The CDC will receive $6.98 billion in taxpayer dollars in 2017. That money will largely go to fund research combating the greatest perils to public health—perils like gun violence, which killed 33,881 Americans in 2014. More than 12,500 of those deaths were homicides, and for 2016, the figure is expected to be even higher, with 14,971 homicides.
But thanks to defensive efforts from the gun lobby, firearm deaths won't receive their share of the research kitty. A study published today in the Journal of the American Medical Association looked at the 30 leading causes of death to estimate how much money should be going toward each one. Between 2004 and 2015, gun violence should have received $1.4 billion according to the number of people affected by it. What it received instead was $22 million, a mere 1.6 percent of the expectation.
"This seemed like an example of not only knowledge being prevented from being disseminated, but from being collected in the first place," says David E. Stark, study author and assistant professor of health system design and global health at Icahn School of Medicine at Mount Sinai.
To make his point, Stark points to an amendment in the 1996 congressional appropriations bill. Backed by the National Rifle Association (NRA), the Dickey Amendment restricts the use of CDC funds for anything that could be used to "promote gun control."
The bill was the result of a study published in the New England Journal of Medicine, which linked gun ownership to an increased likelihood of shooting a family member. The gun lobby responded to the research by persuading Congress to draft and approve a bill that would effectively hinder the use of federal funds for future research that may be anti-gun. "Precisely what was or was not permitted under the clause was unclear," states a 2013 JAMA paper. "But no federal employee was willing to risk his or her career or the agency's funding to find out." (Stark used federal funds for his research, but says he's protected because he was merely publishing existing data, rather than collecting his own.)
The issue is markedly partisan. Every fiscal year from from 2014 to 2017, President Barack Obama has requested a $10 million addition to the CDC's budget for firearm research. Every year, the Republican-controlled congress has voted against the money. Meanwhile, the rate by which people shoot each other continues to increase—as do suicides, which account for about two-thirds of gun-related deaths.
To conduct the study, Stark analyzed CDC mortality statistics, federal funding data, and the body of research tied to specific causes of death. He used the information to predict the amount of funding and number of studies that should have occurred for any given cause of death, based on where it ranks among the other causes. Gun violence, in addition to being underfunded, was similarly under-examined: It received just 4.5 percent of the predicted number of studies.
Drowning was among the killers that received more attention. It kills approximately 90 percent fewer people each year, yet it receives about the same amount of money as gun violence. And firearm killings received a mere 0.7 percent as much funding as sepsis, a bacterial infection that kills a similar number of people.
But the most appropriate comparison for guns is cars, Stark says. Automobile accidents kill roughly as many people as firearms do, yet aside from a recent uptick in accidents (probably related to cell phone use), highway travel has become safer. Increased regulation stemming from research, such as better seat-belt laws and medians that prevent head-on collisions, have helped keep drivers protected. "[Automobile accidents] have gone down dramatically in the last 30 years, largely because we've treated automobile accidents as a public health issue," Stark says.
And while the CDC has sponsored studies on gun violence, such as a 2015 study on urban firearm violence in Delaware, critics note the agency is still toeing the line: The Delaware study doesn't include any details on how criminals acquired their weapons, or whether common sense regulations could have prevented the homicides.