Dr. Hemenway Responds. And So Do I.

On Sunday, Sept. 26, reader sent Dr. David Hemenway a link to this blog with the following comment:

The subtitle of your book is "A Dramatic New Plan for Ending America's Epidemic of Gun Violence."

The definition of epidemic is 1 widespread occurrence of a disease at a particular time. 2 such a disease.(The Oxford Desk Dictionary, 1997).
Why do you say "gun violence" is an epidemic when it is not? It is not a disease one can catch by being in the presence of a gun.

Have you read a critique of your book by Kevin Smith(sic) at "The Smallest Minority." web site?

I, and a lot of people, would be very interested in your response to him.

Dr. Hemenway responded, and here it is, in its entirety, with some comments interspersed, and a longer response following:

September 27, 2004

I was asked to respond to what is claimed to be a critique of my book appearing on the website, the Smallest Minority. I have neither the time nor inclination to have a detailed response to the many assertions and arguments there, many of which are wrong or misleading.

It turns out that the Smallest Minority isn’t really discussing my book “Private Guns Public Health”, but a magazine article about it. Unfortunately it seems that the Smallest Minority may not have read my book (or the hundreds of journal articles that the book summarizes). It does seem silly for him to accuse the journalist who tried to reduce a 300+ page book and 3 hours of interviews into 3 interesting pages of text, as engaging in “bait-and-switch” tactics or not sufficiently discussing what the Smallest Minority would have liked discussed.

Just for the record, I didn’t claim that my three pieces were a critique of Dr. Hemenway’s book. I was quite explicit that I was asked to fisk a Harvard Magazine review of the book, and I did, at least the first page or so of it. It was the reader who emailed Dr. Hemenway who characterized my pieces as a critique of his book (and got my name wrong, too.)

However, my accusations of “bait and switch” are, IMHO, not “silly.” You’ll note that Dr. Hemenway didn’t rebut, but simply dismissed. For someone who doesn’t have time for a “detailed response,”a two-page reply with a chart certainly seems to be one.

I will talk about one issue, to illustrate the type of problem found in the Smallest Minority’s discussion.

A dozen case-control studies all find that, in the U.S., a gun in the home is a risk factor for “violent death” (i.e., homicide, suicide or unintentional gun death). Some of the other risk factors accounted for in one or more of these studies include age, gender, community, living alone, education, alcohol illicit drug use, depression medication, and psychiatric diagnosis. Ecological studies also find that, across U.S. states and regions, higher levels of household gun ownership are associated with higher rates of homicide (due to higher gun homicide rates), higher rates of suicide (due to higher gun suicide rates) and more unintentional gun deaths. Some of the other risk factors accounted for in one or more of these studies include poverty, alcohol consumption, unemployment, urbanization, divorce, education, violent crime, major depression, and suicidal thoughts.

Massachusetts, where I live, is a state with (relatively) low levels of household gun ownership, strict gun control laws, and low rates of violent death. I remarked to the journalist, who lives in Massachusetts, that I was glad I lived in Massachusetts and that “It’s nice to have raised my son in Massachusetts, where he is so much safer” than most other states. The Smallest Minority took this quote, asserted that I live in Boston, which I do not, and made comparisons to violent death in parts of Arizona, a state that has more permissive gun laws than Massachusetts.

I apologize here. I did indeed assert that Dr. Hemenway lived in Boston, and that is not the case. My most abject apologies. I made an incorrect assumption based on the belief that since he worked at Harvard University, he therefore lived in the Boston metropolitan area. My error. I do hereby withdraw that assertion.

That does not, however, change the comparison data between Boston, Tucson, and Phoenix.

So, let's compare Massachusetts and Arizona. Here are data from 1999-2001, the most recent time period available, easily obtained from the CDC WISQARS website.

Number of Deaths and Mortality Rate Ratio, 1999-2001

	Arizona pop: 5.154 million	Massachusetts pop: 6.356 million	Mortality Rate Ratio, Arizona v. Massachusetts
Homicides	1,374	501	3.4
Gun	909	218	5.2
Non-gun	465	283	2.0
Suicides	2,317	1,244	2.3
Gun	1,433	330	5.4
Non-Gun	884	914	1.2
Unintentional Gun	47	6	10.0
Total Gun Deaths	2,460	565	5.4

In other words, a resident of Arizona is over 5 times more likely to be murdered with a gun, commit suicide with a gun, and be unintentionally killed with a gun than a resident of Massachusetts. Arizona may be nicer than Massachusetts in many ways (e.g. climate) but it’s difficult to understand how the Smallest Minority can suggest that Arizona is a safer state in terms of gun deaths, or violent deaths.

I didn’t. I asserted that Tucson and Phoenix were safer in terms of homicide than Boston during the time period I referenced, gun laws notwithstanding. I also noted that Arizona was a border state with a high level of drug trafficking. Apparently there’s a lot of homicide and suicide going on outside those metropolitan areas here that don't occur in Massachussetts. Given the fact that a lot of drugs do move through this state, I'm not surprised. This does not, however, refute the data for Boston, Phoenix, and Tucson. Massachussett's gun laws have apparently not made Boston significantly safer.

