We should start looking at ways to reduce death that have nothing to do with gun control
- Gun control debates never go anywhere. But there are lots of other policies options to reduce death in the US, including gun deaths.
- Removal of lead from the environment has done a lot to make people less violent. But we have more de-leading to do.
- Safer roads, better alcohol policies, even putting lithium in the water - there are opportunities for consensus on saving lives.
Like all of you, I want less death. So Wednesday's mass shooting has me reflecting on the enormous and tragic social costs associated with lead.
Not the lead in bullets. I mean environmental lead - in our soil, water and air.
Kevin Drum from Mother Jones has been writing for years about the problems caused by lead. Exposure to lead interferes with brain development in children, causing all sorts of behavioral problems, including violent behavior. It also reduces IQ.
After World War II, as lead proliferated through America - in lead paint and especially leaded gasoline - children who grew up around all that added lead turned into the adults behind the crime wave from the late 1960s into the 1980s. And as lead was taken out of gasoline and paint, crime fell precipitously, across the country, regardless of the specific policing policies pursued in any given city.
But there's still a lot of lead left to be removed - even though cars aren't putting lead out through their exhaust anymore, all that lead from the 1970s stays in the soil for decades and decades. Lead paint is on walls and window frames in older apartments all around the country. And we've seen in the Flint crisis how common it is for American homes to still served by lead water lines.
A concerted anti-lead policy could lead to better child development, higher IQ, less violent crime, and many saved lives.
Obviously, de-leading is not specifically an anti-mass shooting policy, and I'm not claiming that Wednesday's shooter was necessarily affected by lead exposure. But most of the gun-control policies that get debated after mass shootings aren't specifically anti-mass shooting policies, either.
If our goal is to save lives, why not talk about lead today?
Gun control is not a promising avenue for an anti-death agenda
In a context where a large fraction of Americans want to keep guns in their homes, and where the legal presumption is that an adult should be able to own a gun unless the state can demonstrate that person's unfitness in advance, policies that aim to ensure the wrong people don't get guns are only ever going to be moderately effective. And we already have some of those policies in place.
Gun ownership is a constitutional right. It can be denied, but not simply because a government official gets a tip about you and decides you seem suspicious. If the suspicious person hasn't been convicted of a felony or a violent misdemeanor, and hasn't been institutionalized, what are those pre-reports the president says we need going to do?
All that said, I agree with Matthews that more effective gun controls, operating within the US cultural and constitutional context that presumes a right to own guns, might save several thousand lives a year, if it were politically feasible to pass such controls.
Closing background check exceptions would cause some dangerous people not to get guns who currently do. Restrictions on gun types and magazine capacity would make some mass shootings less deadly at the margin. Perhaps most significantly, adding some hoops like waiting periods to gun purchases would cut down on gun suicides.
And saving several thousand lives a year would be a good thing. But there are a lot of policy options available to save several thousand lives a year, many of which do not involve the cultural flashpoints and political resistance inherent in the gun debate.
So, when this gun control debate ends the way all the others do - with highly politically active gun owners organizing to block new restrictions, and with voters not punishing lawmakers for siding with those gun owners - instead of throwing up our hands, it's worth thinking creatively about other ways to reduce violent crime and premature death.
Here are some promising policies that make people less likely to die
About 2.5 million Americans die every year. About 1.3% of those deaths are due to guns, and a large majority of the gun deaths are suicides. Gun deaths are important (and tragically common compared to in other advanced countries). But they are also a small sliver of the total set of deaths we have available to prevent.
Gun control is also not the only policy lever that can reduce the rate of gun suicide or gun homicide.
Here is a partial list of policies we could demand from our leaders to save Americans' lives, that I believe offer a greater likelihood of political success than gun controls - and in many cases offer the potential of reducing death by more than even highly effective gun controls would.
- Traffic safety. Death by gun and death by auto accident are about equally common in the US. What would happen if we applied the same moral urgency to preventing auto accident deaths that we associate with gun deaths? This could mean lowering speed limits from 30 to 25 in urban areas, increasing penalties for drunk driving, and supporting regulations that promote the introduction of driverless cars. But most importantly, it would mean applying the same stigmas to all kinds of dangerous driving that we have learned, in the last three decades, to apply to drunk driving. An ethical person wouldn't leave a gun laying around a living room for a child to play with. So why would an ethical person text while driving? Or go 119 miles per hour on the freeway?
