Another child shoots his classmates at school. A disgruntled former employee returns to his office with an assault weapon. A distraught father kills his wife and children and then turns the gun on himself. These days, news bulletins on high-profile acts of gun violence have galvanized the nation's attention, provoking sharp debates on stricter gun control and law enforcement. Contrary to what the televised images suggest, the average number of annual gun-related deaths in the U.S. has fallen in recent years, but the total remains at more than 30,000. That's still very high--much too high for David Hemenway, a Harvard-trained economist who directs the School's Harvard Injury Control Research Center and presides over the National Association of Injury Control Research Centers.

Having worked for over 25 years to improve consumer product, fire, and motor vehicle safety, Hemenway is now focusing his efforts on guns. Concerned that there's no effective policy in place to substantially reduce gun injuries and deaths in this country, he's developing a public health approach that favors pro-active, broad-based solutions. "The key is prevention," he stresses. "And in injury prevention, it's usually more cost-effective to change the environment than the individual." While drivers are no more skilled today than they were 40 years ago, preventive measures such as collapsible steering columns, seat belts, and air bags have reduced motor vehicle fatalities per mile driven by 75 percent since the mid-1950s. Hemenway suggests a similar approach could help curtail gun violence. "We need to figure out ways to make it less likely that people will behave badly or make mistakes, and less likely they will become seriously injured if they do," he says.

The first step in this process is to obtain more detailed information on gun violence incidents than what's currently available from death certificates, homicide reports, and other limited sources. So with funding from five major private foundations, Hemenway and the Harvard Injury Control Research Center (HICRC) recently launched the National Firearms Injury Statistical System (NFISS), a surveillance system to capture objective, ongoing data for use in planning and evaluating gun injury prevention policies. "We'll collect more detailed information on the demographics of the victim and suspect, their relationship, the gun, and the circumstances of the incident," says NFISS co-director Catherine Barber. Questions the system will address include: Did the incident occur indoors or outdoors? Was a short or long gun used? Were trigger locks and other safety features available? Were drugs or alcohol involved? What were the make and model of the gun? How was the gun acquired?

Nine sites around the nation, including the HICRC, are collaborating on collecting a core set of data. According to Barber, most sites will send an abstractor to search for useful data in reports from coroners, medical examiners, police departments, and crime labs. They'll then send the data to a central database for further study. "We'll analyze it here," she says. "But we'll also make it available to other researchers to promote more scientific inquiry into what works and doesn't work for gun injury prevention." Ultimately, NFISS aims to establish a national firearm injury reporting system coordinated and funded by the federal government that includes data collected at the state and local levels.

Meanwhile, Hemenway has used existing data to shed light on the conditions that promote gun violence. For example, he has determined that more accidental shooting deaths occur in states where gun ownership is higher. "The mortality rate was seven times higher in the four states with the most guns compared to the four states with the fewest guns," he says. Hemenway has also found that guns are used much more often to intimidate others than for self-protection; trained gun owners are much more likely to store an unlocked and loaded gun in their home than those who never received training; women often incorrectly believe that guns in their home are stored locked and unloaded; and 23 percent of seventh grade males in certain American cities have at some point carried illegal guns.

Despite popular support for such measures, they have been historically difficult to pass in Congress, Hemenway observes. Noting that guns are one of the few products not regulated by the Consumer Products Safety Commission, he argues that what this country needs is a regulatory body to have power over the manufacture of firearms and bullets. According to Hemenway, all developed countries have more firearms laws than the U.S, including regulations concerning the licensing, registration, and safe storage of guns. "The big difference here," he explains, "is that it's so much easier to get a gun without an effective background check, particularly in the large secondary market." International data indicate that the U.S. doesn't have more crime than other developed nations, just more lethal crime. "Put a gun into a volatile situation, and you increase the likelihood of serious injury and deaths," says Hemenway. He points out that handguns are behind most gun deaths and injuries, and most handgun owners say they have them for protection. But in his view, "Handguns are not a good instrument for protection. They're dangerous to have around the house, and they're often more lethal than is ideal for police work." He therefore recommends developing weapons that can incapacitate without killing, such as a more effective taser or tranquilizer gun.

Hemenway hopes the national reporting system will provide far more insight into those factors that increase the likelihood of gun violence and lead to collective action and regulations that reduce injurious and fatal incidents--including those that capture nationwide attention, such as the Columbine shootings. On that score, he prefers to look at the big picture. "Fewer people are killed in schools now than in 1993. The knee-jerk reaction is to look at blaming the individual user, but in public health, we try to create a better system so that it's hard to act improperly or to make errors, and the errors are not lethal. The real question is how can we change the system so that we won't have 30,000 people dying of gun violence each year."

by Mark Dwortzan