Thursday, June 21, 2007

Book Review: Private Guns, Public Health

Author: David Hemenway
Publisher: The University of Michigan Press
ISBN: 0-472-03162-7

Professor David Hemenway, of Harvard University, has spent much of his career studying public health policy. In Private Guns, Public Health, Hemenway examines many intersections between American gun policies and American public health issues. In the book’s preface, Hemenway states, “Public health is prohealth . . . . Public health is not anti-gun owner” (p. xii). His concern throughout the book is to balance the interests of gun-owning individuals with those of society.

In the book’s opening chapter, entitled Guns and American Society, Hemenway cites several studies which indicate that, even though crime rates in the USA, overall, are similar to crime rates in other high-income countries, American rates of lethal violence, most of which is perpetrated with guns, are much higher. He also notes that approximately 25% of American adults own firearms, and American “gun culture” continues to be fueled by popular Revolutionary War Minuteman and rugged Old West Cowboy images.

In the second chapter, Hemenway describes a public health approach to the issue of gun violence. In addition to changing the public perception of what levels of gun injuries are acceptable (which has happened with such products as toys and automobiles), Hemenway seeks to emphasize injury prevention rather than faultfinding and punishment after injuries and crimes occur.

In the third chapter, Gun-Related Injury and Death, Hemenway examines accidental injuries, suicides and homicides and argues that several measures, including childproofing guns, personalizing guns so that only authorized persons can fire them and requiring trigger locks would go a long way toward reducing or preventing injuries without imposing in any way upon gun ownership privileges.

In the fourth chapter, Self-Defense Use of Guns, Hemenway reports that the efficacy of gun use for self-defense is still in question, since available evidence suggests that guns are rarely used for this purpose.

In the fifth chapter, Location, Hemenway notes that the presence of guns in the homes greatly increases the risk of injury or death by gunfire. Much of this risk is associated with the fact that many gun owners do not store guns and ammunition safely. Moreover, the presence of guns in homes increases the likelihood of successful suicide attempts. Hemenway also discusses the use of guns in school violence and links those events to their larger community contexts. He concludes this chapter by noting that gun-carrying permits have mixed consequences. Available evidence indicates that, while the presence of guns in public places occasionally deters violence, the presence of firearms may also be a factor in escalating violence. For example, some criminals have revealed in interviews that they carry firearms in the event that they may have to defend themselves against armed victims.

In the sixth chapter, Demography, Hemenway notes that adolescents and young adults face the highest risk of injury or death or injury by gunfire. Women and African Americans are also more susceptible to gun violence than other populations.

In chapter seven, Supply, Hemenway discusses the manufacture and distribution of firearms in the United States. He points out that, like all manufacturers, gun makers are primarily interested in profit rather than safety. Therefore, they emphasize measures that require additional responsibility from consumers and resist measures that require modifications in gun design and production. Hemenway also argues that the gun distribution processes in the USA are problematic. Gun sales between private individuals, and at gun shows, flea markets, etc., are not regulated to the same degree as gun sales via licensed dealers. These are venues through which criminals, youth and the mentally unstable procure guns all too easily.

In the book’s final three chapters, Hemenway discusses American gun policy background, lessons and actions. He argues that the current prevalent understanding of the Second Amendment is mistaken. He points to a substantial body of legal precedent to make the case that this amendment is not about individual rights to gun ownership at all. Rather, this amendment addresses the rights of states to defend themselves against an aggressive federal government. He also argues that most Americans favor “reasonable” regulation of gun ownership and do not desire to ban gun ownership. With regard to lessons learned, Hemenway posits that society would benefit greatly by shifting its focus away from punitive gun laws toward practices that will prevent gun injuries. In his view, a public health perspective does not seek to prohibit guns ownership, it simply seeks to reduce and minimize society’s burden for that privilege. He concludes by recommending some broad policy actions, such as better education and enforcement of safe storage practices, more stringent regulation, licensing and manufacturing requirements and better surveillance of firearm practices and policies so that futile practices may be discarded and good practices enhanced.

The newer paperback edition of this book includes an afterword in which Hemenway provides updated evidence from recent studies to support his claims. The book also includes a helpful appendix that describes the strengths and shortcomings of methods employed in most gun policy studies and an extensive bibliography. The appendix listing famous civilians shot in the United States struck this reviewer as a trite, somewhat sensationalist, item to include in a work that generally achieves a high scholastic standard.

Overall, Private Guns, Public Health is clearly written, albeit dense with academic material. Hemenway occasionally uses anecdotal evidence in his arguments, but, by and large, he relies on a large body of statistical and scholarly analyses, presented in a fairly erudite tone. This is not light reading matter. Nevertheless, readers interested in policy studies, public health issues or the American “gun control” debate will benefit from reading this book.

No comments: