But people care about negative outcomes with firearms such as homicide and suicide, including myself and other gun owners, so here we are.

I recently posted about the importance of considering absolute risk compared to relative risk when looking at negative outcomes with firearms. I mentioned, for example, that the relative risk of dying from an unintentional firearms injury in the U.S. is TWICE that of Italy. But the absolute risk of dying from an unintentional firearms injury in Italy is 1 in a million and in the U.S. it is 2 in a million, so some perspective is in order not to spark irrational fear.

In retrospect, the title “absolute vs. relative risk” was not the best, especially for someone who is constantly preaching the importance of both/and in understanding guns and gun culture rather than either/or. We need to understand BOTH relative risk AND absolute risk.

One of my top former students at Wake Forest read the absolute/relative risk post on my Facebook page and commented:

I think these numbers would be more meaningful too compared to some baseline that people can relate to more easily – say, the risk of being injured in a car accident.

I don’t disagree, though this does take us back to the question of relative risk.

Again using data from the Institute for Health Metrics and Evaluation (IHME) and its cross-national Global Burden of Disease (GBD) database, I explore the relative risks of unintentional death by various mechanisms, including firearms.

To my former student’s point, the risk of dying from a car accident injury is 8.61 per 100,000 population as compared to 0.21 per 100,000 population for firearms. So, the relative risk of dying from a car accident is 41 times greater than dying from a firearms accident.

This excludes what the IHME calls “road injuries” (including pedestrian, cyclist, motorcyclist, and other injuries) that alone have a rate of 4.00 per 100,000 — 19 times greater risk than firearms. If we add all “road injuries” together, their relative risk (8.61 + 4.00 = 12.61) is 60 times greater than that of firearms accidents.

I haven’t used this data in previous posts, but the IHME GBD data also includes a measure called “Years of Life Lost” (YLL). I haven’t looked under the hood of the IHME GBD study, but this is typically calculated in the United States by subtracting the age of death from 80 (a rough estimate of life expectancy). So, for example, if someone 65 dies from a fall, the YLL for that person is 15. If someone 36 dies from a motor vehicle road injury, the YLL for that person is 44.

Looking at the table above, we can see the number of years of life lost to motor vehicle road injuries (1,231,236) is 37.6 times higher than the number of YLL to unintentional firearm injuries (32,743).

One final sort of the data highlights a major reason people are particularly concerned about firearms: accidental deaths often affect younger people. And the most horrifying incidents involve very young people, including toddlers.

Unlike falls — which have the highest death rate (13.47) among accidents but the lowest average YLL (14.68) — unintentional firearms deaths have the 11th highest rate of accidental deaths (out of 14, 0.21) but the second highest YLL (48.6). Thankfully, because the rate of deaths from unintentional firearms injuries is so low, the total YLL is also low.

I am sometimes accused of seeking to minimize the harm caused by firearms. Far from it. But if we are going to understand negative outcomes with guns, we need to look at the data dispassionately. My former student asked how accidental gun deaths compared to car accident deaths and this post gives that answer.

It also hints at a very significant difference between car deaths and gun deaths (although public health scholars frequently compare the two in unhelpful ways):

Almost all car deaths are accidents; almost all gun deaths are intentional.

Although I differ from most scholars studying guns by beginning not with gun deviance but with the normality of guns and gun owners, I do take negative outcomes seriously.

Trying to get a better understanding of how the United States compares to other countries in the world in terms of negative outcomes with firearms, I recently stumbled upon the Institute for Health Metrics and Evaluation (IHME) and its cross-national Global Burden of Disease (GBD) database (more about IHME GBD at the end).

The scope of the IHME GBD data is impressive:

The Global Burden of Disease is collected and analyzed by a consortium of more than 9,000 researchers in 162 countries and territories. The data capture premature death and disability from 370 diseases and injuries in 204 countries and territories, by age and sex, from 1990 to the present.

