50 Pages


Course Number: STA 575, Fall 2009

College/University: Air Force Academy

Word Count: 23512


Document Preview

INTRODUCTION The picture is simultaneously appalling and appealing -- an infant playing with what appears to be a pistol. The issue is children and firearms. What's wrong with the picture is that the issue of "children" and firearms abuse, of firearms-related violence and death, virtually never involves an infant. In an average year, the number of infants killed, accidentally or...

Unformatted Document Excerpt
Coursehero >> Colorado >> Air Force Academy >> STA 575

Course Hero has millions of student submitted documents similar to the one
below including study guides, practice problems, reference materials, practice exams, textbook help and tutor support.

Course Hero has millions of student submitted documents similar to the one below including study guides, practice problems, reference materials, practice exams, textbook help and tutor support.

INTRODUCTION The picture is simultaneously appalling and appealing -- an infant playing with what appears to be a pistol. The issue is children and firearms. What's wrong with the picture is that the issue of "children" and firearms abuse, of firearms-related violence and death, virtually never involves an infant. In an average year, the number of infants killed, accidentally or criminally, with firearms is on the order of 10, out of nearly 40,000 infant deaths each year. (NSC [National Safety Council], 1992:22; FBI [Federal Bureau of Investigation], 1992:18) The "child" whose gun misuse has raised the number of gun-related deaths in the past few years to the point where some call it "epidemic" is a teenager without morals or manners or a hope for the future, whose experience with drugs suggests that banning a product does not much concern him. But attacking the problem of "children and guns" is politically appealing. Among the leading anti-gun organizations, the federal Centers for Disease Control and Prevention (CDC) noted that fact in the special "violence" issue of the Journal of the American Medical Association (JAMA): "There is no controversy in the area of children having unsupervised access to loaded guns. No one believes that children should have unsupervised access to guns, but few people are doing anything to prevent children from having such access. This, at least, is a place to start...while we in public health continue to explore the scientific issues associated with this question, through careful research and the evaluation of existing programs designed to reduce ready access to guns." (Rosenberg et al., 1992) With criminological evidence pointing more and more to the irrelevancy of general gun availability to violence, or gun laws to availability or violent crimes (Wright et al., 1983; Kleck, 1991), alternative attacks on firearms have become popular. These include inventing problems where there are no clear data, and no criminological studies exist, such as non-existent "plastic" guns, vaguely defined "assault weapons," and unavailable armor-piercing ammunition. More generally, children provide an interesting basis for suggesting restricting access to firearms. Children are innocent, where so many adults involved with firearms abuse are not. And, as was noted, no one defends unsupervised access to firearms by children. Children also invite rhetoric against claiming the Constitution prohibits restricting firearms. As Dr. Katherine K. Christoffel told Congress, "No one can believe that our Founding Fathers, in crafting the Second Amendment, intended to leave American children as vulnerable to firearm violence as they are today." (U.S. House of Representatives, 1989:40) Actually, of course, our Founding Fathers begot more than just a Constitution and a Bill of Rights. Guns were readily available; the nature of gun use (opportunistic hunting, home and community protection) encouraged them to be kept loaded more than today; and technologically the arms and ammunition were such that accidental discharges were more likely. And the urban homicide rates were apparently high, and at least as subject to unfortunate comparisons with England as today. (Davis, 1957:242) The timing of the interest by the CDC and others is curious. Most of the increase in firearm misuse had peaked by about 1979-81 (Fingerhut and Kleinman, 1989), and the trend of firearm misuse, among women and children in particular, was downward during the early 1980s. The National Coalition to Ban Handguns (NCBH, now the Coalition to Stop Gun Violence [CSGV]) and Handgun Control, Inc.(HCI), however, had begun focusing on children's misuse of firearms as a particular problem by the mid-1980s, and the CDC followed suit, pursuant to getting Congress to authorize such concern with injury deaths among "children" in 1986. Part of the expressed justification for the current emphasis is that firearms violence has spread to the suburbs and rural areas, and is not confined to inner-city blacks. That was the reason given by Dr. George Lundberg, editor of the Journal of the American Medical Association, and Lois Fingerhut, of the CDC's National Center for Health Statistics (NCHS), at the press conference held in Washington, D.C., on June 9, 1992, to herald the release of the June 10th issue of the Journal, and the release of the June issues of nine other AMA publications, each of which featured at least one article on the subject of violence. It is