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Halsey Frank: The CDC and trying to make sense of firearms homicides

On May 14, 18-year-old Payton Gendron traveled more than 200 miles from his hometown to a predominantly Black neighborhood of Buffalo, New York. There, wearing body armor, he used a  Bushmaster AR-15-style rifle to shoot and kill 10 people and wound three at a supermarket. Eleven of Gendron’s 13 victims were Black. He live-streamed the shooting. State authorities arrested him for murder. Federal authorities are investigating him for hate crimes.

Early reports are that he had mental problems, had been the subject of an assessment as a result of having made a threat at school last June, but had been evaluated and found not dangerous. He allegedly posted a 180-page racist manifesto online before the attack. He passed a background check when he bought the rifle.

Current thinking is that mass shooters are on a pathway to violence with specific behavioral markers that can be used to identify, assess, and manage those who are on the pathway. Those markers include harboring a grievance, experiencing stressors, exhibiting concerning behaviors and communications, planning and preparation, and acquiring firearms. Law enforcement needs to study why that thinking wasn’t effective in Gendron’s case where many of those markers appear to have been present.

Four days earlier, on May 10, the Center for Disease Control released a report on firearms deaths in the United States. It showed that firearms homicides increased 34.6% from 14,392 in 2019 to 19,350 in 2020, the highest number since 1994.

Even so, firearms homicides did not rank in the top 10 causes of death for Americans. The top four were heart disease (696,962), cancer (602,350), COVID-19 (350,831), and accidents (200,955). The National Institute on Drug Abuse counted 91,799 drug overdose deaths in 2020. Firearm suicides remained nearly level (23,888 in 1999 and 24,245 in 2020).

The United States’ overall firearm homicide rate per 100,000 persons increased from 4.6 in 2019 to 6.1 in 2020. Historically, that rate has been one of the highest among large, high-income countries.

Among all countries, El Salvador (36.78), Venezuela (33.27), Guatemala (29.06), Columbia (26.36), and Brazil (21.93) had the highest rates. India’s rate (3.0 in 2020) has been declining in recent years notwithstanding having its share of economic, ethnic, religious, caste, and racial issues.

Within the United States, Puerto Rico (19.72), the U.S. Virgin Islands (19.29), and the District of Columbia (17.01) and had the highest rates. Maine had the second lowest (1.05).

Even though they are the cause of significant concern, the report did not break out mass shootings. Mass shootings are difficult to assess among other reasons because there is no standard definition of what constitutes a mass shooting, and they have not been consistently tracked over time. Sources disagree about the number of mass shootings and victims in 2020, and whether those numbers represent increases. Even the higher estimates (20 causing 510 deaths) don’t represent much of the total for the year.

Consistent with the past, the rates and increases in firearms homicides in the U.S. were highest among males, adolescents, young adults, Black or African American persons, and non-Hispanic American Indian or Alaskan Native persons.

The number (11,904), increase (3,405), rate (26.6 per 100,000), and increase in rate (39.5%) were highest amongst non-Hispanic Black persons, and within that group, the largest increase was among males aged 10-44 years old. The number itself constitutes over half of all firearms homicides in 2020. The increase constitutes over 68% of the total increase for the year. Those differentials constitute the widening of long-standing disparities.

The number and rate of non-Hispanic white homicides were 3,192 and 1.7 per 100,000 in 2019, and 4,052 and 2.2 in 2020, an increase in rate of 28.4%. Black people were killed with firearms at a little more than 11 times the rate of white people in 2019 and 12 times the rate in 2020. Between 2019 and 2020, the rate of Black firearms homicides increased 11.1% more than the rate of white people.

While disclaiming that its findings do not support “causal inferences” and acknowledging that the reasons for the increasing rates and widening inequities were “unclear and potentially complex,” the CDC identified as risk factors economic conditions such as poverty, income inequality, employment and housing instability, and social challenges associated with the pandemic. For example, the homicide rate correlated with the poverty rate in the sense that it was the lowest and increased the least at the lowest poverty levels (wealthiest) and it was higher and increased the most at higher poverty levels (poorest).

It went on to note that possible explanations include increased stressors, disruption in services, strains in relations between communities and law enforcement, increases in firearms purchases, intimate partner violence, exacerbation of existing social and economic stressors, and long-standing inequities and structural racism.