Dr. Hemeway writes that "Massachusetts, where I live, is a state with (relatively) low levels of household gun ownership, strict gun control laws, and low rates of violent death." Yes, indeed it has. It also has a tremendously lower level of drug trafficking. According to the U.S. Dept. of Justice in Massachusetts, in 2003, the following drug seizures occurred:

Cocaine: 374.7 kgs.
Heroin: 29.7 kgs.
Methamphetamine: 1.2 kgs.
Marijuana: 177.4 kgs.
Ecstasy: 5,717
Methamphetamine Laboratories: 1

Via the same source, in Arizona in 2003 the following was seized:

Cocaine: 2,373 kgs.
Heroin: 3.2 kgs.
Methamphetamine: 538 kgs.
Marijuana: 322,374 kgs.
Ecstasy: 107 tablets
Methamphetamine Laboratories: 119
Heroin and Ecstasy seem to be more popular in Massachusetts, but nothing else. Arizona appears to be the central pipeline for Marijuana, and a major thoroughfare for cocaine - and drug trafficking is a major risk factor for violent death. Add to that the traffic in illegal aliens. The people involved in both of these are members of a culture that survives by personal violence. Guns are a byproduct of this culture, not a cause of it, and gun control laws will not disarm them.

In general, the Smallest Minority seems to believe if he can find an anomaly, then the general associations scientists find between guns and death is disproved. It is analogous to his finding that Abel smokes but Cain doesn’t, and Cain has heart disease but Abel doesn’t, and believing that this proves that smoking does not really cause heart disease. Or believing that the fact that Japanese smoke more than Americans and have less cancer shows not only that cigarettes don’t cause cancer, but may well be protective. But such anecdotal evidence shows only what everyone knows, that there are many factors affecting the likelihood of heart disease or cancer, and smoking is only one of those factors. It is not the only factor. Nor is gun availability the only factor affecting homicide or suicide—but the evidence is quite strong that it is one important factor.

I will not argue that gun availability is one important factor affecting criminal homicide, but I will argue that I believe no such causality has been proven when it comes to suicide. I will argue that guns are not the cause of homicide or suicide or even accidental death by gunshot. Culture is. This is the critical difference between my position on “gun control” and that of the gun control movement.

What makes the Smallest Minority’s arguments even more questionable is that his claimed anomalies are often specious. One can find states with more guns and a lower homicide rate than Massachusetts (HINT: look for very rural states, since virtually all crime, including homicide, is much higher in urban areas), but Arizona is not one of them. There are many other examples. The Smallest Minority also says that about half the households in Finland contain guns. While a UN report did say that, the information appears to be incorrect. Probably the best source for comparative gun ownership is the International Crime Surveys that found that in 1989 23% of Finnish households contained a gun, in 1992 it was 25%, and in 1996 it was about 26%.

I’ve used International Crime Survey data before, and been burned by it. The ICS claimed that Scotland in 2000 had a homicide rate of 13.3/100,000. Scotland’s government reports the level is 2.0. Sweden’s homicide rate was given as 10.01. Sweden reports 1.2. (Apparently sometime since I did the research for that piece, the “International Crime Statistics” pages of Interpol have been made accessible only to "authorized police users.") Pardon me if I don't feel the ICS data is all that reliable, and used a different, assumably accurate source. (If you can't trust the UN, who can you trust?)

Which brings us to,

Discussions of firearms in the Smallest Minority, and many other internet sites, seem primarily to be debates, where each party tries to find evidence to support his already held point of view. These are interesting exercises, but they add little to science, and I am not very interested in them. There seems to be a surprisingly lack of curiosity as to what really is happening in the lives of 300 million American, or the 5-6 billion people on the planet. We can’t rely on news to tell us much. We should rely, not on anecdotes, but on good scientific studies, where the goal is to find the truth rather than support for what one already believes.

David Hemenway

Thank you, Dr. Hemenway, for your reply. (You could have cc’d me a copy, but the original respondent was kind enough to forward it.)

I agree with you on your characterization of my site and others on the internet. In general we are, and I unashamedly proclaim to be, advocates of our personal positions. I concur that we do not “add to science.” I concur that we “can’t rely on the news to tell us much,” and much of what they do tell us is wrong, either out of ignorance or bias. I agree that we should rely on good scientific studies, but I have seen that in much of the study of firearms that “good science” isn’t used a great deal.

You state that "A dozen case-control studies all find that, in the U.S., a gun in the home is a risk factor for “violent death” (i.e., homicide, suicide or unintentional gun death).” I have no doubt that firearms were present, but were they the risk factor, or were they merely an indicator of the real risk factor? You state, “Some of the other risk factors accounted for in one or more of these studies include age, gender, community, living alone, education, alcohol illicit drug use, depression medication, and psychiatric diagnosis.” I have to wonder why no one who does these studies considers that people who die violently overwhelmingly belong to a culture that practices personal violence, and that guns and other weapons are the accoutrements of this culture, not its cause. Millions of people own firearms who won't die by gunshot because they are not part of that culture, yet your efforts seem aimed at treating the United States as if it were homogeneous where it comes to firearms possession.