Even better, the database is publicly accessible (though permission must be requested to download) through the IHME website: https://vizhub.healthdata.org/gbd-results/.

I will be looking at the data to better understand how the United States compares to other nations in terms of homicide, suicide, and accidental death rates. Today I begin with the most straightforward of the three: accidental death by firearm.

This is interesting not only in itself, but also because it highlights something important about understanding risk when it comes to firearms. I am not among those who deny that firearms introduce risk into the lives of their owners. As I have argued on this blog and on my “Light Over Heat” YouTube channel, guns are tools that are by design dangerous, so gun owners assume a certain amount of risk for themselves and their loved ones when they bring firearms into their homes and lives. The key is to be thoughtful in understanding and mitigating risk.

When assessing how much risk firearms pose to members of a household, public health scholars typically examine the relative risk: compared to households with no firearms, how much additional risk do firearms-owning homes have? Examples abound but include the landmark studies of “gun ownership as a risk factor” by Arthur Kellermann and associates.

Now, I have critically engaged these studies, noting the limits of case-control designs, for example, but also appreciating more recent cohort studies that have been published.

Today, I want to highlight the importance of looking not just at relative risk but also at absolute risk.

For example, a recent study found that use of hormonal contraception (vs. non-use) raises the relative risk of developing breast cancer by 30%. But because the average woman has a 1-in-8 chance of developing breast cancer, the absolute risk of developing breast cancer in connection with hormonal contraception is only 0.2% more than what would be expected overall. And hormonal contraception has other benefits that offset that absolute and relative risk.

So, for starters, what does the IHME GBD data tell us about the relative and absolute risk of accidental death by firearm in the United States compared to other countries? I sorted the 204 countries for which the IHME has data from highest to lowest rate. The range is from 5.22 per 100,000 (Haiti) to 0.01 per 100,000 (Oman).

The United States falls in the middle of the pack, #103 out of 204 at 0.21 accidental gun deaths per 100,000 population. The risk is not zero, of course, but I judge the absolute risk to be low, especially considering how many guns (hundreds of millions) and gun-owning households (tens of millions) there are in the U.S. There are many more things that are likely to kill me than someone unintentionally shooting me or me unintentionally shooting myself.

But this data could be used to tell a very different story. Imagine a headline that reads: “Rate of accidental gun deaths in U.S. twice as high as Italy.” This would be true, since the rate in the U.S. is 0.21 per 100,000 and the rate in Italy is 0.11 per 100,00.

But the relative risk tells a different story than the absolute risk. The absolute risk of dying from an unintentional firearms injury in Italy is 1 in a million and in the U.S. it is 2 in a million.

Are there too many unintentional firearms deaths in the United States? Absolutely. As Kids S.A.F.E. Foundation president Derek LeBlanc says, “ZERO firearm accidents are the only acceptable goal!!®”

But these data highlight, for me at least, the importance of always examining absolute risk alongside the more commonly cited relative risk of negative outcomes with firearms.

***IHME “ABOUT US”:

An independent population health research organization based at the University of Washington School of Medicine, the Institute for Health Metrics and Evaluation (IHME) works with collaborators around the world to develop timely, relevant, and scientifically valid evidence that illuminates the state of health everywhere. In making our research available and approachable, we aim to inform health policy and practice in pursuit of our vision: all people living long lives in full health.

We steward one of the world’s largest scientific collaborations, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), which involves thousands of researchers around the world. Through this project, we quantify health loss worldwide to help leaders improve health systems and address disparities. We continue to publish new GBD results regularly, adding new causes and risk factors and working to improve our methods. Additional IHME research includes forecasting Future Health Scenarios, Health Financing, and US Health Disparities, among other endeavors.

Here I engage the 4th of the model’s 5 points: Based on the first 3 points, defensive gun ownership is IRRATIONAL.

Links to the first four videos in the series are below.

