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Private Guns, Public Health

David Hemenway

Publication Year: 2006

In this small book David Hemenway has produced a masterwork. He has dissected the various aspects of the gun violence epidemic in the United States into its component parts and considered them separately. He has produced a scientifically based analysis of the data and indeed the microdata of the over 30,000 deaths and 75,000 injuries which occur each year. Consideration and adoption of the policy lessons he recommends would strengthen the Constitutional protections that all of our citizens have to life, liberty, and the pursuit of happiness. -Richard F. Corlin, Past President, American Medical Association "This lucid and penetrating study is essential reading for anyone who wishes to understand the tragedy of gun violence in America and-even more important-what we can do to stop it. David Hemenway cuts through the cant and rhetoric in a way that no fair-minded person can dismiss, and no sane society can afford to ignore." -Richard North Patterson, novelist "The rate of gun-related homicide, suicide, and accidental injury has reached epidemic proportions in American society. Diagnosing and treating the gun violence epidemic demands the development of public health solutions in conjunction with legislative and law enforcement strategies." -Kweisi Mfume, President and CEO of NAACP "In scholarly, sober analytic assessments, including rigorous critiques of NRA-popularized pseudoscience, David Hemenway constructs a convincing case that firearm availability is a critical and proximal cause of unparalleled carnage. By formulating such violence as a public health issue, he proposes workable policies analogous to ones that reduced injuries from tobacco, alcohol, and automobiles." -Jerome P. Kassirer, Editor-in-Chief Emeritus, New England Journal of Medicine, and Distinguished Professor, Tufts University School of Medicine "As a former District Attorney and Attorney General, I know the urgency of providing safe homes, schools and neighborhoods for all. This remarkable tour-de-force is a powerful study of one promising solution: a data-rich, eminently readable demonstration of why we should treat gun violence as an American epidemic." -Scott Harshbarger, Former Attorney General of Massachusetts, President and CEO of Common Cause On an average day in the United States, guns are used to kill almost eighty people, and to wound nearly three hundred more. If any other consumer product had this sort of disastrous effect, the public outcry would be deafening; yet when it comes to guns such facts are accepted as a natural consequence of supposedly high American rates of violence. Private Guns, Public Health explodes that myth and many more, revealing the advantages of treating gun violence as a consumer safety and public health problem. David Hemenway fair-mindedly and authoritatively demonstrates how a public-health approach-which emphasizes prevention over punishment, and which has been so successful in reducing the rates of injury and death from infectious disease, car accidents, and tobacco consumption-can be applied to gun violence. Hemenway uncovers the complex connections between guns and self-defense, gun violence and schools, gun prevalence and homicide, and more. Finally, he outlines a policy course that would significantly reduce gun-related injury and death. With its bold new public-health approach to guns, Private Guns, Public Health marks a shift in our understanding of guns that will-finally-point us toward a solution.

Published by: University of Michigan Press

Title Page

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pp. iii

Copyright, Dedication

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pp. iv-v


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pp. ix-x

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pp. xi-xiv

When I was growing up in the 1950s, cars did not have seat belts, shatterproof windows, collapsible steering columns, or air bags. In high school, when schoolmates of mine died in automobile accidents, people said they were driving too fast or too carelessly. Perhaps this was no surprise, it was thought, for, after all, they were teenagers. In the late 1960s, I went to work for Ralph Nader, then at the height of his...

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1. Guns and American Society

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pp. 1-7

On an average day during the 1990s in the United States, firearms were used to kill more than ninety people and to wound about three hundred more. Each day guns were also used in the commission of about three thousand crimes. The U.S. rates of death and injury due to firearms and the rate of crimes committed with firearms are far higher than those of any other industrialized...

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2. The Public Health Approach

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pp. 8-26

During most of the twentieth century, gun assaults were seen almost exclusively as a criminal justice problem, gun suicides as a mental health problem, and unintentional gunshot wounds as a safety issue. Since the mid-1980s, it has become increasingly recognized that the most promising approach to reduce firearm injury is to emphasize prevention, focus on the community,...

