Good afternoon. How are you all doing? Staying warm, I hope. I'm Michael Barr. I'm the Joan and Sanford Wildein of the Gerald R. Ford School of Public Policy. I'm really thrilled to see all of you here this afternoon and to welcome you here for the Gill Oman and Martha Darling Health Policy Fund lecture at the Ford School. This talk is on one of the most pressing issues facing our country, gun violence. I understand that we have groups that have gathered outside of Ann Arbor to watch the live stream of the event as well. A special welcome to those of you who are watching online. The lectureship we're experiencing today, the event we're having today is funded by Gill Oman, who just walked in, and Martha Darling. And we're just deeply grateful for their support, which provides funding for health policy faculty and health policy outreach activities here at the Ford School. And the Ford School is able through this funding to address a spectrum of health policy issues. I really want to just pause and thank Gill for being here. Unfortunately, mass shootings have become a regular story in our cycle of news. In the last two weeks alone, the country has seen no fewer than nine incidents of gun violence, where five or more people have been injured or sadly killed. Today we have assembled a distinguished panel of experts to discuss the issue of gun violence in our country. Paula Lance, Professor and Associate Dean for Academic Affairs at the Ford School and Professor of Health Management and Policy at the School of Public Health, will introduce our panelists and moderate what will surely be a provocative conversation. Let me just say a word on format. We'll have some time toward the end for questions from the audience. Ford School Professor Brendan Nyean and two Ford School students, Marina Deden and Stephen Oliphant, will sift through your question cards and pose them to the panel. So you'll see staff members and helpers coming around with those cards for you to fill out your questions on during the course of the event. For those of you who are watching online, please tweet your questions using the hashtag policy talks. Again, welcome to all of you both in the room today and those watching online. And let me now turn the podium over to Paula Lance. Hi everyone, welcome. Thanks so much for joining us today. Let me just take a moment and set the stage a bit before we jump into our discussion today. In public policy, we always consider framing or how issues are being defined, shaped and talked about both in terms of how problems are being defined but also in terms of how policy responses are going to try to address those problems. In the U.S., there are multiple competing frames about the problem of the high rate of gun violence in the U.S. and what to do about it. This includes that the main underlying problem is violence. Guns are not the problem. Violent people and violent communities are the problem. The main problem is that there are too many guns. Guns are too easy to get and too many people have them. A different frame is that, no, it's that too many bad people have guns. Criminals, people with mental health issues. Another frame, the main problem is that good people are not armed enough to protect themselves and their property. Another frame, the main problem is that people don't follow the laws we already have. We don't need more laws, we just need better enforcement of the ones we have. Another frame, the problem is that we have a lot of public policies that mostly don't work and in fact actually have unequal and restrictive burdens placed on people, sometimes based on their social characteristics including race. And some people don't really care what the problem is. The U.S. Constitution gives everyone the right to bear arms so the government needs to protect that right first and foremost. Again, many competing frames, different ways of looking at this problem and we're fortunate to have a very distinguished group of experts with us today to discuss this complex topic. I'm honored right now to introduce them all to you. First, we are thrilled to welcome journalist and writer Jane Kostin back to campus today. After attending the University of Michigan as an undergrad, Jane started her career with the St. Louis Post Dispatch. She's now a senior politics reporter at Vox and writes on a wide range of topics including conservative politics, college and professional sports, and also she has written on what she calls the really, really racist history of gun control in the United States. Next, we're fortunate to have Dr. Rebecca Cunningham as a part of the University of Michigan community every day and also with us here at the Ford School today. An emergency room physician, Dr. Cunningham is professor of emergency medicine, professor of public health, the associate vice provost for health sciences research, and she also has time to be the director of the University of Michigan's Injury Prevention Center. She's a nationally known expert on many topics including injury prevention among children and young adults with a special focus on injury from firearm violence and also from opioid and other drug overdose. And also we are very fortunate to have Dr. Jonathan Metzel back on campus with us today as well. Dr. Metzel is at Vanderbilt University right now where he is the Frederick B. Rentschler, the second professor of sociology and psychiatry and the director of the Center for Medicine, Health and Society. A board certified psychiatrist, Dr. Metzel also has a PhD in American culture from the University of Michigan and he's a well-known expert on many topics including medical, social and historical perspectives on mental illness, health inequities and gun violence. Regardless of what national TV news program you watch, you have likely seen him on that show. I see you at the gym quite a bit actually. Please join me in welcoming our distinguished panelists today. So we're going to start out just by letting our panelists talk a bit about their own work in the area of gun violence, some of the key perspectives that they bring to this issue, some of the work that they've done and just give them a chance to kind of lay out for all of us how they see this issue and what they really, you have five minutes, and what they really want us to know about them and how they work on and think about this issue as we get further into our discussion and we're going to start with Jane. Hi everyone. It's really nice to be back. It's very funny to have graduated 10 years ago and still like walking around and being like, oh good, BTB Burrito's still there. That's great. So my work on gun violence is a little bit different from the other two very distinguished people on this panel and that my work is focused on kind of thinking about gun violence from a legal and journalistic perspective and not so much as a public health issue or thinking about it in terms of what can actually take place in policy. A lot of my writing focuses on conservatism and the GOP and so I've spoken with a lot of folks on that side specifically about the issue of gun rights. But I've also written about gun rights and who has access to gun rights and who doesn't. I've written about the racist history of gun control, which in many ways you see in the antebellum south and even under Jim Crow, African-Americans were not so much allowed to own bullets, let alone guns. And yet you had figures like Harriet Tubman and Frederick Douglass who wisely recognized that a Winchester rifle was perhaps the only thing standing between them and the tyranny of the Klan and other groups at the time. And you see in some ways you see that legacy percolating. We were just talking about the Mulford Act, which banned the open carry of weapons in California and that was set in place by then Governor Ronald Reagan who saw the Black Panthers protesting outside the California State House holding long guns and was like, that just can't happen. And so I think that having that historical context when we talk about the issues of guns and gun violence is something that's really important to me. And also important is in the conversations I have with conservatives and I think we're probably going to talk a little bit about the Supreme Court and some of the legal issues involved with dealing with the problems of gun violence is when you talk to conservatives about this issue and you talk to legal scholars also, public policy on guns needs to fit into a pretty narrow space that's been created by the United States Constitution and the Supreme Court of the United States. Into that space between those two things is where public policy on guns needs to be. And I think that putting it into that framework is really helpful but it's also really depressing in a lot of ways because you talk to folks who are thinking about, well, other countries may have massive gun buyback programs and you're like, okay, those other countries are not this one. We need to abide by the constitutional framework that is set up that we have now or we need to change the constitutional framework and there's a process by which you can do that and I welcome you to try. But I think keeping that context, both the historical context of what guns have meant in this country for different groups of people, what access to