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Gun Safety in Homes

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Matthew Miller
Assistant Professor of Health Policy and Injury Control, Department of Health Policy and Management, Harvard school of Public Health
Tuesday, May 30, 2006; 2:00 PM

Matthew Miller, associate director of the Harvard Injury Control Research Center and co-author of a new study on gun safety in Archives of Pediatric and Adolescent Medicine,  was online Tuesday, May 30, at 2 p.m. ET to discuss gun safety in families' homes. He also fielded questions and comments about the study.

Miller, a physician with training in internal medicine, medical oncology and medical ethics, has been the Associate Director of the Harvard Injury Control Research Center since the year 2000. Miller has conducted extensive empirical research in injury and violence prevention and is the author of more than 35 articles and book chapters on fatal and non-fatal violent injuries, including homicide, suicide, and other topics. Recent projects include analyses of the relationship between physical illness and suicide among elderly Americans, the connection between recent changes in rates of homicide and suicide among African American youth, the relative risk of suicide and suicidal behavior among users of different classes of antidepressants, the effects of firearm legislation on rates of suicide and homicide, factors influencing public opinion about the inevitability of suicide, and the association between rates of household firearm ownership and rates of violent death.

From The Post:

In Harm's Way: Guns and Kids (Post, May 30)

Safety Begins at Home

Child Access Prevention Laws By State

Gun Ownership by State

The transcript follows.

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Matthew Miller: HI,

This is Matt Miller from the Harvard School of Public Health. I'm glad for your interest in this important issue and will try to answer as many questions as I can.

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Arlington, Va.: I thought Ms. Boodman's article was both excellent and disturbing. My father grew up in Texas, is a retired Army colonel and a staunch Republican-basically the perfect stereotype of a gun-owner. I also know that he owns at least three guns. However, in 25 years, I have never seen any of his weapons, don't know where they are kept and don't know if he has any ammunition for them. I am shocked that parents who spend hundreds or thousands of dollars baby-proofing their homes wouldn't simply lock up their guns. This is a 100% preventable tragedy and I hope that gun-owning adults (whether they have children of their own or not) will take these warnings to heart.

Thanks for being here to discuss an incredibly important topic.

Matthew Miller: Thanks for your comment. Your father did a great job keeping his firearms hidden from you -- but as the study that Frances Baxley and I conducted shows, most children, even those as young as five years old, know where their parents household guns are stored and half of the boys in our study had handled a gun in their home. Of greater concern is our finding that of the parents who reported that their child had never handled a gun in their home, one in five were contradicted by their child's report. Other studies have also found a disconnect between what parents believe their children will do when they find a gun and what their children actually do when they find a gun.

In one study, boys aged 9-15 were strongly warned not to touch guns. However, when left alone with a gun, about a quarter touched and played with it. Almost all then denied doing so when they were asked. None of the boys touched any other forbidden item after being warned against doing so. "The results of the current study indicate that guns hold a unique allure and cast further doubt on the ability of gun admonitions to keep children safe around guns" (Hardy 2003, 352).

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washingtonpost.com: In Harm's Way: Guns and Kids (Post, May 30)

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Rockville, Md.: Do you have any references to the studies supporting the notion that teaching kids about safety does not work? I find it hard to believe that teaching safety does not have some positive impact.

Matthew Miller: A great reference -- and a sobering one -- is Hardy behavior oriented approaches to reducing youth gun violence. It can be found at www.futureofchilden.org

Here are a few examples:

Currently, some 10 percent of elementary school teachers provide some firearm safety education. The most popular curriculum is the National Rifle Association's Eddie Eagle program (Price et al., 2005). Unfortunately, recent evaluations find that while the Eddie Eagle program may teach children aged 4-7 to verbalize safety messages, these messages do not lead to actual behavior change (Howard 2004; Himle et al 2004; Gatheridge et al 2004). In one study, boys aged 9-15 were strongly warned not to touch guns. However, when left alone with a gun, about a quarter touched and played with it. Almost all then denied doing so when they were asked. None of the boys touched any other forbidden item after being warned against doing so. "The results of the current study indicate that guns hold a unique allure and cast further doubt on the ability of gun admonitions to keep children safe around guns" (Hardy 2003, 352).

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Baltimore, Md.: Have you compiled statistics on how many times a gun has actually been used to protect/defend family members in their homes in recent years? Thank you.

Matthew Miller: I highly recommend David Hemenway's book "PRIVATE GUNS PUBLIC HEALTH" as a one-stop shopping source for clear and unbiased information about the costs and benefits of firearms in the U.S. Here are a few of the statistics Dr. Hemenway notes in his recent book:

Numbers of Uses: The National Research Council (2005) examined the scientific literature on self-defense gun use. They concluded that: "self-defense is an ambiguous term" (p.106), that whether one is a defender or a perpetrator may depend on perspective, and that "we do not know accurately how often armed self-defense occurs or even how precisely to define self-defense" (p. 13). The claim that there are 2.5 million self-defense gun uses each year received no support.