a commonly expressed message in the popular media. For example, "The problem is not confined to big cities like New York and Los Angeles. Kids have been gunned down in small towns like Obetz, Ohio, and Crosby, Texas." (DeClaire, 1992:30-32.) Or "this onslaught of childhood violence knows no boundaries of race, geography, or class." (Henkoff, 1992) But saying something has occurred some place is different from establishing that the problem approaches being similarly serious all places. One of the articles released by the CDC in JAMA emphasized the vast degree of difference in the problem of violence, homicide, and gun-related homicide among different groups. The gun-related homicide rate among males 15-19 years of age varied dramatically based upon race and location. Among big-city blacks, the rate was about 144 per 100,000; among rural blacks, the rate was 89% lower, at 15. In central cities, the white rate was about 21 (Fingerhut et al., 1992), and an analysis of some of the FBI's Supplementary Homicide Reports would suggest this means the non-Hispanic white rate was probably in the 10-12 range. For the most part, gun-related violence is a growing problem among young urban black (and Hispanic) males. For girls, women, and men over the age of 30, gun-related violence was stable or decreasing in the 1980s. (Fingerhut and Kleinman, 1989; Fingerhut et al., 1991; Hammett et al., 1992) Even one of the articles describing the problem as "epidemic" noted that the 50% increase in mortality of late in the "urban pediatric population" occurred with no change or a slight decline in the suburban and national pediatric populations. (Ropp et al., 1992) Nonetheless, to make a case for more restrictive gun laws, the CDC, other anti-gun organizations, and their friends in the media, produce a number of false or misleading statements. Many of the statements are accurate but irrelevant, for example noting percentage breakdowns of different types of gun-related death or different locations for accidents. Some of the statements might be described as half-truths, keeping in mind the warning that "half-truths are very commonly offered us in place of whole truths; and it sometimes happens that of all forms of falsehood none is so misleading as the half-truth." (Fiske, 1892:454) Other statements are either deliberately misleading and occasionally simply false. It might be flattering to opponents of restrictive gun laws that supporters must use distortion to buttress a case. But the issue of reducing the number of deaths among children is a serious one, and should be addressed seriously, particularly if taxpayer dollars are being expended, as is the case with the CDC. Everyone is against children killing children, but some of the statements calling attention to the problem and proposing solutions are less than honest, whether produced by the CDC, inspired by the CDC, or merely enjoyed by the CDC. DEFINITIONAL ISSUES A dramatic increase in the ranking of firearms as a leading "cause" of death in "children," expanding beyond the ghetto to the suburbs and even rural areas, affecting children with dramatic increases in the number of injuries threatening trauma centers, is said to have spurred the interest of "pediatricians" and other public health professionals in reducing firearms-related violence. Unfortunately, the use of terms is flawed and fluid. "Children" Medically, children would generally include those around 0-14; those would be the persons most apt to be treated by pediatricians, and most apt to be designated in various statistical studies dividing society into three age groups: pediatrics, 0-14; adults, 15-64; geriatrics, 65 and over (Covington et al., 1992). Other governmental breakdowns use four categories, splitting the "adults" into 15-44 and 45-64, as in the report noting about half the injury rate for children as for the two categories of adults, and about one-fifth that for geriatrics. (Graves, 1992) For statistical purposes, the fact that most data are reported in five- or ten-year age groups, with one normally ending at 14, helps to justify such a final period for childhood. In addition, in terms of firearms misuse, persons 15-19 are much more similar to persons 20-24 or 20-29 than to those 10-14 (Kleck, 1991:ch.7). Similarly, in terms of causes of death, the 15-24 age group is much more similar to the 25-34 age group, in terms of numbers and rank-ordering of causes of death, than it is to the 5-9 or even 10-14 age group. (Hammett et al., 1992:16-17) A clear definition of children as being 0-14 is, however, often avoided. The best example of the problem of the fluidity of the term "children" is in the materials produced by HCI (and its Center to Prevent Handgun Violence) and NCBH/CSGV (and its Educational Fund to End Handgun Violence) to demonstrate the problem. Both advocacy groups use the same photograph to indicate the problem of children and firearms: an infant pointing what is supposed to look like a Colt Model 1911A .45 caliber semi-automatic pistol at its face. (Treanor and Bijlefeld, 1989:cover photograph; Center to Prevent Handgun Violence, n.d.[2]) Firearms instructors would, of course, be appalled at the idea of anyone posing an infant with a gun pointed near its face, whether out of concern for the child modeling or for other children who might see the unsafe handling of firearms and seek to imitate it. On the other hand, most of the statistics regarding firearms-related deaths deal with "children" aged 15-19 or even 15-24, ages at which most violent offenders could, or must, be tried as adults, ages for which the United States Supreme Court has approved punishment by execution for capital offenses. Only slightly better an example of misleading uses of ages would be an article entitled "Kids & Guns," published by a Washington State Group Health Cooperative, featuring a cover photograph of a handgun being held by a male apparently about the age of 8-12. The article highlights a statement: "Homicide and suicide are the second and third leading killers among 15- to 24-year-olds, just behind car accidents." (DeClaire, 1992:33) Generally speaking, persons do not think of the 15-24 age group when thinking of "kids." And, while the homicide and suicide rates do follow motor vehicle accidents, they follow a considerable distance behind, with twice as many motor vehicle accidental deaths as either suicide or homicide (NSC, 1991:7). The reason for using the higher age groups is that those are the ones most involved in firearms-related violence, whether accidental, suicidal, or assaultive. Defining "children" as ending at 19, 81 percent of gun-related deaths involve persons over 14; defining children as ending at 24, 91 percent of gun-related deaths involve persons over 14. (Fingerhut, et al., 1991:11) It is easier to find a serious problem justifying massive public and legislative interest in 4,000 or 8,500 deaths than in about 750. To further emphasize the relationship of firearms to deaths among the young, not only are persons nearer to adulthood in law and medicine treated as children, but very young children are removed from consideration. Ignoring persons under the age of one provides two benefits to those seeking to maximize the apparent dangers of firearms to children. First, it allows the removal of 70% of deaths from the 0-14 age group. And of the nearly 40,000 deaths among children under one year of age, roughly ten involve firearms; the big killers are such natural causes as conditions originating in the perinatal period, congenital anomalies, and sudden infant death syndrome. (NSC, 1991:6-7,22; FBI, 1992:18) Second, by excluding non-firearm deaths, the percentage of firearm-related deaths rises. When the CDC announced that 11% of deaths of "children" involved firearms, the official report (Fingerhut et al., 1989), but not the press coverage, emphasized that "children" was not merely extended to 19 but excluded those under one. Otherwise, the percentage figure would have fallen to about 4.5% for those under 20, or less than 1.5% for those under 15. (Fingerhut et al., 1991; NSC, 1991) Similarly, rankings of "firearms" as the nth leading "cause" of death would be muddied, since the three leading causes of death for infants exceed the number of firearm-related deaths among children (0-14), and two of those causes of infant mortality exceed the number of firearms-related deaths among those 0-19. In addition, however, perhaps to take advantage of mortality data being on computer tape, public health professionals tend to play around with the definition of children, creating various age groups for various rhetorical purposes. In addition to the straight-forward extension of "children" to include 24-year-olds to near 1,000 accidental deaths in the home where more common definitions would put it at one-fourth of that (Teret and Wintemute, 1983), Diane Schetky used such age groups as "young children" (undefined), "young people aged 13 to 18 years," "college students," and "teenagers." (Schetky, 1985) Another group found the 13-17 age group an interesting one. (Wilson et al., 1991:149) The CDC's Mark Rosenberg (1992a) used a 12-24 age group. The CDC has also described "teenagers" as being 15-19 (Fingerhut, et al., 1992) and "children, teenagers" as being 10-19 year olds (CDC, 1992a) -- unfortunately in an article which also defined them as 0-19, leading some in the media to report that a statement regarding the smaller, older group (third leading cause of accidental death) applied to the larger, younger one, about which it was not true. There is no indication that the CDC has written to any news media outlets to correct the misreporting; it is unclear whether the CDC varies age group definitions deliberately to confuse not-very-bright and generally careless reporters. Perhaps the most absurd apparent definition of children was that used by Congress in enacting Public Law 99-649, calling for a study of injuries to "children." The legislative findings -- part of the Act of Congress -- asserted that injuries caused the deaths of half of "children" 1-15 and two-thirds of all deaths of "children" over the age of 15. In order for that to be approximately true, Congress's view of "children" was that they constituted persons aged 1-34 or 1-35. For younger "children," the data available to Congress would have indicated that injuries were the cause of 75-80% of deaths. (NCHS, 1987) "Pediatrics" and "Pediatricians" The issue of defining "children" is especially significant in explaining the interest of the American Academy of Pediatrics in firearms. In January 1992, the AAP announced its support of highly restrictive gun laws -- perhaps including bans on handguns, semi-automatic "assault weapons," and "deadly air guns" -- noting the data and trends on gun-related deaths and injuries among "children." (AAP, 1992; AAP Committee on Adolescence, 1992; AAP