guns has meant for different groups of people and what that access has really looked like on a day-to-day basis and also recognizing that we have the strictures created by both the Constitution and the Supreme Court and law in general to guide us forward in what policies not so much work or don't but are possible or impossible. Thank you. Rebecca? This is going to be fun. So, Rebecca Cunningham. I'm an emergency physician by training, so also with a public health background and as the director of the Injury Prevention Center here, I bring a lot of the frame of firearms within an injury prevention framework, not really to be thought of any different than the other mechanisms of injury that we've spent a lot of time thinking about from motor vehicle crash to fire and burn to the opioid overdose, and that is the framework of injury and injury prevention that I bring to this. I also bring to it as a practicing physician that has taken care of patients extensively, both here and in Flint, Michigan, at the bedside and given an awful lot of very bad news to families on the fatal and near-fatal wounds that their children have had. I bring to this the frame of a handout that you might have gotten, which shows the trends of death over time and if we just look at the death rates over the past 10 or 15 years, and we see that firearms are the second leading cause of death among children and teens in our country, and that's from 1 to 19. As of 2017, it's actually from ages 1 to 17. We're not allowing the children in our country to become 18-year-olds to really get to even discuss voting or our Constitution. We're really cutting off about 3 to 4,000 of those children and teens a year completely. Firearms is now the leading cause of death. Actually, if you're a teenager in this country, regardless, your mechanism of death is most likely to be firearm. If you are not white in this country, the most likely thing, no matter what emergency department I treat you in this country, the most likely thing you will die of after I release you from my emergency department will be a firearm before your 18th birthday. So that's the framing that I bring to this. So I have a much more optimistic view than you do, and I think we're going to get to talk about this. I view that not as a very narrow niche for the Constitution at all, but as actually something that's a mile wide. So because the framing that I bring to this in our work with the firearm safety among children and teens consortium, which is an NIH-funded consortium that I direct here at the University of Michigan, focused on decreasing this injury and death among children, we have a stakeholder group and we are very much focused on the fact that we do have a Second Amendment rights in this country, and that there is so much we could do within those Second Amendment rights that we haven't even begun to try to do because of a lack of attention at how much of this topic has been a third whale. We do not, we have cars in this country, I'm not going back to my horse and buggy. We can talk about the Constitution does not protect your car, yet we have more cars on the road and more miles driven. There's plenty of room for us to do amazing things both at the bedside and in public health around addressing and decreasing this topic, so I'm much more optimistic. Nothing. Well, thank you everyone. It's really such a pleasure to come back home and I just want to thank Gil because he's been a very important figure in my career as well. I understand now why I'm sitting in the middle here because I'm a frameshifter in a way. I don't ever really adopt one frame and I've had three maybe major frames that vacillate a little bit between some of the ones we've already heard. I started off my engagement with this issue of guns and gun rights. When I was here at the University of Michigan I wrote a book called The Protest Psychosis that looked at basically the over diagnosis of schizophrenia in black men and the ways that the angry black man have medicalized threat through representations of people like James Brown and Malcolm X and things like that that all of a sudden black men who were angry and protesting were seen as insane. And part of the story I told in that book was a story about what happened when black men tried to access gun rights, making an argument that the Second Amendment applies to everybody, we have a right to protect ourselves and in fact a lot of the people who were trying to protect themselves need to protect themselves. People who are political leaders like Robert Williams and NAACP chapter head in the Carolinas, Malcolm X and Stokely Carmichael and other people were basically saying the police aren't protecting us. We have a Second Amendment constitutional right to protect ourselves and the government is tyrannical because for them it particularly was and what happened when these black political leaders tried to access firearm rights was all of a sudden the full weight of the government really came down on them. They were all to a person, this is what I'm going to show in the book diagnosed with schizophrenia locked away or chased. Williams was chased to Cuba and factors like that and so it was this kind of complex story about the relationship between gun rights gun control in a way and I do tell part of that story of what happened in California when the Black Panthers tried to get guns and what happened to them in a way and part of it is I started with this particular story about the history of guns and race and mental illness. Somehow as part of that the second phase of my career then was all of a sudden there was a standard ground shooting in Florida and Zimmerman case and Trayvon Martin all these factors and I started getting called into media to talk about that particular shooting and the racial politics of that shooting and kind of this trope of what happens when Black boys and men are seen as threats and that somehow led into me getting called as a psychiatrist into pretty much every single mass shooting which is why I spend a lot of time in the gym de-stressing after going I mean I enjoy this but everything from MSNBC to Fox News and pretty much everything in between and so I became a kind of voice about this relationship between guns and mental illness and I really started going on media a fair amount to basically say that the same stigmatizations that were happening about African American men were getting applied to people with mental illness I think that there's real stories we need to tell after mass shootings but one of the stories that the media tells again and again is here's mental illness and here's mass shooting and there's a direct line, a causal line and so what I tried to argue is there are all these other stories that play out in mass shootings, gun access carry a gun, who gets to stockpile a gun things like that and so I started doing a lot of media and this media story really I think took off and I ended up just getting really interested in this question of guns and politics and ended up transitioning from media into becoming the research director of a gun policy institute in the south it's called the Safe Tennessee Project and similarly it's a bipartisan policy institute that tries to form centrist bipartisan consensus about reasonable reasonable gun reform I'm so heartened by the existence of this well the thing is we have people all over the place and the thing is we started we thought we'd start with low hanging fruit so we started with celebratory gunfire in other words you get a yee-haw you know up in the thing but turns out there's this dude Newton who figured out like when it goes up it comes down and people were getting hit by these bullets coming down so we had bipartisan support for some particular bills that came in so I've seen what happens there are divisive factors that want to keep us away you know keep us from forming any kind of consensus and that for me the second lesson I've learned is about the forces that want to keep us thinking that there are only two options about you know either pro or anti pro or anti and it's really frustrating if you're doing on the ground work but actually people are complicated and they're not just that but there are forces that really benefit from keeping us polarized and then I'll just say if I have one minute left I've been a scholarly part so I've been trying to reach out into the policy realm I've done writing for the American Journal of Public Health and I have a book that it's coming out in a couple of months that I'll be back in Michigan in April giving a talk about where I went through the south I'm from Missouri I went through very rural Missouri talking to people about what guns meant to them and really trying to get a sense really about the scourge of of white male suicide in southern pro-gun red state areas and again what I found was frustration because when I talked to people and I didn't use the charge words like gun control or even gun rights or stuff like that what I found was that there was there was a much more nuanced rich picture of what's happening that people were I'm for the NRA but I'm for a gun safe or a gun lock I want to be able to keep my community safe factors like that and so I developed a real frustration about the ways that polarization is