In this video, I highlight a 1969 book by George Newton and Frank Zimring called Firearms and Violence in American Life. It is one of my Top 10 books on guns in America and expresses in kernel form much of what the public health approach to guns argues today.

I also mention Kellermann and Reay’s very early assessment of guns as a risk factor and conclusion concerning the irrationality of defensive gun ownership, “Protection or Peril?,” published in the New England Journal of Medicine in 1986.

Last, I again cite an article by David Studdert and his colleagues from the Annals of Internal Medicine in June 2022, “Homicide Deaths Among Adult Cohabitants of Handgun Owners in California, 2004 to 2016: A Cohort Study.”

The previous four videos in this series follow.

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The episode focused on a recently published study by a group of public health scholars who fielded a national survey of 916 Asian Americans asking about their experiences of racial discrimination and their firearm-related behaviors during the COVID-19 pandemic.

There is a lot of anecdata floating around about how anti-Asian discrimination increased during the pandemic (think of people taking the “China virus” and “kung flu” language to the next outgroup level), and that this led to unprecedented gun buying among Asian Americans.

Of course, without historical data, we can’t really speak to “precedent,” but these scholars find that 6.0% of respondents said they purchased a gun during COVID and another 11.2% said they intended to purchase a gun. Of the 6% of COVID gun buyers, 54.6% were first-time gun buyers.

If the survey is accurate and representative, then 3.3% of Asian American adults in the United States became new gun owners during the COVID-19 pandemic. Some quick calculations (roughly 20 million Asian Americans, about 75% being over 18) suggests that about half a million Asian Americans became new gun owners.

On the podcast, the authors note that part of the idea of doing the study was a phone call from a gun store owner in Battle Creek, Michigan who was wondering why so many Asian Americans were buying guns all of a sudden. Battle Creek is home to refugees from Burma dating back to the mid-1970s and a couple thousand live in the community today.

According to the abstract, the study found:

Asian Americans who experienced racial discrimination were more likely to purchase a gun and ammunition and intend to purchase more ammunition during the COVID-19 pandemic. AAs who perceived more cultural racism were more likely to purchase a gun. Individuals who reported higher anticipatory racism-related stress reported greater intent to purchase guns.

Examining racism and firearm-related risks among Asian Americans in the United States during the COVID-19 pandemic (Preventive Medicine Reports, June 2022)

I was not surprised that the authors are working within The Standard Model of Explaining the Irrationality of Defensive Gun Ownership. This was evident in the podcast appearance if not fully in the associated article. They understand that these Asian Americans are buying guns for personal protection (Point 1 of The Standard Model).

They highlight the frequency of gun carry by their gun-owning respondents:

Finally, 38.2% (n = 39) of individual gun owners indicated that they had carried a gun more frequently since the start of the COVID-19 pandemic and the top reason was for protection (Table 2). Furthermore, more than 1/3 of gun owners (38.5%, n = 15) reported that they carried a gun over half of the time (greater than 45 days) in the last three months.

They suggest (on the podcast) that guns are rarely used for self-defense (Point 2 of The Standard Model) and instead “the COVID-19 pandemic and the subsequent racism directed toward Asian Americans increased their risk for firearm injury through increased gun and ammunition purchase and unsafe storage” (Point 3 of The Standard Model).

They conclude by characterizing their study as one of the first to consider “the effects of discrimination of firearm-related risks,” there of course not being associated benefits worthy of mentioning.

Which recalls the conclusion of Studdert and his colleagues in their recent article on handgun ownership and suicide: “This information is also important for current and prospective firearm owners seeking to weigh the risks and perceived benefits of ownership.” Objective risk vs. perceived benefits, if any.

In the podcast, they advocate what Eric Ruben (SMU Law School) called in a Twitter exchange with me a “softer version” of The Standard Model. They don’t condemn gun ownership outright but highlight the need for better firearms safety education, especially around issues of safe storage. That’s something I can definitely get on board with.