The CDC prescribed a “comprehensive strategy” to address the factors that drive homicides. To address the economic, physical, and social inequities that drive the racial and ethnic disparities, it prescribed increasing temporary assistance to families, housing assistance, and livable wages, enhancing green spaces, and remediating vacant buildings. It recommended prevention programs such as firearms safety programs, surveillance programs, outreach programs, intervention programs, coping skills and therapeutic programs. Among other things notably absent from its factors and strategies were family circumstances and law enforcement.

As general propositions, I accept that poverty, income inequality, employment and housing instability, racial and ethnic disparity, and tensions between communities and law enforcement create needs and foster resentments that fuel crime and violence. Government has been trying to remedy those issues with social programs since at least the Great Society program of the 1960s and arguably before. It should continue to try to do so.

But all those problems existed prior to 2020. If they were exacerbated by the pandemic, it seems more likely they were exacerbated by the mitigation measures rather than by the virus itself. I’m not sure how useful those propositions are for controlling firearms homicides, but it is macabre to note that mass killer Gendron said he became radicalized while he was bored by the pandemic, by which I understand him to have meant the idleness fostered by mitigation measures.

Otherwise, it’s hard to critically evaluate the CDC’s conclusions without more details, such as who the shooters were, what the circumstances of the shootings were, and whether there were any patterns in those details.

For example, if a significant number of the homicides occurred during robberies, it might support the theory that poverty and the lack of a livable wage were factors. When I was a homicide prosecutor in Washington D.C. in the mid-90s, all of my cases were against Black defendants for killing Black victims. A couple were domestic. The vast majority were drug related, usually rival drug dealers killing each other. A small cohort of dangerous people was responsible for most of the homicides, and that continues to be the case. My sense is that they were, and are, not likely to be dissuaded from their path by TANF, housing assistance, a livable wage, enhanced green space, or building renovations.

The increase in firearms purchases seems an unlikely explanation given the high level of gun ownership among Americans before 2020: in 2017, 120.5 guns per 100 people or 1.205 guns per person. But it would be a relatively easy proposition to test by tracing the guns used in the shootings to their purchasers.

The report didn’t identify intimate partner homicides, but I would expect them to have increased because of the isolation of pandemic mitigation measures. To the extent that they are a proxy for intimate partners, firearms homicides of females increased 670 or 29.3% from 2,284 in 2019 to 2,954 in 2020. The 2,954 homicides of females in 2020 constitute 15.27% of the total 19,350 firearms homicides in 2020.

Relations with law enforcement were increasingly strained in 2020. Most of that increase started after George Floyd was killed on May 25. The Armed Conflict Location and Event Data project, in conjunction with researchers at Princeton’s Bridging Divides Initiative, counted 25 people who were killed during protests or linked to protests in 2020. According to the Officer Down Memorial Page, 45 officers were killed by gunfire in 2020, down from 50 in 2019.

According to the market research company Statista, police shot and killed 1,021 people in 2020, a 1.7% increase over the 1,004 killed in 2019. The 1,021 deaths in 2020 represent 5.28% of all the 19,350 firearms homicides for the year. Among those, 241 of them were Black people. That represents 2.02% of Black firearms homicides in 2020 and was an increase of 2.55% from 235 in 2019. The 2020 rate at which police killed Black people with firearms, 1.7 per 100,000, is significantly lower than the overall rate for Black firearms homicides (26.6), less than the rate for all firearms homicides (6.1), and less than the rate for white firearms homicides (2.2).

It’s not clear whether or how strained relations with law enforcement led to an increase in the number of any type of firearms homicides.

The bottom line is that the majority of firearms homicides, and majority of the 2020 increase in those homicides, were of Black Americans. It would make sense to focus our efforts there. I favor studying and fighting the problem, but it is not clear that the CDC is the agency best suited to do so. Its mission is to fight disease.

The CDC has been trying to treat gun violence as a public health issue since at least 1993. The idea that firearms violence can be prevented and treated like a disease is questionable. The CDC has authority to control communicable disease, regulate toxins like anthrax, conduct public health assessments of hazards like waste sites, maintain preparedness to respond to health emergencies, support testing programs for the diagnosis, prevention and treatment of disease, and regulate occupational safety.

That really isn’t the authority or expertise to address firearms homicides.