enforced in this country and really people benefit from this polarization in a way that I feel like common sense people could and if I could just say one last thing it is just to add to lead into the next it's that another thing I learned from this is also that things like the Constitution and the Second Amendment they're not the document hasn't always been the same so part of what I learned in the history is there have been multiple reinterpretations we're about to see another one about the Second Amendment and so in a way there are political shifts about how we interpret the Second Amendment I think are part of the issue that was great and actually you've all touched a bit on the next thing we want to talk about and that is do you think from your perspective what are the ways in which this issue is talked about that you think are the most unproductive polarizing not moving the conversation forward that you just wish the media would stop doing or advocacy groups or policy makers and then of course the corollary to that is what do you think will be the most productive ways to have these conversations and actually move conversation and potentially policy action forward Rebecca we'll start with you and I think you set this up just beautifully for me so the polarization is not necessary and people not only people but solutions are much more nuanced than many forces would gather us to believe and I've been my stick lately has been if you can walk away from one thing or as you write if you can never write one thing again the word gun control needs to be eliminated from our language we don't use it if you know back to my historical roots here as an injury prevention researcher if I told you I was going to talk to you about car control you would go like this if I said to you I'm going to talk to you about control of any other thing there's no health behavior technique it starts by thinking that you're going to get consensus by telling people that you are going to talk to them about control and controlling them it is a frame that is not particularly helpful at all and not really consistent with the way that we think of injury prevention science which is a science in any other framework we think about safety so we have car safety we have fire alarm safety we have there's a safety frame with this and with that frame we automatically start with a common understanding which is guns are going to exist in our culture cars are going to exist in our culture and now together we have to work towards how those things are going to be more safe and how we're going to have less children dead for example and so when we talk and we talk extensively with stakeholders across a political spectrum as well and I have yet to find a single NRA gun member who says I really like his grandchild to end up dead from a gun we all agree that we would not like to have children and teens and other folks dying inadvertently we're dying at all from guns we think about a safety frame and so that's my shtick on frame change thank you I mean I'll just rip off of that because for the book that I have coming out I actually went and talked to people who lost grandchildren from self inflicted or accidental gunshot wounds and they still were equally they were just as pro-gun before as after and so for me I think that there are some important lessons I mean one I would just say is I think that you've kind of touched on the pressing issue for our time which is how do we work back from these positions and it's much much harder than I think we expected I've done a lot of work looking at just the meaning of guns within people's communities and what it means and people really feel like it's almost an extension of their identity some people there's a history to it and there are other people who are mortified at the very sight of a gun and so in a way it's become this kind of Rorschach test where the politics of it are so polarized and as I mentioned before there are profound financial interest in keeping us polarized and for me one of the most frustrating parts of all of this even when and again I've done conservative that if you give an inch you're going to give a yard and with all respect I feel like actually this rhetoric has to this point maybe not going forward but I do feel like in the gun violence prevention community there is a move toward saying the second amendment exists we're not going to take away anybody's guns but a lot of people that I've interviewed basically said if I agree on something I actually maybe agree on like I'll give you an example after the Las Vegas shooting the shooter used a bump stock right a bump stock turns a semi-automatic weapon into an automatic weapon I don't know how many people here have eaten dinner of an animal shot with a bump stock but it's basically entirely lead you couldn't possibly do it so there's no real hunting reason to have a bump stock a bump stock just makes an instrument more lethal so I think that there were people there people I interviewed who said yeah I could probably see bump stocks I could see safety locks or something like that but there was a fear I put an inch in a way was going to be to give up the whole farm and I really feel like that's part of the issue that frames like public health have had a hard time accounting for because on the other hand there are frames like Daniel Webster and his group from Johns Hopkins does amazing work on gun violence prevention they went into Missouri they found out that a particular bill in Missouri that was passed in 2008 in 2008 led to a whole host of other changes and their argument was that they should go back to earlier laws and implement more gun control but they never asked the people on the ground what does your gun mean to you or something like that so the minute this policy research came out it was immediately immediately rejected by people like lot and other people who write about pro-gun policies on the right so I think that it's interesting for the students here if you're thinking about studying gun policy it's interesting to see the relationships between what happens when a gun study is published and the response the different responses and the way it's framed in different medias and things like that and I really think that that is a problem it's really a problem to be addressed and we haven't done a serious enough job of doing that but again I also would say that just to say what I've said five times already we also need to really pay attention to who is keeping us polarized because I think that's as important part about this am I over time already don't worry stop looking at me yeah and so the last the last part about this I would just say is that the two frames I think we need to think about going forward also obviously there's the academic frame where we're talking here but I do feel like part of the issue of what's happening and it ties to some of the issues that people have talked about already is the relationship between activism we're seeing a lot of gun activism right now you know mom's demand and every town and groups like that and after you know the parkland shooting a lot of vocal feelings and sentiments about guns so there's the activism realm and then there's the legal realm and the legal realm is really where people's everyday practices are being shaped right what's happening with the Supreme Court just took its first gun case in ten years that's going to really influence how people own, carry, transport, buy think about guns in this country and so part of the issue for me is that the activism realm and the academic realm also but I think we need to pay more attention on a certain side to what's happening in the legal community because I think that really at the judge level it's just interesting for me that there's not the same level of activism about the legal cases when really that's what's going to shape how we engage with guns really across the country. Exactly I would say that kind of going off of that I know that I am the person here who's from the media so I am not speaking on behalf of the media because I would need to consult a whole lot of people first but I do think that you mentioned the term kind of Rorschach test and that we use the idea of guns as kind of to tell you everything else about someone's political priors and that there are certain groups that really kind of want you to do that and you see that I've done a ton of reporting on the NRA and the NRA's current financial situation which is not great but part of that has come because the NRA decided in some ways once it became in the 1970s which it was kind of a sportsman's organization you were going to go out and hunt buck or you're going to go out and hunt deer or something like that and this is the organization that was for you it turned into a and I think that this is something people have said that oh this is a new thing it's not new you know how the NRA has become in some ways it sees guns as a cultural issue and you know we saw this in the early 1990s in which Wayne LaPierre head of the NRA described the FBI as jack booted thugs causing former president H.W. Bush to resign from the organization and you see that kind of the transference of guns onto other political perspectives which for one thing it kind of removes the interesting