Committee on Injury and Poison Prevention, 1992) Speaking on behalf of its 42,000 member pediatricians, the position was justified because of injuries and deaths "affecting the pediatric population." Data were presented including age 0-19 (AAP Committee on Adolescence, 1992), but with emphasis on 15-19 year olds, even to the exclusion of those under one year of age (AAP Committee on Injury and Poison Prevention, 1992). Naturally, the AAP felt obligated to explain why firearms were of great concern to pediatricians, and did so by assuming the pediatric population was suffering from gun-related injuries. The data, however, suggested otherwise. About 86% of pediatric patients are in the 0-10 age group (Woodwell, 1992:3), involving under 250 gun-related deaths, or about 0.5% of deaths in the 0-10 age group (NSC, 1991:22; Kleck, 1991) and about 2% of the deaths in the 1-10 age group. Those gun-related deaths represent less than one percent of all gun-related deaths which occur annually in the United States. Indeed, most pediatric patients (69%) are 0-5 years of age, an age group which suffers approximately 150 firearms-related deaths out of about 47,000 deaths annually. Virtually all of firearms-related deaths among those under 20 (94%) occur in the 10-19 age group, which account for about 12% of pediatric patients. And, of course, the sorts of persons most involved in firearms-related violence for socioeconomic reasons generally receive less than average medical care. Nonetheless, the AAP justified its concern over "children" by noting that "one out of six pediatricians reported that he or she had treated a child for a gun-related injury" during the preceding year. (AAP 1992; AAP 1989a) The survey report is accurate, but may be misleading for a number of reasons. First of all, the term "gun-related injury" included air guns, in addition to rifles, shotguns, and handguns. The percentage falls to about 10% having treated handgun-related injuries during the preceding year, and about 3.5% treated long-gun-related injuries. (About 8% of pediatricians reported treating gun-related injuries related to criminal or gang-related activity, which might raise concerns about the likely impact of restrictive measures.) (AAP, 1989b) Second, the survey showed dramatic differences between those treating patients as part direct patient care and other pediatricians. Those in direct patient care were less likely than other pediatricians to treat such injuries -- and were more apt to own handguns and less likely to be involved in promoting community gun control legislation -- than were other pediatricians responding to the survey. If the proportion of handgun wounds to all gun (including air gun) wounds applies, then just over 7% of pediatricians engaged in direct patient care treated handgun-related injuries during the preceding year. It should not be surprising that those more apt to work in hospitals would be more apt to treat all sorts of ailments, particularly, as the AAP notes, those more apt to be treated in hospital emergency rooms than in private offices. (Letter from Dr. Ruch-Ross to author.) The fact remains, however, that the proportion dropped to only 7% likely to have treated handgun wounds in the preceding year. And estimates on the number of gunshot wounds occurring annually would suggest that only about one-third are treated in emergency rooms and the rest in office visits, or even not at all. (Kleck, 1991:ch. 2) Third, the survey tells nothing of the relative likelihood of pediatricians treating different ailments. Published results of surveys indicated over half of pediatricians had treated child abuse, and nearly one-third had treated child sexual abuse during the preceding eight weeks -- respectively, roughly five and three times as many as had treated gunshot wounds during the preceding twelve months. Similarly, 20% had treated a "serious bicycle-related injury" within the previous year, about twice the portion as for handguns, where seriousness was not reported. (O'Connor, 1991) Not surprisingly, the data really support the notion that gunshot wounds make up very little of the ailments treated by pediatricians, and that pediatric patients make up only a small portion of gun-related violence in America. And, of course, the survey gives no indication of whether there is a trend toward greater firearm- or handgun-related violence affecting children or pediatric patients. Trauma Centers The most popular figure given as a trend is "Since 1986, the number of gunshot wounds reported in children by major urban trauma centers has increased 300 percent." (AAP Committee on Adolescence, 1992) Alternatively, this has become: "Gunshot wounds to children ages 16 and under nearly doubled in major urban areas between 1987 and 1990." (Center to Prevent Handgun Violence, 1991a) In neither case is there much in the way of justification. The only hard data presented at a conference of the American Trauma Society (April 1992) involved an increase to about 125 injuries in hospitals in New York City (Christoffel, 1992). Nationally, it appears unlikely to be a valid statistic. The number of homicides and suicides have increased at a much lower rate; the number of accidental fatalities has been stable. The argument would have to be that homicides, suicides, and/or accidents are much less likely to be fatal recently. It is certainly possible that the shift in the firearms market from revolvers to