Plenary Contribution to IPPNW Conference Aiming for Prevention: International Medical Conference on Small Arms, Gun Violence, and Injury. Helsinki, Finland, 28-30 September 2001 Wendy Cukier, Professor of Justice, Ryerson University; Co-founder and President Coalition for Gun Control; SAFER-Net Thanks very much. I m very pleased to be here, I will try to keep my presentation at a fairly high level given the fact that I am the principal thing standing between you and your coffee. I also should mention that this is based on a number of papers, the latest of which is being prepared for the Small Arms Survey, and will be available on the SAFER-Net website. And the other thing I should say is those of you who want the Injury Prevention Conference Call for Papers, I did bring it as promised yesterday, so see me after the session. To a certain extent for many of us, I think, the link between firearms availability and misuse is fairly self-evident. David Meddings talked about this to a certain extent yesterday. But I want to walk through some of the evidence that currently exists both from a theoretical and empirical standpoint. I also want to talk about what the implications are from a policy perspective. At the same time I want to preface my remarks by saying that I don t think that anybody who talks about the need for interventions on the supply side with respect to firearms or small arms would ever dispute the notion that we also have to address demand. So I want to say that at the outset because I think that goes without saying, and the next panel will in fact talk about the demand factors. If we go back to the public health model which was referenced yesterday, the notion about the interaction between the environment, the agent, vector and host for those of you who are operating in that context, I think it s worth quoting my colleague, Antoine Chapdelaine, who said that access constitutes the universal link. The one against which we can take action in the chain of events leading to an injury with a firearm. This is part of the reason why a lot of the research as well as the advocacy efforts in this area are focusing on the firearm or the small arm. And in fact, a number of researchers have looked at interventions which focus on restricting supply, and the notion about focusing on various interventions to restrict supply are based on the idea that this will make it more difficult, time consuming, or costly for a violent individual or a suicidal individual to obtain a gun. There is no notion that controls on availability in and of themselves will eradicate violence. The notion is primarily that it can reduce lethality, and we heard a lot about lethality in the context of suicide in Finland yesterday. And also that in some cases impulsivity is a critical factor particularly when we re talking about youth. So I want to talk about some of the research that s been done, and I can provide
references for all of this. Certainly one of the things that interests me the most, and one of the things that gave rise to some of the cross-cultural research in the national profiles and so on that we ve been working with, are looking at cross-jurisdictional comparisons. Looking at ownership rates, and firearms death rates. This has been done at the level of cities. Many of you will remember Arthur Kellerman s seminal work, I guess it was Sloan and Kellerman, A Tale of Two Cities, which compared firearms violence in Washington D.C. and Seattle. That sort of research has been extended to look at different regions I ll talk more about that as well as comparisons among countries. There have also been studies that have defined accessibility in a more localized basis, and simply looked at homes with guns versus homes without guns. And again a number of studies have indicated that where there is a gun in the home, the risk associated with homicide increases dramatically as does the risk associated with suicide. Another sort of interpretation of accessibility has to do with the ease of access to these weapons. For example, the simple difference between homes which store firearms safely and those which don t. There s lots of research that looks at that issue. There s also research that looks at the general ease of access, and the notion here is that legislation and I ll talk more about the limits of this assumption the notion here is that legislation can make it easier or more difficult to obtain firearms in certain contexts, other factors being held constant. And there is some longitudinal research looking at links between stronger regulations, declining ownership, and declining death rates. But again we all know that longitudinal studies are very difficult, particularly where you re looking at something as complex as crime or suicide. And because of the wide range of factors that come into play, it s difficult to isolate firearms availability alone. But certainly there is research that tries to do that as well. The thing that I ve probably spent the most time on, and I ll talk more about the specifics, is looking at the link between availability measured in terms of households with firearms, and firearm death rates. There are a number of different sources of data with respect to firearm death and injury. We ve heard a lot about those the health based sources, the crime based sources, victimization studies and so on but we haven t talked a lot about where we get information, about availability. How do we measure the availability of firearms? And certainly this data is very, very weak. I think that s the best that we can say. There are government statistics. The problem with government statistics, as was pointed out in the case of Colombia, is that the rates of registered and licensed firearm owners and firearms are often a very small fraction of the actual numbers of guns in circulation, or the rate of households with guns. And in fact my basic argument would be that in general, in high income, well-regulated societies, where there are high levels of regulation on firearms, your government statistics are more likely to be an approximation of gun ownership and use, than in countries which don t have the necessary social, political, and economic infrastructure. So, government statistics are useful but imperfect. Then there are also surveys like the international crime victimization survey, which comes up with estimates of households with firearms, but there are dramatic inconsistencies in the data. For example, the international crime