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3. Gun-related Injury and Death

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pp. 27-63

The Centers for Disease Control and Prevention divides injury deaths into accidents (unintentional injuries), suicides, and homicides. This chapter discusses the extent to which firearms contribute to deaths in each of these categories, including scientific evidence regarding the problem, and examines gun use in robberies, assaults, and other crimes. The chapter also briefly...

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4. Self-defense Use of Guns

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pp. 64-78

The previous chapters highlighted some of the costs guns impose on society. But guns also provide some safety benefits. Guns may be used to thwart criminal acts, and awareness of their presence may deter individuals from attempting to commit crimes. But how common is self-defense gun use, and how much benefit do guns really provide for our society? This chapter...

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5. Location

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pp. 79-106

Gun use can occur in various locations, including at home, at school, and on the street and in other public venues. This chapter examines guns in these three settings, starting with the home. The first section describes empirical evidence on the actual and psychological risks and benefits of having a gun in the home, the way Americans store their guns at home, and the effects of...

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6. Demography

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pp. 107-129

Firearm problems strike different groups differently. For example, suicide is more of a rural problem, while homicide disproportionately affects city dwellers. Black Americans have about half the risk of suicide of white Americans but more than five times the risk of becoming homicide victims. This chapter describes the risk of firearm injury to four vulnerable populations...

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7. Supply

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pp. 130-151

In a gun's life span, four main opportunities exist for legal interventions or regulations to be imposed: (1) the time of manufacture; (2) the time of sale; (3) the period of possession or carrying; and (4) the period of use (Baker, Teret, and Dietz 1980). A comprehensive policy approach to reducing gun injuries includes sensible regulations concerning all four of these periods, but...

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8. Policy Background

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pp. 152-176

Prescribing reasonable and feasible firearm policies for the United States requires understanding the context in which American firearms policy is set. The starting point for any discussion of this topic must be the U.S. Constitution--specifically, the Second Amendment, which is sometimes claimed to limit possible policy alternatives. After examining these arguments, the chapter turns...

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9. Policy Lessons

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pp. 177-208

The public health approach is optimistic, flexible, and pragmatic and has succeeded in many areas. It emphasizes the wide array of policies that can be used to improve the nation's health. By contrast, gun advocates sometimes appear pessimistic, inflexible, and doctrinaire, seemingly unable to visualize more than a narrow range of punitive policy alternatives. Gun advocates also...

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10. Policy Actions

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pp. 209-223

There are a wide variety of reasonable, feasible policies that could reduce the firearms injury problem in the United States. To explore such policies, it is first necessary to understand the history of federal firearms laws in the United States, and this chapter begins with a brief description of these laws. The second section discusses policy prescriptions for the firearms problem. An...

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pp. 224-226

The United States has more guns in civilian hands than any other industrialized nation. We have far more handguns per capita, and a gun is easily obtainable by virtually anyone who wants one. Our crime and violence rates are comparable to other developed countries; what distinguishes the United States is our rate of lethal violence, most of which involves guns.

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pp. 227-260

Private Guns, Public Health was completed in the fall of 2003. Over the next two years, the scientific literature reaffirmed the conclusions of the book. What follows is a brief summary of some of the more important findings from the recent literature through the end of 2005. 1. GUNS AND AMERICAN SOCIETY Scope of the Gun Problem. The United States continues to have by far the...

Appendix A. Methodology

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pp. 261-285


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pp. 287-288


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pp. 289-334

Name Index

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pp. 335-344

Place Index

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pp. 345-347

General Index

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pp. 349-360

E-ISBN-13: 9780472023820
E-ISBN-10: 0472023829
Print-ISBN-13: 9780472031627
Print-ISBN-10: 0472031627

Page Count: 376
Illustrations: 16 tables, 3 illustrations
Publication Year: 2006

Research Areas


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Subject Headings

  • Gun control -- United States.
  • Medical policy -- United States.
  • Firearms ownership -- United States.
  • Firearms -- Law and legislation -- United States.
  • Gunshot wounds -- United States -- Prevention.
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