semi-automatic pistols (Howe, 1992), which tend to make cleaner wounds, might slightly lower the fatality rate from assault, but one noticeable trend in urban youth shootings is for more wounds to be inflicted, indicative of an apparent increased motivation to kill. (Webster et al., 1992a) Nonetheless, the alleged increase in the numbers of young persons needing treatment for gunshot wounds is blamed for the threat to the continued existence of trauma centers, and thus another reason given in support of restrictive gun laws. (Skolnick, 1992) There is a threat to trauma centers for a variety of reasons, but blaming something other than the medical community itself seems farfetched. And some of the actual reasons point out how different the victims of gun-related violence are from the typical Americans HCI and CDC wishes the public to believe them to be. Trauma centers are threatened because new physicians and surgeons do not want to go into emergency medicine; existing surgeons do not wish to treat trauma victims -- neither the blunt trauma victims (largely from motor vehicle accidents) nor the penetrating trauma victims (largely from gunshots and stabbings). The former do not provide surgeons with enough operations, and surgery residents do not like "the unsavory type of patients encountered with most penetrating trauma injuries." (Organ, 1992) Those unsavory patients not only do not reimburse surgeons as well as other patients, but the surgeons do not wish them in the same office as other patients. The penetrating-trauma patients are not so well insured as normal patients. At one extreme, it was found that about 86% of gunshot injury patients were un- or underinsured, compared to the reverse, 88% of expenditures among hospital patients being covered by insurance generally. (Martin, et al., 1988; U.S. Bureau of the Census, 1991:Table 140) In addition to not paying as well as other medical work, emergency room trauma care increases exposure of physicians and surgeons in two major ways, not always acknowledged by the medical profession. Legal exposure is increased, particularly as it has been estimated that emergency room care is the single leading cause of "adverse events due to negligence" (Harvard Medical Practice Study, 1990), and some 25,000 of the 150,000 annual deaths from trauma are due to "an inadequate trauma system." (Organ and Fry, 1992) The other major exposure for trauma centers is to potentially contaminated blood. Again, atypically unsavory persons are the victims of penetrating trauma, whose unhygienic experiences with drugs and sex may expose them to the AIDS virus. Although the actual risk to HIV infection by treating physicians and surgeons is very low if universal precautions are used (Ling, 1992), universal precautions are universally ignored. (Hammond, et al., 1990) Instead of using precautions in treating bleeding patients, too many surgeons avoid the patient altogether. The danger to emergency-room personnel is from contaminated blood of penetrating wound victims -- generally assault victims. When those persons die, the official cause of death is homicide. "Causes of Death" In an effort to make it appear that firearms are the problem in society, the CDC and others prefer to ignore the International Classification of Diseases, where homicide, suicide, and accidental deaths are the causes for most gun-related deaths, and assert that firearms are a "cause" of death. This rhetorical tool exaggerates the significant of firearms, while inviting confusion as the rhetoric switches from various topics. The CDC has asserted in the same year that firearms and that suicide are the eighth leading "cause" of death. (Cotton, 1992; Kellermann et al., 1992) Once causes of death are separated out, and merged with different categories of death, a certain amount of consistency and certainty in discussion is lost. The official causes of death separate homicide and suicide from unintentional injuries (World Health Organization, 1977). But public health professionals also like to combine various "causes" in different ways, which will alter the rank-order. When tobacco becomes a "cause" of death, it outranks cancer (since many malignant neoplasms must be switched from one category to another); if alcohol is a "cause" of death, the rank-ordering changes in other ways. Combining all injury deaths to one "cause" ranks them third or fourth, if alcohol and tobacco ceases again to be "causes." The medical profession would presumably be less pleased with combining unintentional deaths due to medical mistakes into a new cause of death (Kleck, 1991:43), although it has also been suggested that hospital-caused blood infections could justifiably be listed as a new "cause" of death, probably competing with suicide for, now, ninth place. (Wenzel, 1988) Once causes of death are revised at the wills of the advocates and researchers, of course, different groupings and divisions can be made, some of which may be useful in evaluating trends and treatments, and some of which are largely rhetorical. Most scholars will separate out causes of accidental death into motor vehicle and other; but motor vehicle deaths are further capable of being broken down into categories by victim, such as passenger, bicyclist, and pedestrian. At that point, bicycles accidents tend to supersede firearm accidents as a cause of death among real children, thus possibly changing some rank-ordering for some age groups. (Baker