Public Health Pot Shots

How the CDC succumbed to the Gun "Epidemic"

(Page 3 of 3)

While the CDC shows a selective interest in homicide trends, it tends to ignore trends in accidental gun deaths -- with good reason. In the 25 years from 1968 to 1992, American gun ownership increased almost 135 percent (from 97 million to 222 million), with handgun ownership rising more than 300 percent. These huge increases coincided with a two-thirds decline in accidental gun fatalities. The CDC and the researchers it funds do not like to talk about this dramatic development, since it flies in the face of the assumption that more guns mean more deaths. They are especially reluctant to acknowledge the drop in accidental gun deaths because of the two most plausible explanations for it: the replacement of rifles and shotguns with the much safer handgun as the main weapon kept loaded for self-defense, and the NRA's impressive efforts in gun safety training.

The question is, why hasn't it been studied? The answer illustrates how the CDC's political agenda undermines its professed concern for saving lives. In the absence of an anti-gun animus, a two-thirds decrease in accidental gun deaths would surely have been a magnet for studies, especially since it coincided with a big increase in handgun ownership. But the CDC wants to reduce gun deaths only by banning guns, not by promoting solutions that are consistent with more guns. So the absence of studies is an excuse to dismiss gun safety training rather than an incentive for research.

Taken by itself, any one of these flaws -- omission of relevant evidence, misrepresentation of studies, questionable methodology, overreaching conclusions -- could be addressed by a determination to do better in the future. But the consistent tendency to twist research in favor of an anti-gun agenda suggests that there is something inherently wrong with the CDC's approach in this area. Implicit in the decision to treat gun deaths as a "public health" problem is the notion that violence is a communicable disease that can be controlled by attacking the relevant pathogen.

Dr. Katherine Christoffel, head of the Handgun Epidemic Lowering Plan, a group that has received CDC support, stated this assumption plainly in a 1994 interview with American Medical News: "Guns are a virus that must be eradicated. They are causing an epidemic of death by gunshot, which should be treated like any epidemic -- you get rid of the virus. Get rid of the guns, get rid of the bullets, and you get rid of the deaths."

In the same article, the CDC's Rosenberg said approvingly, "Kathy Christoffel is saying about firearms injuries what has been said for years about AIDS: that we can no longer be silent. That silence equals death and she's not willing to be silent anymore. She's asking for help." Similarly, in a 1993 Atlanta Medicine article on the public health approach to violence, Arthur Kellermann subtitled part of his discussion "The Bullet as Pathogen."

It is hardly surprising that research based on this paradigm would tend to indict gun ownership as a cause of death. The inadequacy of the disease metaphor, which some public health specialists seem to take quite literally, is readily apparent when we consider Koch's postulates, the criteria by which suspected pathogens are supposed to be judged: 1) The microorganism must be observed in all cases of the disease; 2) the microorganism must be isolated and grown in a pure culture medium; 3) microorganisms from the pure culture must reproduce the disease when inoculated in a test animal; and 4) the same kind of microorganism must be recovered from the experimentally diseased animal. A strict application of these criteria is clearly impossible in this case. But applying the postulates as an analogy, we can ask about the consistency of the relationship between guns and violence. Gun ownership usually does not result in violence, and violence frequently occurs in the absence of guns. Given these basic facts, depicting violence as a disease caused by the gun virus can only cloud our thinking.

It may also discredit the legitimate functions of public health. "The CDC has got to be careful that we don't get into social issues," Dr. C.J. Peters, head of the CDC's Special Pathogens Branch, told the Pittsburgh Post-Gazette last year, in the midst of the controversy over taxpayer-funded gun research. "If we're going to do that, we ought to start a center for social change. We should stay with medical issues."

If treating gun violence as a public health issue invites confusion and controversy, why is this approach so popular? The main function of the disease metaphor is to lend a patina of scientific credibility to the belief that guns cause violence -- a belief that is hard to justify on empirical grounds. "We're trying to depoliticize the subject," Rosenberg told USA Today in 1995. "We're trying to transform it from politics to science." What they are actually trying to do is disguise politics as science.

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