and you were talking about that tension a little bit you know there have been a lot of people and groups that have used guns you know they're the pink pistols an LGBT group that kind of groups in San Francisco in the 1970s and 1980s that were like well you know to respond to gay bashing perhaps this is our best means of self defense but then there were also you know certain Supreme Court cases like the last gun case as far as I know that the Supreme Court took up DC versus Heller that is about the issue of you know African-American gun owners and what kinds of guns and how guns can be owned in the District of Columbia which is actually where I live and it's interesting because I think that when we talk about guns and gun policy a lot of times we're not talking about guns we're not talking about you know the specifics of bump stocks which I think is such a fascinating issue because that is one where this particular administration has moved away from the position of a lot of people within the gun rights community the NRA went with the administration the gun rights community has not in the gun rights community is suing the Department of Justice over the bump stock ban but it is interesting how this conversation it has become a political one in a lot of senses in a lot of ways it didn't need to be and you were talking about kind of that enforced polarization that you know when I talk to people who about for example a child access prevention laws generally they act after the fact but they would in sense punish the parents if children got access to their guns and then did something with them 27 states have such laws however in a lot of those states the age at which it is applicable is insanely low so for instance in some states if you are a child under the age of 11 and you use a gun to do something then your parents could be held responsible but for someone older than that that's not applicable but when I talk to people about that you know and they were like okay this is a former policy in which I think gun rights advocates could kind of get behind one that pointed out that it was retroactive so it wouldn't necessarily stop a mass shooting but then you know I remember someone told me that you know for a lot of us we basically take the idea that as you said one step is a mile and their view is basically molon labé like come and take them that any step any step whatsoever is giving in to your issue and I think that that is an example of the polarization because you're not you're not thinking about guns as we think about cars, you're not thinking about guns as something where it's like yes you can own them but we also need to have safety mechanisms insured so that children don't use them or they're not mis-fighted or something like that it's almost viewed as if the gun is an extension of your politics of your beliefs and by curtailing guns you are curtailing politics you are curtailing expression in a sense and I think that that's made this conversation really difficult to have and especially in a media environment that really wants to generate conflict it's difficult to have someone say well on the one hand on the other hand it's complicated that's not a very interesting viewing experience for television for conversation and kind of how guns have become kind of a slang way of getting to know someone's politics when they really shouldn't be I think that that's something that's been a really big hindrance to this conversation going forward Thanks, I want to remind you all that we will be having Q&A with the audience coming up soon so write your questions on the cards and also for our online audience we welcome your participation as well and if you have a question or something you want to post to the panel you can do that through Twitter with the hashtag policy talks okay we're in a school of public policy we like to talk about policy so to our distinguished guests here's your chance what are your top two the highest priority for reducing the suffering, pain, toil and cost that gun violence has in our society and it could be something you want to promote it also could be a policy recommendation of something that should not be pursued Jonathan okay well I'm going to just do the thing that Jane said not to do which is I'm going to give you either this or that so I will say that on one hand the answer to this question is really not a mystery it's not related to injury and death just do the opposite of everything we've done in the last 10 years in a certain kind of way and the reason I say that is because there are just clear lines clear graphs between the effect of particular state laws the number of guns in circulation and just the kind of shootings I live in a state Tennessee where we've made it easier if anybody wants to come visit me open invitation I should tell you that I live above a bar and I think about that a lot because one of the laws we passed in Tennessee is allowing loaded handguns into bars people can just bring their guns into bars and again I worry about the guy who's just like I just got a raise you know that kind of stuff and I want to make sure I have a bunch of rugs down or something like whatever will stop it so if you care about public policy public health things like that don't let guns into bars right because people know that there's about a 5-7 chance more likely chance gun related injury and death if there's an argument and there are loaded guns around if you want to stop partner violence for example there's a much higher chance that somebody has a history of partner violence is going to shoot their partner so if somebody has that particular history you don't want to make it easier by avenues like what's called permitless carry reducing the power of background checks things like that because people who will flag on an idealized idealized background check there are people who have history of domestic domestic abuse and things like that and they're at higher risk of shooting their partners and I could go on and on about this and so I think the take on point just from a policy point is on one hand I think if we nationalized the background check system and closed gun show loopholes and did things that made it more uniform across the country so you couldn't transport guns across straight lines and things like that I do believe the research that shows that states that have more strict background check systems and tighter regulations have less gun related injury and death by roughly 50% and I've done a pretty deep dive into this research and I will say that if injury and death is your frame that there's no huge mystery and you can actually go back to the articles that Kellerman studies that actually started the so-called CDC ban in the first place they're not incredibly controversial Kellerman argued in the 1990s that homes that had guns had more shootings that's basically the the corrects of it more partner shootings more suicides and you think like it would be harder to have more shootings in homes that don't have guns it's kind of a little bit self evident in a particular way but there was this tapped into something really really deep that tied into this question of identity and factors like that so I guess point number one is illness is injury and death there's not a huge mystery I don't think about I mean we're in this debate about these particular policies but we have policies that work if it was just about illness and death and injury and death look at New York look at DC look at other cities that relatively have been able to control certain gun markets and you'll see that they have less of particular kinds of shooting less partner violence less gun suicides less shootings of police people the police getting shot things like that so that's that's on one hand on the other hand I think that I think that there's a lot of a lot of concern among people I mean it's just funny that people on the very very pro-gun side who I talked to they reject public health out of hand they argue that it's a tainted government model that the goal is is underlying there's an underlying kind of underlying anti-gun bias in public health and things like that and that's been the case really since the 1990s here in a way and so I do think that it's very incumbent on public health if it really wants to make a dip a dent here is to also look at the meanings of guns in pro-gun communities and to try to think about ways to engage those policies and there are many pro-gun communities obviously and things like that but I do think that for too long we've been looking just at illness and death and so I think that that's an important a very important point of this conversation and I I guess my take home that I argue kind of controversially in the book is that if we can solve the question of what are the policies that are going to work in different pro-gun communities we can actually solve this problem nationally too often we're trying to implement policies that are of no relevance in pro-gun communities and so I think that's what gets us down but in a nutshell more background checks and gun violence restraining orders so that people can identify their relatives who are at risk I think those would be for me the two that would be they would probably cut gun death in this country by at least a half