In a study appearing in JAMA, David E. Stark, M.D., M.S., of the Icahn School of Medicine at Mount Sinai, New York, and Nigam H. Shah, M.B.B.S., Ph.D., of the Stanford University School of Medicine, Stanford, Calif., examined whether funding and publication of gun violence research are disproportionately low relative to the rate of death from gun violence.
The United States has the highest rate of gun-related deaths among industrialized countries, with more than 30,000 fatalities annually. To date, research on gun violence has been limited. A 1996 congressional appropriations bill stipulated that "none of the funds made available for injury prevention and control at the Centers for Disease Control and Prevention [CDC] may be used to advocate or promote gun control." Similar restrictions were subsequently extended to other agencies (including the National Institutes of Health), and although the legislation does not ban gun-related research outright, it has been described as casting a pall over the research community.
For this study, CDC mortality statistics were accessed from 2004 to 2014 (the most recent year available) and the top 30 causes of death were determined. For each cause of death, MEDLINE was queried for the total number of publications between 2004 and 2015. Research funding data from 2004 to 2015 (all years available) were accessed from Federal RePORTER, a database of projects funded by U.S. federal agencies. To determine how research funding and publication volume correlated with mortality, analyses were performed using mortality rate as a predictor and funding or publication count as outcomes.
The researchers found that compared with other leading causes of death, gun violence was associated with less funding and fewer publications than predicted based on mortality rate. Gun violence had 1.6 percent of the funding predicted ($1.4 billion predicted, $22 million observed) and had 4.5 percent of the volume of publications predicted (38,897 predicted, 1,738 observed) from the analyses. Gun violence killed about as many individuals as sepsis. However, funding for gun violence research was about 0.7 percent of that for sepsis and publication volume about 4 percent. In relation to mortality rates, gun violence research was the least-researched cause of death and the second-least funded cause of death after falls.
"Injury research has been generally undersupported - a finding replicated in the present study," the authors write. "Gun violence had less funding and fewer publications than comparable injury-related causes of death including motor vehicle accidents and poisonings. Given that gun violence disproportionately affects the young and inflicts many more nonfatal injuries than deaths, it is likely that the true magnitude of research funding disparity, when considering years of potential life lost or lived with disability, is even greater."
This work was supported by a grant from the National Library of Medicine of the National Institutes of Health.
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