Dec. 06 2017

In The Crosshairs

Gun Violence and Injury Prevention

Americans spend more time on the road than ever, and yet our risk of dying in a motor vehicle crash has plummeted over the last 100 years. Credit decades of meticulous research that has shaped everything from vehicle design to roadway engineering, as well as emergency protocols and laws on child passenger protections and drunk and distracted driving penalties.

By stark contrast, Americans run an ever-increasing risk of dying due to firearm violence. And unlike motor vehicle safety, there’s a dearth of evidence and scientific resources to guide prevention, says Charles Branas, PhD, chair of Epidemiology and co-author of a March editorial on the topic in the American Journal of Public Health. Scientists, he says, must tackle this nation’s seemingly intractable gun violence problem.

Branas knows of what he speaks. A one-time paramedic who did a stint in the Philadelphia morgue in the early 1990s, when the city’s murder rate was at its peak, Branas has seen firsthand the casualties of America’s gun violence crisis. In the two decades since, he’s built a body of research on the topic that has been cited by the Supreme Court, Congress, and the director of the National Institutes of Health. Among his findings: nationwide, suicides are a more common cause of firearm deaths than homicides; possessing a gun may not be as protective as many people think; and the risk of being fatally shot is actually greater in small-town America, where gun suicides are more common, than in our cities, where gun homicides prevail.

A city dweller since birth, Branas founded the Urban Health Lab to produce new scientific evidence for the cost-effective design and implementation of health and safety programs in cities—on themes as diverse as buildings and housing, greening and land management, climate and resilience, and murals and art. In December, the American Journal of Public Health published the lab’s analysis of low-cost blight remediation projects to reduce firearm violence in poorer neighborhoods in Philadelphia.

Working in partnership with several U.S. cities, Branas and his colleagues at several universities have conducted multiple observational studies and randomized controlled trials to analyze gun violence before and after an array of interventions. In the process, they’ve raised milllions of dollars, greened thousands of acres of vacant lots, fixed thousands of abandoned buildings, even built affordable housing.

Their simple, relatively inexpensive design fixes have reduced gun violence and shown a clear cost-benefit, without spurring gentrification. “When you clean, green, or rebuild a place, people who have often been asking for decades for someone to do something don’t want it to go back to the way it was,” he says. “They feel more connected to their surroundings and each other and will go out of their way to prevent negative things—from noise complaints to gun violence—from reoccurring in those spaces.”

Urban, place-based interventions are just one facet of the work needed to turn the tide, says Branas, noting increasing rates of gun suicides in impoverished rural areas. “Shootings are everyone’s problem, big cities and small,” he says. “A lot of scientists make a career out of elegantly associating social determinants of health with negative outcomes, but then never provide actual solutions. We can do better.” 

By Sharon Tregaskis, with reporting by Tim Paul and Ruby Olisemeka.