This is part of my ongoing series systematizing the dominant academic approach to understanding Gun Culture 2.0, what I call “The Standard Model of Explaining the Irrationality of Defensive Gun Ownership.”

Here I engage the third of the model’s 6 points, offering my own take on guns as a risk factor that tries to navigate between the “YES THEY ARE” and “NO THEY’RE NOT” that too often characterizes discussion of the issue.

Links to videos 1 (Light Over Heat #41) and 2 (Light Over Heat #42) and 3 (Light Over Heat #43) are below.

In this video I again focus in particular on an article by David Studdert and his colleagues from the Annals of Internal Medicine in June 2022, “Homicide Deaths Among Adult Cohabitants of Handgun Owners in California, 2004 to 2016: A Cohort Study.”

It is an excellent model of how scholars attempt to isolate guns as a risk factor when the gold standard of causality — the randomized controlled experiment — is not possible. It is also not without its limits.

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The model has 6 points, and in this 3rd video, I discuss point 3: how guns are seen to add risk of negative outcomes.

Links to videos 1 (Light Over Heat #41) and 2 (Light Over Heat #42) are below.

ACADEMIC TRIGGER WARNING: I got carried away discussing the methods employed in public health research on guns as a risk factor (I am a professor, after all), so this video is longer and more tedious than average. AND I also took the last third of the video in which I critique the public health research and put it in a separate video that will run next week.

In this video and the next I focus in particular on an article by David Studdert and his colleagues from the Annals of Internal Medicine in June 2022, “Homicide Deaths Among Adult Cohabitants of Handgun Owners in California, 2004 to 2016: A Cohort Study.”

It is an excellent model of how scholars attempt to isolate guns as a risk factor when the gold standard of causality — the randomized controlled experiment — is not possible.

Please surf over to my “Light Over Heat” YouTube channel and SUBSCRIBE to follow, RING THE BELL to receive notifications, and SHARE so others can learn about this work.

If you are able to support this work financially, please consider making a contribution:

In this and the next five Light Over Heat videos leading up to the Saint Anselm workshop, I will be sharing what I am calling “The Standard Model of Explaining the Irrationality of Defensive Gun Ownership.”

This week’s video summarizes the entire 6-point model.

I am risk-averse in certain ways, but in other ways, I take risks all the time. Notably, drinking alcohol which has many well-documented short-term and long-term health risks. Rather than always trying to avoid risk, perhaps we should, in gun trainer Will Petty’s terms, think of risk as a currency that we get to choose how to spend?

In spending our risk wisely, we need to be thoughtful risk analysts and wise risk managers. In bringing firearms into their homes and lives, gun owners are assuming a certain amount of risk for themselves and their loved ones.

This raises the question: Are gun owners thoughtful risk analysts for their own lives?

Mentioned in this week’s video are Jonathan Metzl’s book Dying of Whiteness, John Farnam’s “rules of stupid,” the Center for Disease Control’s page on alcohol use and your health, and San Francisco’s last gun store, High Bridge Arms, that was forced to close in 2015.

New “Light Over Heat” videos are released on YouTube every Wednesday, so please surf over to my YouTube channel and SUBSCRIBE to follow, RING THE BELL to receive notifications, and SHARE so others can learn about this work.

That said, John Johnston’s Ballistic Radio has been at the top of my diminishing list of must listen to podcasts for some time now. Recently he had on a guest who is an extremely high-level shooter, K.A. Clark. This is not unusual for Ballistic Radio, of course. What I found interesting was the advice Clark had for new gun owners.

The old saw has it that “those who can’t do, teach.” This is mostly false with a dash of truth mixed in, but so too is the opposite: “those can do, can’t teach.” When I was in graduate school there was a legendary story of one of the world’s top quantitative researchers in sociology who got so frustrated trying to teach graduate statistics that he flung an eraser across the room. Later when I was working at the University of Notre Dame, I tried to have one of the top 20 college tennis players in the country help me with my serve. I hit a few serves for him under his watchful eye as he formulated his advice: “Swing harder.” Uhhhh, okaaaayyyy.

