An empirical scientific viewpoint about gun control

For just a moment, let’s take a scientific viewpoint about gun control here and try to leave emotions (and the Constitutional argument) out.

The best type of study to determine whether gun control and/or regulation would be a Randomized Trial:

  • Randomizing a state or country to regulation or not.

Since that’s not going to happen, the next best type of evidence we have to go by is observational, either case-control or cohort studies:

The exposure is: gun control regulation.

  • This could be considered dichotomously (Yes/No) or continuous (level of regulation from strict to lenient/none)

The outcome is: death by guns.

  • This could be considered in numerous ways: absolute numbers of gun deaths annually; relative numbers of gun deaths adjusting for size of population; number of gun massacres, etc.  We could even consider any violent deaths, if you want to be more general.

In a case-cohort study, we’d look at the outcome first (let’s say, massacres) and look backward for the exposure, then calculate an odds ratio that the outcome was significantly associated with the exposure.

In a cohort study, we’d look at the exposure first, looking at level of gun control as a continuous variable.  This could be done retrospectively or prospectively.  As of now, we could only do this retrospectively.  Then look for the outcomes (deaths, massacres, etc.), and determine a risk ratio that the outcome was associated with the exposure.

Either way, the data would indicate that countries with increased exposure (increasing regulation) is associated with a decreased odds/risk of the outcome (fewer deaths, massacres).

Please NOTE that I did NOT say that increasing regulation CAUSED fewer deaths, just that it was ASSOCIATED WITH fewer deaths.

Now, I do not have numerical data, so I am only going on what I understand to be true, the empirical data.  For those who would not believe this to be true, the best way to deal with this is to show data that decreasing the exposure to gun regulation (i.e., increasing the populace’s ability to acquire firearms legally) is associated with fewer gun deaths.

Therefore, my preference is the following: until evidence (not raw emotions, beliefs, or Constitutional Amendments) that decreased regulation (including eliminating gun zones) results in decreased odds/risk for the outcome (gun death) is found in other countries, then there is no reason to accept the notion that we need to stop advocating for strict gun control.  For that matter, stricter gun control has evidential support (even if not emotional support among some) and should be advanced.

If you choose to comment on this in the opposite direction, please think before you do. The anecdotal evidence currently being provided by those who would oppose stricter regulations is purely speculative.  I am open to hearing the data to refute the above contention, but it needs to be at least as strong methodologically.  In other words, “case reports” (testimonials by individuals) or “case series” (testimonials by groups, including lobbyists) are weaker forms of evidence scientifically, and I will not consider them as valid as the comparative empirical data I have put forward as an argument.


Update: July 20, 2016

A large study with sound methodology has been published in JAMA this week with data backing up this blog post.


About Ryan Madanick, MD

I am a gastroenterologist who specializes in diseases of the esophagus, with a strong interest in the diagnosis and treatment of patients who have difficult-to-manage esophageal problems such as refractory GERD. I can be followed on Twitter: @RyanMadanickMD (he/him)
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4 Responses to An empirical scientific viewpoint about gun control

  1. Excuse me if you’ve seen this already, but here is an observational study of the effect of changes in gun control on firearm deaths.

  2. This reminds me of the debate about seat belt laws that physicians started because they saw the evidence that wearing seat belts reduced fatalities. I know many pediatricians who ask about both seat belts and household access to firearms at well child visits. Do your colleagues in gastroenterology inquire about environmental and safety health hazards like firearms? And do you think that’s an appropriate step for health care professionals to make?

    • I think it is an appropriate question to ask. Not to pass judgment but more for the educational value of the response.

      Because of the nature of the subspecialty, I doubt GI docs ask questions about this.

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