victimization study estimated households with firearms in Finland at 29%, whereas the Finnish government reported firearms ownership to the UN survey at 50%, and the truth is somewhere in between. David Meddings showed you this graph before which simply plots the intentional firearms death rate against the percentage of households with firearms in high income countries. If we tried to plot this against reported ownership rates and against death rates in a wider range of countries we would see tremendous anomalies. A country like Jamaica for example has a very low rate of reported legal firearms ownership and yet a very high rate of firearms homicide. And again I would suggest to you that that probably has to do with the relationship between the reported firearms ownership rate, the actual firearms ownership rate, versus the legal and illicit portions of firearms. And I think it s fair to assume that in most of these countries there s a fairly strong relationship between what s reported and what exists. And as you can see there s a fairly strong relationship. Countries that have higher rates of households with firearms tend to have higher firearm death rates. And that carries through when we look at death rates among children. United States leads, Finland is quite high as is Canada and a number of other European countries. In contrast, countries like Germany, England, and Wales which have low rates of gun ownership have low rates of children killed with firearms. David Meddings talked about the availability thesis in the context of post-conflict zones. The assumption here is that if there s not an effort to remove weapons from circulation they continue to be used. And there s other research that has for example compared Canada to the United States. The big variable here, if you look at the bottom of the slide, is actually the rate of handgun ownership between the two countries. Certainly the United States has a higher rate of gun ownership per capita, but it is handgun ownership which is particularly different. And I just draw your attention to the difference between because this is an important factor if you re trying to evaluate substitution look at the murders with handguns, the US versus Canada rate. The US is almost 15 times higher. Look at the murders without guns. The United States is barely twice as high as Canada. So essentially the difference in the murder rate between Canada and the US is accounted in large part by the difference in the firearms homicide rate,and you will see that pattern plays out in other countries which are relatively similar. SO, for example if you look at Austria, Germany, and Switzerland you ll see a very similar pattern. And I think the key here is comparing contexts which are relatively similar. There are differences between Canada and the US, but there are strong similarities in terms of culture, in terms of socio-economic context, and so on. One of the very clear differences between our countries is the availability of firearms. We also see this play out in regional variations. Within Canada there s a fairly strong association between rates of firearms ownership in different regions in the country and the rates of firearms death. This is from Ted Miller s study,which looked at the costs of gunshot wounds in Canada and the United States. And this was very useful in our own context because as you can see the Yukon and the Northwest Territories, which have the
highest rates of gun ownership in the country up around 70% of households have a rate of gun death which is higher than that which we see in the United States. If you look at the policy implications, then, of this basic thesis, the notion is that if you somehow reduce access, defined in all those different ways, you will also reduce death. And there s a strong theoretical basis for this, both in the injury prevention literature and in the situational crime prevention literature, which tends to be the stuff I m more familiar with. The assumptions are basically that some, not all, firearm death injuries and crimes are preventable. Secondly that the availability of guns increases the lethality of assaults, suicides, and conflicts. And also the duration, when we re talking about conflict. And therefore it s important to address supply as well as demand. As I said at the outset though there s no question that you have to look at demand side factors. And that will be talked about more later. Some of the initiatives that seem to me to be focused on reducing what I would call general access as well as specific access are: regulation which, in effect, raises costs and discourages casual gun ownership. That s probably one of the most significant effects of stronger legislation. Also, there are legislative interventions that are aimed at reducing the changes that those at risk will gain access. For example, licensing, training, screening processes which are in place in many countries. There are interventions which are focused on increasing the barriers between