The Dickey Amendment makes research like this hard to come by.
Gun violence is often identified as a political issue, or a matter of law enforcement. But a new study published Tuesday shows gunshot injuries have a very real health impact, costing Americans more than $6 billion in health care costs over the last decade.
Looking at a database of hospital inpatient records, researchers at Stanford University Medical Center found that more than 250,000 patients were admitted for gunshot injuries from 2006 through 2014, according to the study published in the American Journal of Public Health. Adjusting for inflation, the costs of these hospitalizations totaled $6.61 billion, an average of $734 million per year. The bulk of these costs, 40 percent, was paid through government insurance coverage under Medicare and Medicaid.
These figures only begin to scratch the surface of the true cost, according to Sarabeth Spitzer, a Stanford medical student and lead author of the study.
"Our research is based on the first inpatient hospitalization and that actually excludes a lot of costs," Spitzer told me. "If someone, for example, comes into the emergency department and is released without being admitted to the hospital, then they are not included in this study."
Spitzer said the data set also didn't include any long-term healthcare costs, such as readmissions due to ongoing complications, rehabilitation therapy, or disability. So chances are the costs are even higher than the paper estimates.
"Those are substantial costs that we couldn't access and so what we've produced is really the lowest bar estimation," Spitzer said.
Studies on the health care costs of guns are few and far between. The next most recent examination is from 1999 and only covers two states. Part of the reason for this is an annual budget amendment passed by Congress, called the Dickey Amendment, that effectively prevents the Centers for Disease Control from funding research into guns (the National Rifle Association, unsurprisingly, originally lobbied for this amendment). Spitzer was able to fund her study through her school as a medical student, but told me overall there's a dearth of data in this area.
And that's a major issue, because guns are one of the nation's biggest health problems. The US has the highest rate of gun homicides of any developed nation—25 times higher than other developed nations. In 2014 alone, there were about 81,000 nonfatal gun injuries in the US, and 33,700 deaths.
The Cure Violence project at the University of Illinois aims to reduce violence by taking a public health and disease control approach, rather than solely a political or law enforcement approach. There are a whole host of preventative health strategies that could reduce the number of gun injuries and deaths, according to Charlie Ransford, the senior director of science and policy for the Cure Violence who was not involved with the study.
"It really is a health problem," Ransford said. "Once you identify who is at the highest risk of violence, outreach workers can talk to that person about what's going on, do they need help with drug abuse, anger management, or finding a job."
But these approaches often get tangled up in the messy political debate over gun control. The reality is that gun violence is an epidemic that kills nearly as many people as opioid addiction, yet we treat it like a criminal issue rather than a public health concern. It's something we can't continue to ignore, with billions of dollars on the line and, more importantly, hundreds of thousands of lives.