and Waller, 1989) Alternatively, cancers and heart diseases could be broken down into more categories, some of which would be ahead of "firearms," suicides, and homicides. (NCHS, 1991; CDC, 1992b) Another risk in combining the various types of gun-related deaths is that it leads to otherwise avoidable statistical errors. For example, by assuming that, overall, there are about 3-5 non-fatal gun-related injuries for every fatality -- a figure which may be defended for gun-related assaults, but not for suicide -- public health activists, such as Katherine Christoffel, have suggested larger numbers of non-fatal injuries than were likely to have occurred. (U.S. House of Representatives, 1989:40-49) The more reasonable way to deal with firearms and children is by discussing the various causes of death in which firearms may be involved, along with some special concerns regarding firearms ownership and use by school children. THE RISK OF ACCIDENTAL DEATHS AND INJURIES Rhetorically, accidental firearms-related deaths and injuries provide the focus for much of the CDC and other public health interest in firearms, as well as in some of HCI's primary legislative proposals, such as storage requirements or public-health calls for redesigning handguns to make them "childproof." In one sense, this is reasonable, since, while firearms accidents normally account for about five percent of gun-related deaths in the United States, accidents account for over one-third of children's firearm-related deaths. (Kleck, 1991; NSC, 1991) On the other hand, accidental firearms-related deaths among children represent a rather small and declining number, roughly one-half the figure from the mid-1970s -- and that is true even if children are defined with higher than pediatric ages. (Kleck, 1991:310) Studies on the Possible Risks of Firearms Accidents One result is that some of the CDC's claim that firearms pose a public health problem which must be addressed is not based much on the actual misuse of firearms in accidents, but more on the potentiality for such misuse, generally combined with a warning against using education -- of adults or children -- as a means to prevent accidents. One survey noted no difference in how firearms were stored (locked and loaded or not) related to whether the owner had firearms instructions; "instruction in the proper handling of firearms was not associated with whether a gun was kept loaded when not in use." (Weil and Hemenway, 1992:3037) Unfortunately, instruction was measured by asking about training, including military training, which is not generally designed to address the issue of keeping firearms away from children. In addition, the dismissal came despite acknowledgement that the only study possibly relevant to actual misuse found that owners of guns involved in accidental shooting deaths of children were unlikely to have received any safety training. (Heins et al., 1974) The study did not deal with misuse of firearms, only with whether guns were stored in a potentially dangerous way. Similar dismissal of firearms safety instruction is widespread, but not studied. Wintemute dismissed education as irrelevant to reducing gun violence primarily because accidents play such a small role in firearm-related deaths, but they nonetheless lobby for other changes in gun regulations which are also aimed primarily at accidents, such as a call for loaded indicators and safety devices. (Wintemute, 1987) And a massive book on reducing violence, sponsored by the CDC, espoused many proposed cures for accidental shootings, but expressed concern about experimenting with education in firearms safety: "An important research question is whether the safety benefits of such courses are outweighed by their ability to promote an interest in firearms, an interest which increases the number of firearms in circulation and the potential for both intentional and unintentional injuries." (National Committee for Injury Prevention and Control, 1989:266) The AAP dismissed education asserting: "No published research confirms effectiveness of gun safety training for adolescents. Most preventive gun safety education is directed at hunters and marksmen, but hunting and target-shooting accidents are a small part of the adolescent firearm problem" (AAP Committee on Adolescence, 1992:21). The AAP went on to warn that because "gun safety education programs are also widely available and heavily promoted, the Academy cautions educators to choose educational programs and approaches carefully, avoiding those that might inadvertently encourage or promote the access of youth to firearms." And the CDC has opined that "educational interventions...are often expensive and rarely result in lasting behavioral change. Some educational interventions...may actually increase the probability of injury." (Kellermann et al., 1991:19) The American Youth Work Center agreed with Kellermann and his colleagues, complaining that "many youth organizations such as the Boy Scouts of America and the American Camping Association flat out promote marksmanship and gun ownership in households with children. This organizationally induced enthusiasm by children for guns adds up to a lot of dead Boy Scouts and unhappy campers." (Treanor and Bijlefeld, 1989) Clearly, more study should be done on the impact of firearms safety instruction, but public health professionals tend to dismiss it without study while espousing numerous other proposals