Ruth Abaya, an attending physician in the emergency department at the Children’s Hospital of Philadelphia, has witnessed the ravages of gun violence in her city firsthand.
“In the emergency department, we see young people in the trauma bay who have been injured by firearms, sometimes numerous times,” Abaya says. “We also see the immediate impact on relatives and community members who are at their bedside.”
These experiences sparked her desire to intervene and prevent violence, not just treat its effects. Abaya has served as program manager for the Injury Prevention Program at the Philadelphia Department of Health, and today she is the senior director of health systems and community violence intervention integration for the Health Alliance for Violence Intervention.
More than 100,000 people in the United States are killed or injured by firearms each year, including homicides, suicides, and accidents. In fact, firearms violence is the country’s leading cause of preventable death. Yet despite this crisis of public health and community safety, little objective information about the problem is available. Current data does not account for 60% of all gun injuries, and policymakers and practitioners can’t answer basic questions: How many people are shot each year and survive? How do people get their hands on guns used in crimes? Which firearms dealers are selling the most guns used in crimes? The answers to such questions are integral to finding solutions that will save lives.
That’s why the nonprofit organization Safe States Alliance, with support from Arnold Ventures, has convened a working group aimed at building firearms data infrastructure. Abaya is a member of the new group, which brings together researchers, practitioners, and advocates in the field. Together, these stakeholders are working with policymakers to implement recommendations that will help strengthen the data available through federal and state governments, the criminal justice system, and health care providers.
“It’s impossible to build relevant real-time solutions without data,” Abaya says. “The working group wants to make sure that we have really high-quality data that’s timely, responsive, and accurate from all these different sources in the violence prevention ecosystem. The real power will be in bringing that data together, integrating all those sources, and building toward a data infrastructure culture.”
“Not much has changed”
The lack of firearms data in the United States is not a new problem. In 2013, a National Academy of Sciences (NAS) report found that basic information about guns is “limited, disorderly, and highly segmented.” The U.S. Constitution protects gun ownership, the report notes, and there are many safe and legal uses for firearms. But a range of federal laws and regulations implemented since the 1960s have constrained state and federal governments’ ability to collect data on gun sales, ownership, use, distribution, and storage. Furthermore, the information that is available often lags by years, is inaccessible to communities that need it, and lacks integration with other systems.
“Not much has changed since the NAS report,” says Asheley Van Ness, director of criminal justice at Arnold Ventures. “Firearms data infrastructure is limited, it’s opaque, and it’s not shared across state, local, and federal governments. Without systematic collection of data, it’s difficult to craft effective, constitutional policies that can reduce firearms deaths and injuries, whether from accidents, violent crime, or suicide.”
Firearms data infrastructure is limited, it’s opaque, and it’s not shared across state, local, and federal governments.Asheley Van Ness director of criminal justice at Arnold Ventures
In recent years, experts have made efforts to address this shortcoming. In 2019, with support from Arnold Ventures, the National Opinion Research Center (NORC) at the University of Chicago launched an independent expert panel — convened three times over the course of a year and including 14 distinguished academics, government leaders, and trailblazing practitioners — whose charge was to create a “blueprint” for a better firearms data infrastructure.
John Roman, senior fellow of economics, justice, and society at NORC, was a key steward of the panel. “There are lots of data collection agencies and entities, but they’re not coordinated,” Roman says. “There are huge gaps in the information that’s available, and much of it is not comprehensive or useful. The panel focused on ways to improve that.”
NORC published its recommendations in the 2020 report A Blueprint for U.S. Firearms Data Infrastructure, which serves as expert guidance for a set of policies to develop an improved firearms data infrastructure. It includes a prioritized list of future projects, providing empirical support for the public, researchers, and policymakers.
Filling the Gaps
The goal of the Safe States Alliance’s working group is to raise the visibility of the recommendations in NORC’s blueprint and put them into practice nationally. The Safe States Alliance has previous experience translating recommendations into action on this issue. It recently completed a successful push to expand the National Violent Death Reporting System (NVDRS) beyond a handful of states to all 50. NVDRS, a federal tool administered by the Centers for Disease Control and Prevention (CDC), connects existing primary data sources, such as medical examiner reports, to provide a comprehensive picture of violent deaths in the United States. This information is critical for informing violence prevention programs, yet before its expansion the country had no nationally representative system for tracking violent deaths.