It is a particular gift to be able to reach novices as an instructor, especially if you as the instructor are highly proficient at what you are teaching. Glenn Seaborg earned a share of the 1951 Nobel Prize in Chemistry for his (co-)discovery of ten transuranium elements including plutonium and element 106 which was subsequently named seaborgium in his honor. He also taught freshman chemistry at my alma mater, UC-Berkeley, long after he needed to. In his words, “The education of young people in science is at least as important, maybe more so, than the research itself.”

This brings me back to K.A. Clark on Ballistic Radio. He is a Glenn Seaborg-level shooter. He and Johnston review his credentials at the start of the show. But when asked to talk about goal setting, his advice for new gun owners — of which there are an abundance these days — was spot on.

Johnston asked Clark if there was a difference in goal setting for new shooters. Clark responded that goal setting is even more important for the novice. And the particular approach to goal setting he advises is worth quoting at length:

I think the first place to start, piggybacking off the work of Claude Werner, is avoiding negative outcomes. The first goal is your involvement with firearms and firearms training should be a value-add and a positive to your life. Not a negative. And if you buy gun and you’re unsafe with it and you don’t know anything about negative outcomes and you don’t get training and you don’t take it seriously, man, it can mess up your life. It can ruin your life. And people don’t realize that. They just say, “Well, I got a gun, I’m good.” And it’s like, well, maybe. Now it’s just random. Maybe it’s good. Maybe it’s not. So setting that goal of “I want to be able to protect my family.” Fantastic. So, guns are good place to start. Get some training. But you’ve got to learn about safe storage, you’ve got to learn about negative outcomes, you’ve got to listen to Ballistic Radio. That’s where you start. That’s much more important than, “Well, I want to do a two-second Bill Drill tomorrow.” One, that’s not going to happen. And two, it doesn’t matter that much, right? So the beginners really need to hone in on what’s important. They really need to get their goals together early. And that’s a challenge. How do we do that as a training community? How do we help those new people set realistic goals and relevant goals to make firearms ownership and their involvement in this community a net add to their life.

K.A. Clark on Ballistic Radio (Ep. 354)

As host John Johnston said by way of reinforcing Clark’s take, “A lot of people, lately especially, get into guns as some form of risk mitigation. Now, whether or not the risk is real or imagined doesn’t really matter. When you [get a gun] you’re not necessarily mitigating risk so much as setting it to random. Like maybe you’re good, maybe you’re not. And, and I agree with you completely that if you’re introducing any level of new risk in your life and you don’t mitigate it, that is probably not a net value-added.”

Whether you’re already deeply involved or are new to guns, there is a lot of value-added to listening to the Ballistic Radio podcast. And if you are outside or critical of American gun culture, you should listen also so you can see what thoughtful gun owners sound like when they talk to each other.

This is the eighth and final final reflection essays, written by a student whose initial reflections on our field trip to the gun range can be found here. (Link to the first, second, third, fourth, fifth, sixth, and seventh reflection essays.)

By Grace Taylor

This class has made me think a lot about the role of guns in society, gun culture, and gun safety, as well as why different groups are so divided about whether the fact that so many people own guns is a good thing or a bad thing, and how we can make gun ownership less dangerous.

As I write this, it is hard to think about everything we read and talked about in class and not think about the terrible school shooting in Michigan last week, where parents bought their son a gun for a Christmas present, and then he went to school and used it to kill four of his classmates. I realize that these kinds of people are not the “normal” gun owners, and that millions and millions of people own and use guns safely and responsibly, but it is hard to think about the role of guns in society and not let the Michigan shooting, and all the school shootings before it, influence my thoughts.