yeah I actually I think the issue of gun violence restraining orders is such an interesting one because that is one where I've seen conservatives say like okay that is something that we can work with I mean I think that it's and I'm so glad we're having this conversation because I think that even the internal mechanics of those policies for example a gun violence restraining order involves going to a judge and saying like this person should not be permitted to like to have and possess guns and I think that that gets into all of this is going to get messy and because you are dealing with the internal lives of individuals and I think that that's one of the you know when I was thinking about how best to answer this question you know I'm thinking oh are we talking about you know intimate violence are we talking about mass shootings because I think that there are different policy priorities for both of those because both of those have different models I know it's not necessarily a policy priority but something that I've noticed and I think it's a good thing that people in media are doing is that one of the issues that we see with mass shootings is that mass shootings create their own hagiography and they you know we saw that with Columbine I mean even the fact that I can name and list off like a place and shooter in a number of of mass shootings that have happened since I'd say with 1997 1998 there is a move in media to stop doing that to one largely do not publicize the names of shooters and do not you know try to really focus more on what has actually taken place and the people who have been lost because I think there's been some really interesting research on the copycat effect that you start seeing from certain mass shootings but I think in when it comes to and I'm going to use this term everyday shootings and I don't mean to be flip in any way I just mean shootings that are more likely to be something over an argument or something that happens as a result of domestic violence I think gun violence restraining orders are really important I think child access prevention laws however the fact that they work retroactively I do think that that is an important perhaps touchstone to begin talking about how parents are interacting with their children with relation to guns we've had multiple recent cases in which someone you know I believe it was actually a case in Nashville Waffle House in which the shooter in that case he had had his guns taken away the guns were returned to his father who then returned them to the child in question and this person I believe the person in that case was 19 years old so Tennessee has a cap law but it doesn't apply because he was too old and so I think that these question you know I think cap laws and gun violence restraining orders are important but I also think something that's important that I would want to prioritize is occasionally when we're talking about you brought up the point of like talking to pro-gun communities and talking about how they feel about guns and gun laws that work for them because something I've noticed a lot in my reporting is you know when you talk to some folks in the conservative movement how they think about guns is very different from how they think people who own guns in other communities think about guns so their guns are very much like this is my means of self defense whereas you know you get the kind of what about Chicago that like they're using guns to be terrible and shoot everyone whereas if you go to talk to people who are living in environment you know in Baltimore elsewhere who are interested in owning guns they're interested in owning guns for the same reason that someone in Dubuque Iowa or somewhere in Boise is for the interest of self defense or maybe because like they want to go to a gun range at some point so I think that while we are talking about you know nationalizing policy priorities we also need to kind of in some ways while talking to communities about guns we need to make sure that communities understand that they're not as dissimilar as they think when we're talking about these particular issues you know I think you get the sense from some folks that you know while these urban areas that see gun violence it's happening for very different reasons than gun violence is happening in suburban or rural areas I don't think it is I think that like the same human impulses exist in a lot of these different communities and I think that we should be able to talk about guns across communities in a way that's a lot more effective on stopping gun violence and not doing so much you know kind of division and polarization even among people who also own guns so you set me up beautifully again so one of the other yeah one of the other things we've been looking at lately in data is exactly that polarization there's a concept that firearm violence and injury and death happens in somebody else's neighborhood more and there it's really a problem and the data that we looked at last year found actually for kids and teens the rates of kids and teens dying was pretty much exactly the same in suburban America and in rural America and in urban America the mechanism is a little bit different in 10 we can talk about that and where it's suicide and where it's homicide but essentially those rates are in everybody's backyard and are everybody's the same and that's how you start to get communities when you say we need to get communities talking that's exactly right we're not going to get anything to happen until we get the communities talking until now there's really been no ability to have any conversation with that so as to what we think we can do I mean I sit here first of all with a research hat on and then second of all running our consortium and when we think about I heard you mention a number of times you know we know and this research shows this about policy and we know this research and the data shows this and my reaction to that is we know almost nothing because there's been virtually no data so our ability to have any of these conversations has been almost 100% in a vacuum so a little bit of comparison for that trend graph in front of you so over that last 10 year period we spent about a billion dollars on motor vehicle crash prevention research we studied a lot of it all over this campus we have an entire building on this campus dedicated to transportation research and spent a lot of money on it in this country the number three cause there is cancer we have an entire cancer institute on this campus and in fact almost every major medical campus across the country has a cancer institute and we spent a billion dollars over in the last decade trying to figure out how we were going to keep people a lot more safe from those two problems and decrease injury and death in that same time period for firearm violence we spent about three million dollars and as opposed to the 3,000 grants that were instituted for those other causes of death over those same 10 years we gave out nine grants in this country and the people that you mentioned you have been doing a lot of work on actually looking in the policy as has Daniel Webster and I could name the other three on my hand because there hasn't been any money for anybody to actually do any of that policy analysis and people have been scraping by trying to in their closet heart practically with dollars scraped together look at something and then been too terrified to actually publish it because they're afraid that they would then be blacklisted and it's only post ten year people also and only post ten year people like ourselves who are willing to even begin to have that conversation over the past four or five years ten years ago I couldn't get a single junior faculty on this campus to even begin to think about having a conversation because there was no career path in that one can't get promotion in tenure in any major academic institution without grants and with funding so therefore there is no career path here so Dr. Cunningham I will study something else thank you very much so if we're going to do something different and we've seen this lately beautifully with the opioid crisis we've decided in a bipartisan way that we do not want this many people dying from opioid overdose which is as complicated a problem as stigmatized a problem and has prevention and interventions that are as confusing and messy we are dumping millions and millions and millions and millions of dollars into this and all of our communities and making it a priority and with that we are bringing people together in a public health way and in a medical way that we don't usually do at all and we are making some real progress and inroads and we're near the top of that epidemic yet but we're starting to be able to have the resources to address it and if we gave even part of that amount of funding to firearm violence we would have a lot of brilliant people coming up with a lot of brilliant solutions to that I go back to this concept and it amuses me in the media and it amuses me in policy conversations there's no other firearm injury prevention is a science in the end and there's a science to the policy and a science to the policy analysis and a science to the writing around it but there's no other science debate that we have