury; how and why people use or don't use certain gun storage practices; what approaches are most effective to help alcoholics avoid gun injury; and so on. These are just a few of the questions that could save millions of lives if answered with well-funded public health research. Unfortunately, just last week, US Senators continued to ban funding for the CDC to research gun violence.
Fortunately, a coalition of over 140 medical groups representing thousands of health care professionals across nearly every field of medicine is urging Congress to reverse its previous decisions and fund gun violence research at the CDC and NIH. For the past 20 years, appropriations bills passed by Congress have "had a dramatic chilling effect" on the CDC's efforts to study the health impacts of guns. We are overdue to thaw out the denial and get to the hard work of answering tough questions.
Though we may not know where exactly the path of smarter gun policies will take us, the current process of "thoughts and prayers" has predictably failed. If policy makers and public health experts offered only "thoughts and prayers" as thousands died in motor vehicle accidents, Americans would be justifiably outraged. However, as mentioned earlier, the persistence of traffic fatalities has not turned people against traffic laws and road safety. There is a very good chance that learning the complicated answers to tough questions about gun violence and passing smart, specific policies will require inconveniences and temporary sacrifices. We must find the wherewithal, patience, and decency to adapt, like we have done with wearing seat belts, using car seats, and following speed limits. It is also highly likely that we will have to adapt again when new gun laws are passed or old ones are revised -- just like we do with car seats, speed limits, and restricting teenage drivers. Neither the "freedom of the open road" nor the Second Amendment give us freedom from responsibility.
Note to readers: Since the Orlando shooting, leaders from the fields of medicine and public health have re-doubled their efforts to "end the ban" on CDC gun violence research. An earlier version of this article did not mention this advocacy, which is still developing.