with even less study. There is some indication of a relation of firearms safety instruction to reduced accidents, particularly with regard to hunting accidents (Kleck, 1991:ch. 6) -- and data from the Hunter Education Association (1991) indicates that only about one-third of hunting accidents involve shooters who are hunter education course graduates, even though the numbers of educated hunters, and state laws requiring instruction for hunters, would suggest that the vast majority of hunters have such instruction. And more study has to be done on the relationship of potential access to firearms, due to storage and other practices, and any actual harm. Most public health research on children's actual access to firearms notes that the access exists and assumes that involves a serious hazard, even while acknowledging that the access is among low risk youth. (Callahan and Rivara, 1992) An even more ludicrous study by CDC researchers demonstrated that firearms were often in the homes of so-called "latchkey children" (with no parent at home after school), and that this posed a problem because the "mix of guns in the home and unsupervised children can be deadly." (Lee and Sacks, 1990) There was no indication that it actually was deadly. There was no effort to find whether latchkey children were disproportionately involved in gun-related accidents. There was no effort even to determine whether an increasing number of latchkey children was associated with an increase in firearms-related accidental (or other) deaths. (Although, of course, with gun-related accidents down, the relationship would be suggestive more if the number of latchkey children were declining over the past 15 years.) Since accidents play such a small role in firearm-related deaths both overall and among children, the distortions regarding actual accidental shootings are relatively minor, with rhetorical statements of accurate data more common. It may be asserted, for example, that a certain percentage of gun-related accidents occurred in various locations (home or part of home, for example), or involving the victim shooting himself versus being shot by another, or whether the gun was in the victim's home or that of someone else, and the relationship of shooter and victim. (Center to Prevent Handgun Violence, 1991a) A few distortions do make their way into the literature, such as the AAP's assertion that majority of accidental deaths of "children" 0-19 involve boys under 15 (AAP Committee on Injury and Poison Prevention, 1992) -- a statement which would be accurate if younger girls were included. (NCHS, 1991:300) But the most common potentially misleading statement is to state that firearms represent the third, fourth, fifth, or sixth leading cause of accidental death among a particular age group. As Kleck has repeatedly pointed out, while the statement may be true, the actual numbers -- particularly estimates for handguns as a portion of the firearm-related accidental deaths -- are fairly small, and declining. And the actual accidents may be still fewer, with some child-abuse homicides disguised as firearm-related accidents. The three leading causes of accidental deaths among children -- motor vehicles, drowning, and fires -- are far ahead of firearms. (Kleck, 1991; U.S. House of Representatives, 1989:50-69; NSC, 1991:22) Occasionally, some distortion is made by changing the statement that firearms are the nth leading cause of accidental deaths, or were in some recent year, but that they have "become" the nth leading cause -- a ranking which has been stable. Studies of Children's Firearm-Related Accidents There have been a few studies of actual misuse of firearms in accidents. Most of the information is accurate so far as it goes, merely indicating that accidents often occur where firearms are apt to be stored, frequently occur in the home of the victim, sometimes involve friends and other family members, and the like. The studies provide basis for rhetorical use, especially since one of the studies was performed by HCI's Center to Prevent Handgun Violence, and another was produced by gun-ban advocates. (Wintemute et al., 1987) Perhaps the only interesting point is that revolvers were disproportionately involved, relative to probable ownership at the time, in children's firearms accidents -- suggesting one of the benefits of the apparent shift in handguns from revolvers to semi-automatic pistols. (Howe, 1992) One major study was performed by the General Accounting Office (GAO, 1991), at the request and with the guidance of Senator Howard Metzenbaum, to evaluate whether two proposed modifications of firearms would help to save children's lives. The premise was that, while 84% of the deaths involved violations of NRA safety guidelines, 31% involved shootings where either a loaded indicator or a passive safety device would have prevented the shooting. There are a number of problems with the GAO report. First, their sample was unrepresentatively young. Nationally, less than 3.5% of accidents involve persons under the age of five; the GAO sample had 8% in that age group. Nationally, about 40% of firearms-related accidents involve victims at least 31 years of age; in the GAO sample, only 16% were over the age of 30. Nationally, less than one-third of accidents kill persons under voting age; over half of the GAO sample was too young to vote. In the one area where there is clear knowledge about gun-related accidents, the