The US Centers for Disease Control and Prevention may be back in the gun violence research business.
The agency mostly avoids the topic and has for the past two decades -- despite experts labeling gun violence a public health crisis. The potential for change comes in the form of a short sentence in the 152-page instructions accompanying the bipartisan omnibus spending bill that both houses of Congress passed this week. President Trump said he will sign it, sources said.
A provision in the instructions with the latest spending bill may open the door to gun research
Some advocates for gun research are optimistic, others skeptical
On page 23, the instructions say, "While appropriations language prohibits the CDC and other agencies from using appropriated funding to advocate or promote gun control, the Secretary of Health and Human Services has stated the CDC has the authority to conduct research on the causes of gun violence."
It doesn't sound like much, and there is no money specifically budgeted for the research, but some experts say that even baby steps matter in this area.
The "injury prevention and control" section of the bill describing funds for the Department of Health and Human Services states that nearly $650 million should fund programs in this area, more than double the current level of funding. However, more than $475.5 million of that should be dedicated to evidence-based opioid drug overdose prevention programs, it stipulates, and some will have to be spent researching traumatic brain injury, domestic violence and other programs.
So will the new language drive the CDC to research gun violence? The agency "awaits further guidance and direction from Congress and the Department of Health and Human Services," said spokeswoman Courtney Lenard of the CDC's National Center for Injury Prevention and Control.
Public gun violence research: A quick history
For more than two decades, the agency has been gun-shy on gun research because of its interpretation of the Dickey Amendment.
The amendment was part of the 1996 federal spending bill, added after significant NRA lobbying in the wake of a 1993 CDC-funded study that found having a gun in a home was associated with an increased risk of homicide in that home.
The amendment doesn't explicitly ban federal research funds, but it says "none of the funds made available for injury prevention and control at the Center for Disease Control and Prevention may be used to advocate or promote gun control."
The amendment had a chilling effect. Congress quickly reallocated the $2.6 million that had been set aside for firearms research to traumatic brain injury research. Much of the other government funding dried up. And private funding dwindled as well, studies showed.
A study last year in the medical journal JAMA found that in relation to mortality rates, gun violence research was the least-researched cause of death and the second-least funded cause of death, after falls. After the 2012 Sandy Hook school massacre, President Barack Obama signed an executive order directing the CDC to do more gun research, but no significant research came out of it, according to experts.
After the shootings at Stoneman Douglas High School in Parkland, Florida, in February, Health and Human Services Secretary Alex Azar was asked at a congressional hearing whether his agency would conduct more gun violence research. Azar replied that he did not interpret the Dickey Amendment as restricting gun research.
"My understanding is that the rider does not in any way impede our research mission. It is simply about advocacy," he said.
When pressed on whether his agency would "be proactive" on gun research, Azar responded, "we certainly will."
Gun research advocates' reactions
On the surface, the sentence in the new spending bill seems to reflect this change. Some who have advocated Congress for more gun research are cautiously optimistic and others cynical.
"I don't see how or why this changes anything, so I don't think it will make any difference at all," said David Hemenway, director of the Harvard Injury Control Research Center at the Harvard T.H. Chan School of Public Health. "I would love to be proven wrong in this assessment."
He added that this is not something that only the CDC should be doing; the National Institutes of Health should also be doing gun violence research, he said, but it does not.
Rep. Bill Pascrell Jr., D-New Jersey, said, "Last year, we saw two of the five deadliest shootings in the history of the United States. Children are being killed at schools, in churches, at concerts and on streets all across America. It's a big deal that, just this week, Republicans are finally allowing the CDC to research the causes of gun violence.
"It's a sign that the efforts of the brave students from Marjory Stoneman Douglas are having a profound impact on our national dialogue," he said. "These students have shown more courage against the NRA than Republican-led Congresses have shown in 25 years. I think the tide is finally turning against the gun lobby."
Rep. Alcee Hastings, a Democrat from Florida who has also advocated for gun control efforts, is concerned that the language doesn't go far enough.
"While I am hopeful that the language in the Omnibus will encourage the Centers for Disease Control (CDC) to conduct research into the gun violence epidemic, the language is tepid and may perpetuate the chilling effect that the so-called Dickey Amendment has had on gun violence research since 1996. Congress must make it explicitly clear to the CDC that they may engage in this research and that they ought to start without delay," Hastings said in a statement.
He added that Congress needs to put money behind it, or else "telling the CDC they can proceed with their research is nothing more than lip service."
Gun policy expert Daniel Webster is also concerned. "I view the recent development as a cynical nod to critics of who want CDC to fund gun-related research while inserting language into the spending bill that is actually more restrictive than what the current law says," Webster, the Bloomberg Professor of American Health at Johns Hopkins University, wrote in an email.
He says that although the spending bill includes funds to extend the CDC's National Violent Death Reporting System to all 50 states, it does not address some of the biggest research gaps.
He's also concerned that the language adds limits on the CDC that mean it could only research the causes of gun violence. "Funding could not examine solutions, especially no solution that threatens the status quo on gun commerce and ownership."
Hemenway's concern is more general: "I'm afraid this is doing nothing and pretending to do something so they can claim they are doing something when they are really doing nothing.
"Talk is cheap. What is their actions? Did they put money in the CDC budget for firearms research? Did they put money into (the National Institutes of Health) budget for research? Did they abolish the Dickey Amendment? No. No. No. No. No."
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