“Our work is focused on taking the recommendations developed by NORC and advancing them in the policymaking arena,” says Paul Bonta, senior policy consultant for the Safe States Alliance. “When we first started this project, very few policymakers knew that firearms data needs to be addressed. It’s important that policymakers understand that there are gaps in our nation’s firearms data infrastructure, and that there are steps we can take to fill those gaps.”
It’s important that policymakers understand that there are gaps in our nation’s firearms data infrastructure, and that there are steps we can take to fill those gaps.Paul Bonta senior policy consultant for the Safe States Alliance
The NORC recommendations tackle data issues in both the criminal justice and public health systems. One priority is strengthening data reporting by law enforcement agencies to the Federal Bureau of Investigation’s (FBI) National Incident-Based Reporting System (NIBRS). That system was instituted in the late 1980s to capture more detailed information about shooting events rather than relying on the aggregate numbers of the FBI’s previous reporting system. But most of the country’s 18,000 law enforcement agencies still do not use NIBRS.
Another important step is strengthening the FBI’s National Instant Criminal Background Check System (NICS), which is used to determine if a person is eligible to purchase a firearm, and examining the timeliness and quality of criminal history data reported to the program. That move would help ensure that firearms are not sold to people who are ineligible to own them because of a criminal record or some other reason.
In the area of public health, a top priority is expanding the CDC’s Firearm Surveillance Through Emergency Rooms (FASTER) program. Currently funded in ten pilot sites, FASTER is an effort to rapidly track firearm injuries across the United States.
“Collecting emergency department data reported at the state level can give us nearly real-time information on nonfatal injuries,” says Roman. “Expanding it to all 50 states would be incredibly useful.”
The panel also recommends that the CDC improve the timeliness with which its data is released through NVDRS and standardize death investigation infrastructure, which is currently collected through different methods in different locations. Additionally, misclassification of firearms data — for instance, in emergency departments gunshot wounds are often categorized as accidents when they are, in fact, assaults — is a problem that frustrates research efforts. The panel points to the importance of correcting misclassified data collected through the Nationwide Emergency Department Sample (NEDS) at the Agency for Healthcare Research and Quality.
In general, NORC recommends that the federal government increase public access to federal data systems and improve opportunities for data linkage, sharing, and transparency — a step that would go a long way toward establishing a more coordinated system.
“Let’s have a conversation”
Members of the working group — who include researchers, practitioners, and advocates — are talking to state and federal lawmakers, as well as the stakeholders who maintain data sources, about the importance of firearms data infrastructure and how to make the recommended changes to the country’s data systems.
In June, Roman met with congressional staff on Capitol Hill to discuss new funding for law enforcement agencies that would allow them to enter their data into NIBRS more effectively, a move he said would provide far richer information on violent incidents. Staffers were receptive to the idea, he says.
In some areas, the working group has already made significant progress. As a result of its advocacy, the CDC is committed to updating NVDRS to provide more timely releases of certain databases, developing statistical procedures to address known limitations of the local death investigation systems, and creating a feedback loop between NVDRS and state registries to make coding of firearms accidents more accurate.
The working group has also helped to gain federal funding to maintain the CDC’s National Electronic Injury Surveillance System — All Injury Program (NEISS-AIP), and the CDC is continuing its efforts to expand NEISS-AIP to all 100 hospitals included in the system. Meanwhile, the Agency for Healthcare Research and Quality is urging the CDC to provide public access to state-level files on injury cases through NEDS.
Integrating all those data sources has real power to allow action and change.Ruth Abaya program manager for the Injury Prevention Program at the Philadelphia Department of Health
Roman considers these victories to be promising indicators of what is possible when policymakers understand the current problems of firearms data infrastructure and the stakes of getting it right.
“We really think that the data is a nonpartisan way to get to the heart of this issue and engage people across the political spectrum,” Roman says. “Public opinion polls support gun safety policy, but this requires data and research. We could have much more reasonable and widely popular policy if we simply knew more.”
In Philadelphia, Abaya has high hopes that improved data infrastructure — and sharing data between various systems in particular — will make better violence prevention possible locally as she, her colleagues, and many community members work daily to save lives.
“Speaking from my local experience, I feel strongly about data integration,” Abaya says. “We want to see a situation where health systems, the criminal justice system, and community violence programs are all keeping and disseminating high-quality, timely, usable data. Integrating all those data sources has real power to allow action and change.”