A teenager from Arizona, working with his father, provided a reality check on the claims of millions of self-defense gun uses. They examined all Phoenix area newspaper reports, supplemented by police and court records. Unsubstantiated findings from a Kleck-Gertz study would predict that the police should have known about 98 civilian defensive gun use killings, and 236 defensive gun use firings at criminals during the period studied. Although a homeowner successfully defending his family against a home invasion would provide a juicy news story, a careful investigation by the father-son team could find only two actual cases of self-defense gun use involving a killing or a firing at an assailant. These two incidents appeared to be escalating altercations, with innocent bystanders exposed to the gunfire (Denton & Fabricius 2004).

Is More Better? While there are undoubtedly virtuous incidents of self-defense gun use, there are too many stories of self-defense gone awry. "A five year old girl in Houston is dead after being mistaken for a burglar by her stepfather He shot when someone tried to open the door of the bedroom where he and his wife were sleeping" (NBC56.com, 8/16/04). "A teenager, who celebrated his 16th birthday by playing pranks in his neighborhood, was fatally shot by a neighbor who mistook him for a burglar (the teen) and an unidentified friend were ringing doorbells or knocking on doors and then running away" (St. Petersburg Times, 10/27/03). "A small girl [aged 2] remained in the hospital in critical condition Sunday from a gunshot wound inflicted by a man who had confronted a group of teenagers after one sent a football crashing through the window of his southwest Houston apartment (The man) rushed out, demanding to know who broke the window He took his hand out of his pocket and he had a gun. That's when everybody started running. Police said (the man) raised the pistol toward two of the fleeing juveniles and fired" (Houston Chronicle, 7/24/05).

Claims about the high frequency of self-defense gun use are also contradicted by the data. For example, for sexual assaults, only 1 victim in 1,119 total incidents reported attacking or threatening with a gun (15 used a non-gun weapon; 38 called the police or a guard; 120 attacked without a weapon; 161 ran away; 219 yelled; 343 struggled). In robberies, 1.2% of victims used a gun, whereas 3.8% called the police or guard, 12.7% ran away, 20.5% struggled. In confrontational burglaries, 2.7% of victims used a gun, 3.3% some other weapon, 6.3% ran away or hid, 10.9% struggled, 20.4% yelled or turned out the lights, and 20.1% called the police. In all confrontational crimes, 0.9% of victims reported using a gun, 1.7% a non-gun weapon, 7.2% called the police, 10.1% ran away, 13.8% struggled, and 29.3% did nothing (Hemenway 2005).

The NCVS data show that: (1) gun use in self-defense is very rare; (2) it is not clear whether resistance will or will not reduce the likelihood of injury; and (3) two of the most common forms of "resistance" also appear to be the most successful in terms of reducing the likelihood of injury-calling the police or running away (Hemenway 2005).

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Washington, D.C.: Are you familiar with any studies showing the effectiveness of education or training on children or adolescents using firearms?

The reason I ask is that my grandfather got his own rifle when he was under 10 years old and gave me and my brother instruction when we were that age. No one in my family has ever had any safety problem with firearms.

Matthew Miller: The irony is that existing education and training programs appear not to work and may even have the perverse effect of increasing the risk to children by creating a false sense of security that education and training quell a child's natural curiosity. In addition, some studies have found that parents who receive firearm training tend to store their guns less safely than those who have not received training.

The bottom line is that it is a parent's responsibility, not a child's, to provide a safe environment. Children are impulsive and curious by nature.

As hardy points out in the article I've already cited,"passive prevention efforts require no effort at all on the part of individuals (for example, choosing not to own a firearm). Some active efforts require a one-time behavior (such as placing and keeping a trigger lock on a gun); others require a moderate amount of effort (such as locking up a gun after each use); and still others require constant effort (such as supervising children). Researchers agree that the more effort a prevention strategy requires, the more difficult it is to implement."

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Langley Park, Md.: As a public health official, I am not surprised when statistics shatter our hopes that through education, we can prevent the handling of guns (NRA Eddie Eagle program). But other than outlawing guns, or passing legislation that requires locking up firearms and ammunition separately, WHAT DOES WORK? I would like a prohibition on guns, but prohibition doesn't work! Dr. C

Matthew Miller: Your question is sobering. Studies in the past two years show that many firearms in American households continue to be stored unsafely (Johnson et al 2004; Connor 2005; Coyne-Beasley et al 2005; Okoro et al 2005). Studies have also shown that unsafe storage is associated with firearm injury and death.

