Gun Violence as a Public Health Issue: New Zealand vs. the United States

It took New Zealand six days to respond with gun legislation to Christchurch’s massacre that cost the lives of 50 people. In 2019 alone, there have been 62 mass shootings in the United States that have killed 113 people in school contexts. There are no sweeping gun law reforms in the United States. Why are two countries reacting to gun violence so differently? How did New Zealand act so quickly and why can’t the United States do the same?

In 1996, the Dickey Amendment was implemented to separate gun violence from public health research. The United States Congress reduced the Centers for Disease Control (CDC) budget by the exact amount that they had been spending on gun violence research because being shot was not seen as a “disease.” The CDC has yet to regain funding for gun violence research. Meanwhile, other laws emerged to try to further break the relationship between gun violence and public health. For example, in 2011, Florida passed a law prohibiting doctors from asking their patients about guns in their home.

Since 2015, there has been a movement to address gun violence as a public health issue rather than just about social and civic justice. Why? Public health professionals have the tools and the expertise to address gun violence through research, advocacy and education. There is a lot of misinformation about gun violence that public health professionals can clarify. Additionally, gun violence is a leading cause of death in the United States. Gun violence should be debated in the public health realm because the injuries and death numbers surpass that of cancer, heart disease, and infections. Still, the challenge of getting the political majority to invite the public health sector to create policy solutions remains. Comparing the actions taken in New Zealand versus the United States highlights the role of country context.

Gun control is deeply engrained in American culture. According to the Pew Research Center, about 75% of gun owners say they could never see themselves not owning a gun. In fact, 3 in 10 American adults own a personal gun. Nearly 40,000 people died of gun-related violence in 2017 reaching the highest annual total in many years. Gun violence takes lives and costs the American public about $229 billion dollars a year.

Interestingly, even though our country has a deep connection to guns, man are still able to recognize the gaps in policy. Nearly 6 in 10 US adults say that gun laws should be more strict. But the fear that any reform automatically leads to banning all guns is unique to America and overpowers the political agenda. Therefore, no federal action has been taken against gun violence since 1993. New Zealand sees guns and gun reform in a less polarizing way.

In New Zealand, the political will for gun violence reform is driven by hard data because guns are not as connected to a nationalistic culture. In fact, it is unusual to even see armed police. So, citizens do not label politicians as “evil” and as wanting to take their guns away. Instead, they recognize a need for balance between protecting gun freedoms and making it hard for bad people to terrorize.

To own a gun in New Zealand, you must be 16 years old and pass a background check. Despite this being younger than the age at which you can own a gun in the United States, New Zealand had 0.17 gun-related homicides per 100,000 people in 2015 versus 11 deaths per 100,000 people in 2015 in the US. In fact, the last mass shooting in New Zealand was 30 years ago.

The political context for gun rights in New Zealand is very different than in the United States. Even though the NRA (yes, the American organization) has offered to help, the pro-gun advocates are not a majority. As part of the gun owning voting block, they do not have enough political power. Most gun owners live in rural areas and use guns for agricultural reasons; thus, gun laws have remained relatively unchanged since 1992. Reform attempts did happen in 2005, 2012, and 2017, but nothing changed legislatively in terms of the availability and prevalence of semi-automatic guns. In light of Christchurch, the Prime Minister successfully pushed the simple logic that making semi-automatic guns illegal will make it harder for anyone to terrorize again. Such logic does not exist amongst all policy makers the United States. Rather, we face a challenge with gun violence data that limits any policy progress.

Dr. Mark Rosenberg is a public health official arguing for data to successfully translate into substantial policy in the US. Dr. Rosenberg served as the president and Chief Executive Officer (CEO) of The Task Force for Global Health from 2000-2016 after working with the CDC for twenty years. He shared his views on gun violence data with me by phone in February.

Dr. Rosenberg noted that science does not determine policy, but it does inform it. Currently, there is not enough causation data defining gun violence as a public health crisis and, as noted above, there is a lack of federal funding for the CDC to find such data. Beyond raw numbers on number of deaths, there is no agreement about gun violence research. It is not surprising that Americans are split over whether legal changes would lead to fewer mass shootings. Since the gun control debate is so polarizing, Dr. Rosenberg recognizes a need for solutions that will protect gun owners and promote gun safety simultaneously. He compares the process to searching for the right cancer treatment–find something that kills the cancer and protects the patient from other damages.

Ultimately, the American gun violence problem needs more information about the problem itself.

Further, he believes that research can lead to such solutions if it is based on a public health framework that answers various causal questions, such as where, when, and how gun violence happens; where the guns come from; what the relationship is between the shooter and the victim; and whether the numbers rising or falling and why.

Ultimately, the American gun violence problem needs more information about the problem itself. Dr. Rosenberg emphasizes that current data does not show what works to prevent gun violence; it is easy to identify what is happening–too many people are being shot–however, it is harder to know what will stop the shooting.  Rosenberg believes that carefully designed studies that can be scaled up are key to translating research into effective policy. Without the studies, then the raw data falls flat.

Capitol Hill shows that raw data about the number of deaths by gun wounds is falling flat as the “common-sense” gun reform lobby is not getting any substantial laws passed. However, Rosenberg faults the term “common sense” as not being a rigorous, scientific term. He believes that the term incorrectly simplifies a complicated issue and undermines the effectiveness of the gun lobby. Think about applying the term “common sense” to any other public health issue like stomach ulcers or heart procedures could lead to a common sense solution that actually puts the patient at risk due to a lack of evidence for the solution.

So, if common sense reform is weak because of a lack of scientific evidence, where does the public health sector get the necessary data? The Dickey Amendment has not been overturned even though, according to Dr. Rosenberg, the CDC is the only entity that has the ability to create empirical studies at a magnitude large enough to answer these questions. These studies would need to include multiple states, law enforcement, public health officials, and more.

Academic centers and foundations are trying to work where the CDC can not. But, they only complete a tiny amount of research in comparison to what could be happening with the CDC–about 1/10th in fact. Dr. Rosenberg attempts to quantify their work by saying that without the help of the CDC, it would take research groups 30 to 40 years to create real change.

Something is happening around gun violence as a public health issue but not fast enough. New Zealand is an example of fast and concrete change. But, the U.S. is limited by their gun culture and research barriers. One way change might come is through a universal background check bill in the House and an appropriations bill to undo the Dickey Amendment. Both are currently in the works in the House. Only time will tell what, if any, gun policy changes are in our future.