where we think two guys essentially two women whatever sitting on a corner or in a bar are going to talk together and they're going to say oh yeah I think we should do this I think we should take away everyone's guns I think we should people have too much mental health problems that's the problem where is the data on any of this we don't know that's not the way we came up with solutions for cancer there weren't two guys sitting in a bar who dreamed up safety seat belts they did a lot of testing and a lot of airbag testing and a lot of science and came up with what the best versions of those were and then they tested them in communities and implemented them so when you get back to we need to have communities talking to each other we do those are focus groups that's basic social science and we need to do focus groups and then we need to do analysis of the focus groups and then we need to publish the answers to that and then we need to do the policy analysis on that and figure out what worked and what didn't work and all that takes funding and so one of the biggest things we really need is a massive inflex there is not a ban on federal funding I have an NIH grant for firearm violence prevention there is not a ban on it there's not much of it at all at the CDC right now there's not a ban on it at the CDC either but we don't have enough funding for it in addition to that I think some of the other basic things that people are talking about right now that I do think are important like child access prevention laws are important to get behind even though they're not implemented evenly we don't really understand even hardly how they're implemented everywhere because there hasn't been very much writing nearly enough policy analysis about it they're suggestive to work certainly they could be implemented a lot more evenly but this morning I think in Seattle a 4 year old picked up a gun that was loaded that they found under the mattress in their parent's house and shot their pregnant mother in the face so how did that why so I had two questions with that and this happens a lot we see 100 unintentional children die by unintentional firearm death like that every year by inadvertent discharge not accidental you'll never hear me say the word accidental either inadvertent questions come to my mind whenever I see those now which are one whose responsibility is it in our society to have that 4 year old not have access to a loaded gun and how serious do we want to be about that and then two is this other thing that you got to which I think is really important when you talk about why people own guns across communities and it does have to do with fear why does this young family with a 4 year old and a pregnant mother feel they need to sleep with a loaded gun under their bed and when we start to get at those two causes two issues we'll start to really understand how to address this better and that's going to take a lot more time and a lot more resources thank you ready for audience questions and Q&A I want to remind our folks who are watching this online if you have questions to use twitter and tweet them using the hashtag policy talks so now I'm going to turn it over to two amazing Ford School students we have Senior Marina Deedon and MPP student Steven Oliphant who are going to be helping us get through all of your amazing questions hi I'm Marina Deedon I'm a senior here in the Ford School I have done a lot of work both inside and outside of a classroom on anti-gun violence two summers ago I worked in DC with Giffords which is a non-partisan anti-gun violence organization and I've been reviewing your questions my name is Steven Oliphant I'm a second year graduate student here and I'm an intern with Dr. Cunningham's firearm safety group so the first question I think Dr. Metzl has touched on this a bit but the two part question is at the state or federal level I could see bipartisan support in the near future and the other aspect of the question is should we expect and or advocate for differing solutions from state to state and city to city I can go first well I think the first answer it depends on what you mean by near future because the near future to me is no and I think that that gets to the point we use guns as a Rorschach test for political priorities across the spectrum so something that will come across as I brought this up in a class earlier that there is a phrase that I have learned does not really mean anything it is common sense X policy so whatever people start talking about common sense gun policy I'm like this isn't going to work because what is common sense to you in your political priorities is not going to be common sense to someone else so I think that however I would say that well I think that that's generally true at the federal level I do think that the state and local level can be more receptive and I think that that's because the joys of federalism are that you can have a legislative or legal priority at the local level that might not be something that is done in another state now obviously we've seen time and again that occasionally that obviously gets held up in court but I do think that there is merit to some states and some cities having differing not necessarily gun laws but just kind of gun priorities and I think that that comes from the research that you were talking about it is time to do the research that's not necessarily talking that's not necessarily attempting to steer in a specific direction which I think is where you get a lot of concern among the kind of gun rights people or my kind of more gun supportive groups that research is leading into a specific policy direction or trying to kind of lean into that but I do think that there is room to talk about why is a family of four keeping a loaded handgun under the mattress like what is the priorities or the safety and security priorities of that community as opposed to a community that's different in which people still have loaded guns under the mattress even though they're in an entirely different social and economic context what is that about where are those questions and so I think that there is something to be said for different localities having differing laws and I think though there have been a couple of those laws that have been used in the most recent Supreme Court case that is going before the court is focused on New York gun law and it has to do with the transportation of guns and I think it will be interesting to see what the court says about that because that could kind of render this conversation somewhat moot a little bit but I do think though at the near term I don't think there is really any gun policy move that can be made on the federal level that would go through congress I will say that the bump stock that was kind of signed in and that was done via the Trump administration and the department of justice and obviously that's going to court but that is another means of creating a policy it just doesn't involve congress because congress can't do anything right now so I'll take a quick swat at this I'll be much quicker than emergency physician in me is very quick take your time I think that there are things that are more palatable and how we start to get to a place where we can have a conversation about what can be done and some of those areas and you've heard me touch on this a bit are around children and teens and are around child access prevention laws I think we'd have a hard time finding much disagreement that four year old shouldn't have access to loaded guns so I think we need to start with some of the places that could have immediate agreement like that there's one place to start the other place that has I think more hope and we're seeing the sum in Washington now is around domestic violence restraining orders there is more agreement about folks with who are at risk for domestic violence being able to have the lethal means restrained we know 50 women a month die by gun by their partner every month in the United States and we can probably do there are some simpler pieces as a way to start inroads into that and again Washington State has started we're seeing a massive increase in amount of people asking for those restraining orders to be put in place with firearms now they have to be done in a way that is enforceable so women have to believe that when that happens and they go to the extra risk that they're putting themselves at to suggest that that gun needs to be taken in a way which is likely to increase the anger of their partner a fair amount that they will then be protected by the law and not have that fear and so that's where that needs to play out a little bit and then we need to study that a fair amount which will require policy analysis and data acquisition and we have some folks now combing through those those requests in a qualitative way and understanding what actually is happening with them so I think those are the easier lower hanging fruit places to begin well I'm a clearly liberal centrist democrat and so it's funny that I'm about to make an argument for states rights but that's kind of the nature of the federalism it's a wonder that's the moment we're living in right now but I will say that I just want everybody in this audience to remember this moment and this question because