I learned a lot this semester through our readings and our speakers, but I am not sure I completely “changed my mind” about guns in general. Going back to our field trip to the range, one thing that really stuck with me was just how dangerous the guns seemed when seeing them up close, and eventually using them. Firing them, especially the AR-15, felt intense, even violent, and it is not something that I particularly want to do again. We spent so much time on safety, and all the risks of shooting a gun, and I was very impressed by how good those rules were. But my first thought back then was that, if we need so many rules to treat guns safely, doesn’t that show how dangerous they really are, and do we think most people are going to be strict enough or smart enough to follow those rules.

That was also my reaction to several of our speakers. I respected how serious John Johnson and Melody Lauer were about training people to use guns safely. I respected how Rob Pincus wants gun-rights groups to be more honest about the dangers of “guns in the everyday,” and how he works with mental-health professionals to deal with the role of guns in youth suicide and other difficult situations. But I could never quite understand how they could be so clear about the risks and dangers of guns, and still be so enthusiastic about millions and millions of people owning guns as part of their everyday lives.

In general, I just could never understand or relate to this great excitement about guns, how guns are so tied up in people’s sense of culture and identity, and why people seem to need to own guns to somehow show the world who they are. There is a difference between saying owning a gun is a right, or shooting guns at a range is fun, and being so enthusiastic about people being able to do concealed carry of guns as they go into town or go shopping, because it makes them feel good or makes them feel safer.

The relationship between guns and personal safety is another thing I did not quite understand. Several of the articles we read, and several of the speakers we heard, talked about how people carry guns because they are so worried about the risk of crime and violence and threats to their personal safety: “No one needs a gun until they do” [quoting John Johnston]. But when I read interviews with these gun enthusiasts, or watched some of the videos we used in class, they seem to have such an extreme view of the dangers in society, like that there is a robber or a killer just waiting to attack them every time they leave the house. Every time I found this opinion, I wondered if they really believed that. Also, if gun-rights advocates are so concerned about risk, why aren’t they more concerned about all the risks of widespread gun ownership, from negligence, to accidental shootings, to mass shootings, to guns and mental health. I know all of our speakers were very worried about this kind of risk, and they have great training to help people deal with those risks, but pro-gun politicians do not seem to be, and so many laws are making it easier and easier for people to carry guns without training.

All of these issues about guns, personal safety, and what is happening with the current legislature came together for me in my final paper. In other sociology classes, I have looked at how to best try to address the problem of domestic abuse and intimate partner violence, and how to keep women and children safer and help them leave abusive relationships. Because of my prior knowledge on the problem of intimate partner violence, I thought it made sense for me to look at the role that guns play in the problem. The research was so clear that if there is a gun in the house, or if an abuser has access to a gun, the risk of the woman being killed by her abusive partner goes way up. With a gun, it is so much more likely that intimate partner violence turns into intimate partner homicide.

Yet the federal and state laws that could be used to protect women and children, and get guns out of the hands of abusers, are not nearly as strong as they should be, and the enforcement of the laws is weak and inconsistent. My paper talks about the Boyfriend Loophole and the Stalking Loophole in the federal laws. These are such obvious problems, but Congress has not been able to fix them in 20 years. State laws can be stronger, but there are still many states where judges and police cannot order guns to be removed from a home where abuse is taking place, and there are other states where guns can be removed but do not have to be removed. Again, I just do not understand how, if gun-rights advocates are so concerned about personal safety, they would not be doing everything they can to support laws to get guns out of the hands of abusers who threaten women and children.

In this class, I learned to respect people like John Johnston and Melody Lauer, Rob Pincus, and all the outside speakers who were so serious about minimizing the risks and dangers of gun ownership and maximizing safety. I still don’t understand their enthusiasm for guns, and I don’t agree with it, but I think if their view was more common, we could create a safer society, and deal with problems like the connection between guns, domestic abuse, and intimate partner homicide.