One study used data from the 1993 National Mortality Followback Survey, and found that, among individuals with a firearm in the home, keeping the firearms unloaded or locked substantially reduced the likelihood of firearm suicide. The effect of safe storage was largest among those who had a relatively low intention to die, suggesting that such suicides are often the most spontaneous, and that safe storage can help protect against impulsive self-destructive acts (Shenessa et al 2004). In another case-control study, the cases were youth (under age 20) from areas in Washington, Oregon and Missouri who had attempted suicide with a gun, or had unintentionally shot themselves or someone else. All control households contained a firearm. Good storage practices (e.g. gun unloaded, or locked) substantially reduced the likelihood of a gun suicide attempt (or death), or an accidental gun shooting (Grossman et al 2005). A third study compared unintentional firearm fatalities across the fifty states. After controlling for urbanization, poverty, and levels of household firearm ownership (states with more guns had more unintentional gun deaths) a disproportionately large share of unintentional firearm fatalities occurred in states where gun owners were more likely to store their firearm loaded, and the greatest risk occurred in states where more firearms were stored both loaded and unlocked (Miller et al 2005a).

Unfortunately, improving storage practices is not always straightforward. But that doesn't mean concerned adults should give up on incremental improvements and cultural shifts in what is considered responsible parental behavior. No parent wants her/his child to be injured from gunfire, least of all with a gun from the child's home. If parents take the message of our paper seriously, they should reconsider the costs and benefits of having a gun in their home and, if they decide on balance they want to keep guns in their home, they should get a gun safe, keep the guns in the locked safe separate from locked away ammunition, and keep the ONLY key to the safe on their person at all times. Trust your children to be children -- and protect them by assuming full responsibility for their welfare. Children should not be asked to betray their nature when we are talking about the difference between life and death.

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Washington, D.C.: This topic is a sensitive one for me: When my brother was 8 years old, in the early 80s, he accidentally shot himself with a police revolver my father had borrowed from a friend. The gun was kept in the top of our hall closet, in plain view and with no locking mechanism whatsoever. My brother had taken the gun out because he and his best friend had decided, with the sense of reality of the typical 8 year old, to rob the bank in town so they could buy toy cars. He was trying to load the already loaded gun when it went off.

The only reasons he is alive today are that the bullets were composed of bird shot (my father was using them to scare the crows away from some trees), that my mother immediately drove him to the hospital instead of waiting for the ambulance (about a 15-minute drive to our town), and that the shot missed several main arteries in his leg by a few centimeters.

My question has to do with culpability in such "accidental" shootings. Are the parents in cases where a child accesses a gun often charged? I've often thought that my father should have faced some penalty (he, of course, blamed my mother for leaving my brother alone for 10 minutes while she was in another room). But in our rural locale, guns were everywhere and such accidents commonplace. (Each year when I was in high school, I lost at least one classmate who was drunk and playing Russian roulette with his daddy's gun. This in a school of 1300.)Do you feel the penalties for negligent firearms control satisfactory? Would making it mandatory that a negligent parent would see jail help deal with the problem?

Matthew Miller: Parents in cases where a child accesses a gun are rarely charged, but I do not personally think that making it mandatory that a negligent parent would see jail is the best way to reduce accidents and suicide among our children.

My belief is that far too many parents have not yet properly considered the true costs -- in children's lives lost or in non-fatal injuries, like that of your brother. And, thanks to disingenuous propaganda by pro-gun advocates and flawed tendentious research, greatly exaggerate the benefits of household firearm ownership (with respect to the myth of the added protection afforded). One myth is that where guns are more prevalent killings are less likely -- the exact opposite is the case.

What is needed is a clearer understanding of the costs and benefits of gun ownership and how safe storage can mitigate some but not all the risk. We also need a cultural shift in what is seen as responsible parenting. As a parent I should feel it is my duty to ask my neighbor if they have a gun in their home and how it is stored before letting my son go on a play date. Physicians should also be playing a more active role in educating parents about the medical risks involved in firearm ownership and the risk of various storage practices.

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Chicago, Ill.: What is the one message people need to hear more often about gun violence prevention?

Matthew Miller: Thank you for your interest in our paper. The main finding from our study was that many parents, particularly mothers, who assumed that their child had never handled a household gun, were contradicted by their child's report. Parents who discussed gun safety with their children were no less likely to be contradicted. Our study suggests that parents should take every effort to prevent their children from gaining access to guns in the home and never assume that counseling children about gun safety is the only precaution necessary to keep them safe. Our study's findings support recommendations from the American Pediatrics Association that, because of children's natural impulsiveness, curiosity and inability to always know the difference between what is a toy and a dangerous firearm, the best way to keep children safe from guns is to not store guns in the home.

If parents must keep guns in the home it is incumbent upon them to make sure that all household firearms are securely locked away, preferably in a gun safe that absolutely cannot be accessed by anyone other than the parents themselves. The day our paper came out a NYC police officer's 9-year-old son accidentally shot himself in his family's Long Island home and remains in critical condition on life support. These tragedies occur every two to three days among our nation's children -- and are preventable, but only if parents recognize that they must make absolutely sure that their child cannot gain access to household firearms.

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Matthew Miller: Thank you for all your questions and for your interest in this important topic. I'm signing off.

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