I think it is the urgent question that's kind of face us as we move forward with this question of guns in America and the reason I say that is precisely because the Supreme Court has decided to take up a seemingly small case in New York it happened beneath things that are probably more important to everybody like what did Trump tweet and blah blah blah stuff like that but something huge huge happened a couple of weeks ago which is that the Supreme Court has not taken up a case like this in ten years right and the case is seemingly a small one you know eight people in a small gun club in New York can take their guns from one place to another and you would think oh my gosh you know whatever let them take their guns or something like that but an issue much more broadly is does a city like New York have a right to set gun policy in the context of New York City right and so in a way this is a kind of gateway drug test in a particular way to a much broader issue which is do regions and states have the ability to set their own policy and I've seen this in the research I've done in the south for example Missouri for example 2008 had among the strictest handgun laws in the country you had to go to the sheriff and get interviewed in person or sign out a thing a seemingly small bill that just said you can just don't have to go in person and everybody's like yeah no big deal but it led to a much bigger constitutional issue which was do states have the ability to do that and I really feel like that issue is really what's at stake here that happened in the aftermath of this New York case and I urge people who are interested in this to look at that 2010 DC case because there were liberal judges there were conservative judges and then there was one judge who was far to the right of the conservative judge who basically said DC Second Amendment trumps everything else and DC has no right to set any kind of limitation this was about AR-15s in DC DC has no right to legislate where and how people can carry AR-15s and the judge you might know him Kavanaugh and so we've got people on the Supreme Court who have already gone on record in this issue and I do think this question of does a city like New York now say what you will I'm from Tennessee right, if I go to New York I can't load up my suitcase with a bunch of glocks and bring them into New York because I'm governed by the laws of New York New York has its own regional thing and that's important I'm a tourist maybe Times Square, New Year's Eve I'm running around with glocks but also when I go home I bought a bunch of stuff at Bloomingdale's I don't want these glocks anymore I want all the crap I bought so I'm just going to offload my guns and gun marketing it leads to all these other unintended or intended consequences and so I do feel like this case that's in front of the Supreme Court now has the potential to shift gun policy not in the south where it's already happening but in areas like Los Angeles and New York that have had these issues and I really urge people to pay attention to it and I think the correlate for me I'm thinking about like what it must have been like if you were in a totally anti-abortion area and in a state and people were saying gosh this road versus way thing is coming down the pike and people were like no we're going to have our own regional regional ways to stop it but the minute something becomes embedded into the law the way into into what's about to happen here you really limit the abilities of cities and states and so really I think if you're going to pay attention to one issue going forward it happens in this New York case because it has profound profound implications for as you say making all of this moot and really stopping the ability of locales for really making their own policies that work for them that was uplifting so the next question has to do with the framing of this issue and how we talk about this issue like what do we if we're not saying gun control what are we saying and also how do we communicate the right data the good data on this subject when some data has been you know created by some more dubious research firms and basically just the effective messaging of this issue that leads to improved public safety so I think safety is the word safety implies that the item exists and we are going to work with the item as it is in some form or another to make it more safe and I think that that's the frame it's a less threatening frame and that's the messaging that I would wildly incur you had a second part was your second part of your question there the I guess about like the data and can data change minds of hearts yeah so facts are loose these days I think it's important to work from the best data the best data that we have the way we're going to get the most accurate data is to have better funded research so you know if you want to have the best cancer drug injected and when you're told that you have terrible life threatened cancer you want the NIH to have done a lot of really rigorous studies on that and really investigate it at fair amount about the data that comes out of those trials we don't have high quality research for a lot of firearm work right now because there hasn't been enough funding for it to make that happen and then I think with anything data can be misconstrued data can be twisted I think we all do we all move whatever field of research forward to the best possible way when we try to speak to the data that exists and not touch that and not bias it which is difficult on a good day and we're not really in a good day for facts yeah I would say that how we communicate about guns and even when we do is I think really telling when we talk about guns as a policy issue because a lot of times we start talking about gun policy when something terrible has happened like specifically a mass shooting and we saw that after Parkland we said that pretty much after every well-known mass shooting that that is the time to have a conversation about gun policy when technically we should be talking about gun policy at all times I think that you know there's never a better time to talk about the real issues at hand with preventing gun violence within the kind of the strictures of our available constitutional system and I think that you know focusing on that safety framing is really important and it is it's such a good framing that it's one the NRA itself uses because it has used the argument that had with regards to school shootings for example the NRA has something called the school shield program which is basically an effort to encourage schools to both take part in kind of defense mechanisms including things like getting rid of windows in schools but also involving arming teachers which itself is incredibly controversial but I do think that the idea of education and safety being the same and talking about it in the same way you know I was really glad you raised the point about how we don't say car control because it's just something you know we recognize that car you know unless we're Ralph Nader we recognize that cars aren't going away but I think that there is an idea and I think that this also has to do with how communities differ you know I come from you know my parents hate guns we I had never touched a gun until I like started doing this reporting and actually went to a gun range in Virginia and was like oh this is like it's a thing that people go and do it's very different and I think that there are a lot of people especially you know in journalism who have not had that experience or vice versa they come from a long running like family tradition of guns and gun ownership and can't imagine why people would be at all concerned about guns being in homes and so you're coming from these radically different contexts and there's really no crossover but I do think that the bridge could be to talk about safety and to talk about these issues when they're not spurred by news because I think that you know there's an argument and that you know kind of that do something policy typically it doesn't go exactly the way you would hope and I think that reacting not necessarily to events but to kind of ongoing issues like the crisis of intimate violence that we've pointed out on this panel and kind of the ongoing issues that are caused by access to guns particularly for children and teens I think that's a better way to go to think about safety and think about how to communicate that across kind of partisan and ideological lines I'll just finish that and just say I mean A I agree and B I just want to be clear I'm not making in any case in any way an argument against expertise we need more expertise we need more research we need more funding but I think the moment we're in right now is one in which the danger is not about the lack of expertise we have it we have the potential we need more funding I totally agree it's about vacuums and silos in a certain kind of way that I think that any policy intervention needs to also I mean I think that policy scholars and public health scholars and legal scholars and critical race theory scholars all have to be working together in a particular way right now that even the best policy intervention by itself without taking some of these bigger issues it raises the risk I think of not looking