The research that you and your colleagues do, all the data that you collect, are all directed in the belief that “the number of guns” in our society is responsible for the level of violence, and that if we could somehow get rid of them our problems would abate. I disagree. The problem is that a small minority of the country embraces an extreme culture of violence, and the people who do so will be the very last to be disarmed. I therefore believe that attempting to solve our gun-violence problem by attacking guns is a path to disaster.

You (the gun control advocates) have identified a violent crime problem. You think you’ve identified the disease vector, and that gun violence can be solved by eliminating or at least reducing that vector, but you ignore the example of England that indicates that path is a failure. Worse, you gloss over the fact that our homicide rates are horribly distorted by a small, identifiable minority that is destroying itself by violence. Instead of attempting to address that glaring and tragic problem, your colleagues would rather look away and instead attempt to attack that “iron pipeline” as though efforts to control the illegal flow of any material has ever been effective. You ignore the first rule of economics: that supply will always meet demand by dismissal.

Hemenway scoffs at the rote objection, "A determined criminal will always get a gun," responding, "Yes, but a lot of people aren't that determined. I'm sure there are some determined yacht buyers out there, but when you raise the price high enough, a lot of them stop buying yachts."

However, there are nearly 300 million guns already inside our borders. Guns are not nearly as difficult or expensive to produce as a yacht. Sixty-five million handguns. At most two million violent felons. The current supply will easily keep the price down to a low level for any foreseeable future.

And you claim that my arguments are specious?

Gun control advocates ignore the fact that all gun control attempted so far here has been, at best, inconclusive in its effect (For those interested, read Under the Gun: Weapons, Crime, and Violence in America for more on this). You ignore the fact that there has been over a decade of decreasing violent crime here that cannot be linked to any gun control law. You ignore the fact that during that same period between two and three million new guns have been added to the private market each year, but insist that there need to be more gun control laws passed in order to reduce gun crime.

There is no evidence that "gun control" has been beneficial, but the response to this has been, as I have repeatedly noted, that the philosophy cannot be wrong! We must do it again, only HARDER! Dr. Hemenway, the GUNS aren’t causing the problem, a culture of violence is. But it's easier to attack a steel and lead vector than a behavior. Yet the behavior has been affected, and because of this, not gun control laws, gun violence has been reduced.

You see that the U.S. has a high level of suicide by firearm, but ignore or at least downplay the fact that our suicide rates are pretty average for the world, regardless of gun availability. You want “safer guns” so that accidental gunshot is less likely, but ignore the fact that accidental gunshot - absolute numbers, not just the rates - have been declining ever since we’ve been keeping record - and that "gun control" doesn't affect that except where it keeps people from actually possessing guns. Gun control advocates hype the problem of accidental gunshot among children, but fail to note that such shootings are relatively rare given the huge number of firearms in private hands. You distort this by making claims that ten, eleven, twelve, thirteen children a day die by gunshot, but fail to note that the overwhelming majority of these "children" are young men between the ages of 17 and 20 who are involved in criminal activities. This leads to erroneous conclusions - never dispelled by the gun controllers - such as Jean Hanff Korelitz's claim that "more than 4,000 children... die in gun-related accidents each year."

Is that good science?

You suggest methods by which guns can be made “safer” to reduce the possibility of such shootings, but don’t seem to want to study how such changes will actually effect a reduction, since there are already 60-70 million handguns and possibly over 200 million long arms already in circulation that such changes cannot affect. You recommend additional gun laws, but when such laws are passed and no benefit is seen the cry is, again, that we need MORE gun control because the previous effort wasn't implemented properly.

In short, your solution (and I’m still using the general “you” here), your path to “create a society in which it is harder to make fatal blunders” is to severely restrict public access to the means with which those “fatal blunders” can be made, and you want the U.S. to implement more and stricter gun control laws to accomplish this end.

And this is the part I object to most strongly: You have identified the problem as one of "too many guns," yet you, the gun control advocates, generally claim to not want to confiscate anything. Change designs to make them safer, yes (while not addressing nearly 300 million guns already out there). Confiscate, no. Register, yes (though the only people who would register are the ones you don't need to worry about) but never confiscate (though that's the only function a registration system actually has.) License, yes (ditto.) Confiscate, never.

However, the only way to affect what you yourself have identified as the problem - the number of guns - is to take those guns, and not let the public have any more.

We're capable of logic. We can see where "gun control" is inevitably headed.

The goal of reducing death by gunshot is noble. The path to it is wrong, and I’ll fight that path as strongly as I possibly can because it’s wrong. It’s wrong because it doesn’t address the actual underlying causes. It’s wrong because it’s been proven a failure. And most importantly, it’s wrong because it violates the fundamental law of the United States.

And I will use this and other forums to fight it just as you use your forum to advocate it. You may be a lab-coated PhD, and I may be just a pajama-clad ankle-biter, but there are a lot more people like me than people like you, and our numbers are growing. In a democratic form of government, that means something.