- Substance abuse. The New York Times has a useful overview of expert opinions about how money could be spent to fight the epidemic of opioid deaths. In a country with 16 million problem drinkers, it would be good to see similar attention paid to the enormous social problems created by alcohol. For example, higher alcohol taxes would save lives by causing problem drinkers to drink less. Mark Kleiman from NYU has written about the great promise of 24/7 Sober, a South Dakota policy that subjects DUI offenders to twice-daily breathalyzer tests, putting them in jail for one night if they blow above 0.0. Keeping problem drinkers sober doesn't just reduce drunk driving and therefore traffic deaths. It also cuts domestic violence and reduces deaths from homicide, suicide, and cardiovascular events. Kleiman believes national implementation of 24/7 sober could save 100,000 lives a year, about three times the total number of annual gun deaths in the US.
- Chronic disease management. Lifestyle factors and access to health coverage are both major drivers of disease and death. But many people with coverage and access to care still do not manage chronic diseases effectively, and many become disabled or die as a result. Margot Sanger-Katz wrote a useful overview for The New York Times in 2015 of customer service approaches that aim to improve health outcomes by keeping chronically ill people in care. These interventions can be as simple as having nurses make daily phone calls to people with diabetes to make sure they are testing their blood sugar and taking medication. In addition to saving lives, some of these interventions have the added benefit of saving money.
- Lithium. Lithium, a chemical element sometimes used to treat psychiatric disorders, occurs naturally in some public water sources but not others. Multiple studies have shown significant, positive population-level benefits from high levels of naturally occurring lithium in water, including lower rates of suicide and dementia. One study of Texas counties found suicide rates were 40% lower in counties with high levels of lithium in water than in those with little lithium. After additional study, we should consider adding lithium to all municipal water for its health benefits, in much the same way we do with fluoride.
- Lead. Back to the danger I started this article by discussing. Mother Jones's Drum proposes a very ambitious anti-lead program, focused around cleaning up soil in urban areas and replacing lead-painted window frames around the country. His proposed budget for this is enormous: $20 billion a year, or about 0.5% of the federal budget. (Though, for comparison, that's about one-fourth the annual defense spending increase that was approved in last week's budget deal.) Drum believes the benefits would be even more enormous: Perhaps a further 10% reduction in violent crime and significant gains in IQ, working out to the economic equivalent of $210 billion in annual gains. Fewer children poisoned with lead means fewer adults in prison and more working productively. It would be a literal investment in our youth.
The high cultural significance of guns makes gun control debates unproductive
People are emotional about guns not just because of what they do, but what they stand for. And that makes gun rights an especially difficult subject to move voters or lawmakers with cost-benefit arguments.
Political opposition to gun control is not primarily a matter of industry lobbying or political contributions. Gun industry expenses on politics are low compared to other influential industries. Republican politicians oppose gun control because of millions of highly motivated, single-issue voters who oppose gun control.
In the early 1990s, there were highly motivated voter constituencies on both sides of the gun debate, and gun control advocates won quite a few political victories, including a ban on assault weapons. Gun control advocates often sound perplexed about how they have lost ground with the public, even as mass shootings have gotten more common. Why aren't gun control supporters as motivated as opponents?
But I don't find it surprising: Even though mass shooting deaths are up, gun murders overall are down as part of the huge, overall drop in violent crime - which was driven in significant part by the highly successful effort to reduce the prevalence of lead in our environment.
Voters who are more afraid of cancer than of gun death, and who are less afraid of gun death than they used to be, are understanding the statistical tables correctly.
Almost nobody is in favor of death
One thing that gets lost in these debates is that most Americans sincerely want less death.
Participants in gun control debates often don't believe that: control advocates believe opponents are at least extremely cavalier about the human costs of lax gun policies, while control opponents believe opponents have a social agenda to strip them of rights they would use responsibly.
But there are lots of other drivers of death we can discuss more productively.
There's no pro-lead-in-soil constituency, and nobody is going to think you're cleaning up lead to serve a social agenda.
Putting lithium in the water would surely lead to some conspiracy theorizing about government mind-control schemes, but these conspiracies also exist about fluoride, and they mostly haven't stopped municipal authorities from pursuing fluoridation.
I am pessimistic about the political and policy prospects for effective gun control. But I am very optimistic about the prospects for changing public policy in ways that cause Americans to live longer - including by reducing gun death. It's just a matter of picking the right opportunities.