at the ways in which we're just not living in this moment where oh I learned that the apple falls from the tree and therefore I'm going to therefore do all this things we're not living in an incredibly logical moment we're living in an incredibly anxious moment and we need to combine different forms of expertise to address this and so really is the moment of alliance particularly between policy and law I think because that's where a lot of this is going to play out but also other forms of expertise that tie into all these trends you know history and all these other factors so I really think that that number one that that's the issue and number two is just back to Jane what you were just saying I do think that the the NRA has been such a dominant voice in this particular in this particular domain far more than anybody realized it's not just about how they how they recognize how they they have politicians who are aligned with their interests and judges it's also about the ways they tap into these anxieties in which no matter what the anxiety is guns become the answer and a perfect example of this I would say is the NRA ads that happened after the Black Lives Matter protest and things like that where all these there were all these NRA ads where they were literally showing exactly the history that we were talking about before of urban unrest in Watts and Newark and things like that and the NRA spokespeople were actually showing the Clint sign of the Clint Fist which was the Black Power sign at the time but they were saying this is our moment and things like that so I feel like without that kind of cross-disciplinary expertise we're really at risk of those kind of polarizing messages. I think also if I can add one thing before we go on to the next question is there wasn't a balancing voice across the vast medical community essentially over the past 20 years. Physicians largely for the last 20 years wouldn't say the word gun or NRA out loud at all and that tide is changing now some and are more willing to speak up with the this is my lane movement etc and with that you have a tide of voices who now can begin to speak some from that more health perspective that were just 100% silent for a really long time and the student voices which we heard raised up after Parkland and although I agree there's the mass shootings are have been a really interesting lightning rod for the country to gain attention on this issue and we're certainly horrific and are a call to attention but those to be used as an opportunity then for a discussion about a daily toll of violence that is affecting so many and that student group and that student voice balancing so we had very strong conservative voices only with one pitch for a very long time and we're really seeing now I think some of those other voices because it's going to take a culture shift to begin to think about this. Please. This will be the last one and we'll have to ask you to be brief here. So much of the media attention seems to be focused on mass shootings and interpersonal violence. This person notes however suicides via firearm-related injury are much more common so why has our priority of framing this issue shifted to note this? As a suicide rate climbs should we consider this a strategy to prevent gun violence? So when we talk about suicide we're talking about intent again and I like to encourage to people to think about the mechanism of injury which is the firearm and not the intent as much although to get at prevention strategies we certainly need to do to think about both. So I don't know it's in much of a conversations that we're not talking about suicide we certainly need to talk about suicide and suicide prevention. The evidence overwhelmingly shows us that for example if an adolescent is impulsive and has access to a firearm then they can complete that intent. If they don't have that access at that moment they likely will not go on to substitute and find another means and that has been Hemingway has shown that over and over again. So yes we need to talk about suicide and yes we need better access to mental health treatment and better access to get underlined root causes of why we have increased depression and increased hopelessness across much of the country absolutely but in terms of the actual completion of the act of suicide we have to talk about guns and immediate lethal access to that mechanism of injury. Well how much more time do we have? This is my entire books about this right and so I have a book coming out in March and part of what I argue in the book is that it's not just intent it's access right we just heard a story about access I got really drunk I found out my wife's having an affair I got fired from my job and there's a gun here versus there's not a gun here that changes the narrative right if you overdose that's fatal in 96 in 4% if you shoot yourself that's fatal in 96% so if you just take it in a vacuum the question of is there a gun around and it's not actually linked to mental health diagnosis right it's not people like Sylvia Plath or Kurt Cobain or people who have been seeing psychiatrists for their entire lives when you look across the swath of gun suicide it's also largely white men linked to demographic trends and gun ownership so it's not just a question of intent it's also a question of access but again there's a bigger frame around access which is why is the gun there in the first place and that ties into all of these other questions that we've been talking about and so I guess the other point I want to make is that you can't just see gun suicide or any kind of firearm related morbidity and mortality trend in a vacuum right these are all part of much much bigger conversations about race about socio-economic class about identity and so the minute we link it down and then just say this one moment this one particular anecdote or something like that that you're losing I think the bigger question so research that I have a piece coming out in the nature next the public the open access nature thing and I argued that research I'd love to see is like is there a public health benefit to owning a gun what do people enjoy about being a gun is there is there a pleasure now I don't ascribe to that personally and I'm you know I've spent half my life in New York I'm afraid of if one guy in the subway has a gun everybody's gonna have a gun so talk you know but I do think that in order to answer these questions we also need to understand what's sublime about gun ownership and in a way there's a bigger story that we need to tell without just isolating morbidity and mortality or we're just gonna continue to have this same really frustrating push and pull we have right now which is public health on one hand and gun ownership on the other and we just never seem to get anywhere yeah I would go off the same point because I think that when we're talking the question of suicide is like you were saying it's a question of access and a question of mechanisms because I think that what we're seeing with a rising suicide rate is especially the ability to complete the act in a sense and that happens I've lost friends to suicide by gun and I think that that is a conversation that really plays into how the issue of guns needs to be a part of a larger conversation and you know I was just saying earlier about how guns become a kind of a broushack test for political priorities but I do think that we can't remove guns from a political and social context because you know I've talked to a lot of gun owners and how they talk about guns is in such an interesting it's so different from how the folks I talk to at every town or mom's man talk about guns and it's because they have an entirely different context around guns and I think that it's the same you know suicide is such an it's a particular issue because a lot of times it's you are able to complete that act because you have access to that right then it's that immediacy but then you probably owned the gun for entirely separate reasons beforehand you know you this was not necessarily a part of the plan of you know when you got this gun so why did you get the gun in the first place in what context did that happen and you know I think that it's such an interesting issue because as you were saying you know it's gun owners versus public health whereas we have this potential to bridge we have this potential to have these conversations about the issues of safety and these mechanisms by which people are ending their own lives and it's really important to start asking the questions of why people are owning guns in the first place and then we can start getting into like what that gun means and what you know gun usage and gun ownership means overall thank you so much I am so sorry the bad news is we are out of time for today the good news is we have refreshments out in our great hall out there we invite you to come and join us the panelists will be coming as well we're going to ask you to our usual experiences everyone from the audience comes down here and our panelists can never get out to the reception so give them a moment let them come out we can continue conversations follow all these wonderful people on twitter and please join me in thanking them for a very provocative and wonderful conversation