Researchers join forces to expand evidence base on gun violence

Dr. Megan Ranney, a longtime emergency physician and Brown faculty member, is leading both national and Rhode Island-based efforts to address firearm injury based on research and facts.

PROVIDENCE, R.I. [Brown University] — According to data from the Centers for Disease Control and Prevention, firearm-related fatalities are now the second leading cause of death among children in the United States.

In recognition of the need for substantially increased research and training in the field of firearm injury prevention, the National Institute of Child Health and Human Development (NICHD) recently awarded $5 million to the University of Michigan to lead a research capacity building grant that includes more than 20 researchers at 12 universities and health systems across the nation, including Brown.

The award represents the largest funding commitment from the National Institutes of Health (of which NICHD is a part) in the past 20 years to reduce firearm injury.

The new Firearm Safety Among Children and Teens Consortium (FACTS) will bring together expertise from scientists from public health, emergency medicine, pediatrics, criminal justice, psychiatry, psychology, data science and trauma surgery, among other fields.

Dr. Megan Ranney

Dr. Megan Ranney, an associate professor of emergency medicine at Brown's Warren Alpert Medical School, is leading the Brown arm of the study. A longtime emergency physician and researcher, she was also appointed in April by Rhode Island Gov. Gina Raimondo to co-chair a gun safety working group for the state.

We asked Ranney about the need to address gun violence based on evidence and facts and how these new efforts can contribute to creating solutions.

Q: As an emergency physician, you see firsthand the effects of firearm injury. How have those experiences informed your perspective in thinking about solutions to prevent gun violence?

Injuries caused by guns are different from any other type of injury. If I take care of a stabbing victim in the emergency department, or if I take care of someone who tried to commit suicide by taking pills, I can almost always save them. The fatality rate from guns, in comparison, is much higher: 30 percent of gun assault victims and 90 percent of gun suicide attempts die. As a doctor, it's really upsetting to not be able to save a patient's life — especially when it's a young life and a senseless death.

Firearm injuries also have a unique impact on patients' families and communities. The possibility of gun violence creates fear and despair in a way that few other injuries do. Since I have limited ability to help these patients or their families after the gunshot wound happens, I am determined to try to stop as many of the injuries as I can from happening in the first place.

Q: Why do we need to research firearm injury? Don't we already know what to do?

Injury prevention, like any other field of research, is a science. We have used the science of injury prevention to reduce car injuries and deaths by developing multifaceted interventions that have good evidence behind them. And we have achieved these successes without taking cars off the road. Unfortunately, due to a lack of federal funding over the last 20 years, we have made little progress in addressing firearm injury. I could easily list three dozen scientifically valid questions, on both sides of the political spectrum, that need answers.

Q: Why is this NIH grant so significant?

Federal funding for firearm injury research is less than 2 percent of what it should be, based on the number of deaths. In the last 20 years, less than a dozen researchers have published more than an article or two about firearms. Few young researchers are going into the field. Who would want to create a career around something that you can't get funding to study?

This grant is a big deal because it is helping us to jump-start the science of firearm injury prevention for kids. It allows us to unite existing researchers and to attract new ones. The hope is that through this grant, the best and brightest minds will be motivated to address this problem.

I'm confident that it will make a big difference for the field.

That said, it is a drop in the bucket. Last year, the NIH spent $500 million on opioid research alone. So, this $5 million, five-year grant for pediatric firearm injury prevention is terrific, and is necessary... but it's not sufficient. What would be sufficient is to have enough money to fund studies to answer every one of the key questions that our workgroups are identifying and to fund studies addressing adult firearm injury prevention, too.

Q: Can you share some details about the workgroup that you're leading as part of the NIH study?

I am leading the workgroup focused on "secondary prevention and longitudinal consequences" of firearm injury. In other words, we are identifying and addressing the consequences of pediatric firearm injury. Some of our topics include exploring how to reduce mental health disorders, addiction and future injury among youth affected by gun violence; and how to reduce the impact of firearm injury (including mass shootings) on kids' families and communities.

Q: What other research are you conducting focused on gun violence?

I have a number of research projects focused on youth violence in general. I have a new five-year grant from NICHD that is examining the efficacy of an automated text-message program to reduce violence and depression among at-risk youth. I also have a grant from NICHD through which I'm developing an innovative new mobile phone-based cyberbullying prevention program. I am hopeful that both of these projects will reduce gun violence by addressing the underlying causes.

I also represent Rhode Island on a multi-state research consortium, established by the governors of Rhode Island, Massachusetts, Connecticut, New York, New Jersey, Delaware and Puerto Rico.

Finally, I am serving as the chief research officer for a great new collective of public health and medical researchers and medical societies — the American Foundation for Firearm Injury Reduction in Medicine. Through this cooperative effort (which the FACTS consortium is part of) we hope to further spur the use of science to reduce firearm injury.

Q: The FACTS consortium mentions "capacity building" and includes a focus on training postdocs and graduate students. Can you talk about the need for training new researchers? Will any of that work happen at Brown?

As I mentioned, the field desperately needs restarting. To attract young researchers, they need to feel assured that they can develop a career in firearm injury research. This grant helps to show that they can do that. I have already taken on two trainees here at Brown and hope to train more.