individuals and guns, particularly individuals who may be at risk, but also children: safe storage would fall into that category. And there are initiatives which are aimed at reducing access in specific contexts, which we ve heard a bit about. Gun free zones, for example, which are included in the new legislation in South Africa, aimed at reducing access to guns in drinking establishments, for instance. Some of you are also familiar with some of the initiatives in Cali and in Bogota which introduced temporary time restricted bans on the carrying of handguns and were associated with roughly a 14% reduction in homicide. Now again, they re not entirely conclusive but there are suggestions that those sort of initiatives work. As well as initiatives aimed at reducing surplus. And while there s a lot of controversy about weapons collection and destruction programs at various levels, I ll refer you back to the Australian representative s comments, because really the Australian legislative initiative as with the UK legislative initiative can be seen not only as tightening legislation but as massive weapons collection and destruction programs accompanying the buyback. The other piece that I think is important because everybody s preoccupied with the 2001 Conference even though I have argued that from a public health perspective, whether a gun is legal or illegal is largely immaterial from the point of view of effects. If we are trying to reduce criminal violence, if we are trying to reduce conflicts that are fed by illicit trafficking, we have to understand how the supply works. And many of the legislative mechanisms are aimed at I won t go into this in detail because I m conscious of the time but if we think about what the controls on legal firearms and legal transfers are aimed at, they re essentially aimed at reducing the risk of diversion from licit to illicit. And
whether you re talking about state to state transfers, or whether you re talking about the fact that there are half a million guns stolen in the United States every year by definition fueling the American illegal gun market, what we have to try to do if we accept that there are legitimate purposes for legal ownership of firearms, is you want to keep the firearms or the small arms in the hands of their legal owners, and you want to prevent diversion. And that s what a lot of the legislative initiatives are aimed at addressing. And there s been some interesting research out of the United States which supports the notion that if you restrict controls on firearms at the state level, what you do is reduce the likelihood that those firearms will be used in crime. Unfortunately because American states have open borders, what tends to happen is the crime guns come in from out of state. And those of you who are interested in this issue really should look at the Webster study, but basically it showed that in cities where there was no licensing or registration, 84% of the guns recovered in crime were from local markets. In cities which were in states which had both licensing and registration, very few of the guns actually originated from local markets. And certainly our experience in Canada is that our stricter controls have had some impact, but of course some guns continue to come in from the United States. And the extent to which legislation is effective in controlling supply in my mind, is to a large extent tied to the effectiveness of enforcement infrastructure and so on as well of course the demand factors. So there are some real cautions that we have to consider in looking at this whole issue and how legislation may effect availability. Where demand factors are very strong, where there are not the kind of supports necessary to translate the law into reality, you don t see much of a connection between stricter laws and firearm death rates. And certainly Jamaica, Estonia, and to a certain extent South Africa are evidence of that. At the same time there are a number of studies that have been done, and there is one by Katherine Mackenzie in the South African region which shows that many of the countries in the same region have lower gun-related death rates than South Africa. And that study associates it as well with availability. Again we ve heard a lot about the importance of other factors at the social, political, and cultural level. The Falvo study which I think is extremely interesting, it s one of the few case control studies that s been done, looked very specifically at a wide variety including age, criminal activity, drug use and so on. The other thing we have to acknowledge, especially if we re doing longitudinal studies, is frankly the biggest predictor of violent criminality in a country is the proportion of the population between the ages of 15 and 24, at least from the criminology literature. We can t ignore the play, the impact of demographics. So when we re looking at declines in gun related violence in many countries, those are very much associated with changes in demographic patterns. The thing that I would like to end on is the fact that I actually think that there s a strong argument to say that supply and demand feed one another. I just heard about one of these studies, actually yesterday, but there s certainly empirical research which suggests a
strong link between legislation on the one hand, values on the other, and consequently on demand. So the notion is that legislation not only has a practical impact, but it also is an expression of values. And I think I ll leave you with a quote which was now almost 40 years ago quite prophetic by Martin Luther King, who really alluded to the fact that there is a very strong link between the culture of violence and the instruments of violence. Thank you very much.