GAO sample was unrepresentative. Under the circumstances, there can be little confidence regarding estimates from such a sample. And, since the sample overrepresented urban accidents, the 70% handgun involvement is not evidence that such is the overall involvement, although it has been relied upon (Weil and Hemenway, 1992), as if it were definitive: "The federal government reports that handguns are involved in 70 percent of unintentional firearm deaths." (Goldfarb, 1992) National data are unavailable, although where a firearm type is identified, handguns are involved less than half the time. As has been noted, however, if one is assessing the risks of loaded guns, the issue would be, relative to being kept loaded, what percentage of firearm accidents involve handguns? And the suggestive data are that handguns, relative to loaded accessibility, are disproportionately less involved in accidental fatalities than long guns. (Kleck, 1991:280-281) There were additional problems with their recommendations, although they have been popular with the CDC and its grantees. The recommendation that guns all have loaded indicators -- some device for determining whether the firearm is loaded -- is worthless without some education about what the indicator is and what it means. Thus, the denounced education remains essential. The GAO also noted that the loaded indicator, to be effective, would have to be put onto all firearms, noting that the false assumption that the device was on the gun could mislead and increase carelessness. For a number of reasons, gun owners would not cooperate by having their firearms retrofitted with such devices. And, unlike consumer products with rather short life spans, where safety improvements can be imposed prospectively with some hope of rapidly covering most of the items owned by consumers, firearms last for decades. Another problem with the idea is that the education associated with loaded indicators would run counter to proper safety instruction. Under NRA guidelines, a firearm is presumed loaded until proven otherwise. The GAO approach would teach that, if a loaded indicator indicated that a firearm were empty, one could treat it as if it were unloaded. Such education would fly in the face of rational education. To gun owners, firearms have a variety of loaded indicators: open cylinder, open bolt, etc. The other proposal was estimated to cover a smaller portion -- 8% compared to 23% for loaded indicators -- by requiring passive safety devices, devices which automatically renders the firearm inoperable until disengaged, as opposed to safeties which have to be deliberately engaged. The most common example is the grip safety, where the hand gripping the gun releases the safety. The GAO's assumption was that passive safeties would save the lives of children too young to strongly grasp the gun, although too high a percentage of their sample involved persons that young. Again, the GAO acknowledged that the device should be universal to be effective, and might be counterproductive if absent on large numbers of firearms, since that would encourage false confidence of safety. In general, firearms owners do not wish passive safety devices. In public addresses, Stephen Teret often uses as an example of a passive safety on a revolver a model of Smith & Wesson. The marketing history of that revolver tells something of the likely success of such a device. In response to the fact that gun owners were undoing the safety, Smith & Wesson modified the gun so that inserting a pin would allow the safety to be permanently disengaged. Then, further responding to market pressures, the grip or backstrap safety disappeared altogether. Although Teret asserts the revolver was never involved in an accident, some firearms experts have asserted that the way children play dangerously with revolvers (with thumbs inside the trigger guard and the rest of their hands at the back of the gun with muzzle point toward the child), they do have strength to disengage the safety. In any event, gun owners generally decide which safety devices they want or do not want, and if a firearm comes with unwanted safeties, they are permanently disengaged, either with amateur or professional gunsmithing, or jerry-rigging. The most common passive safety, the grip safety, can be easily permanently disengaged even by the mechanically incompetent by using a variety of household tapes. Gun owners would be unlikely to allow guns to be retrofitted with unwanted safeties. Most owners of classic automobiles have not had them retrofitted with seatbelts, and, of course, the permanent buzzer warning of unengaged seatbelts was changed because so many drivers were disengaging the device. Similarly, while childproof medicine bottles enhance safety, many adults overcome the device for ease of use. And the risk is that parents taught that guns have passive safeties could endanger children by not being cognizant that most guns do not, and will not, have such safeties. As a practical matter, most regulations of consumer products affect the manufacture and sale; the consumer is generally free to alter products for personal use at will, as the National Highway Traffic Safety Administration has felt compelled to point out. (Breslin, 1992) The only review of firearm-related accidents giving some care to statistics, and without an anti- or pro-gun bias, suggests that accidents, like homicides, are not something threatening all groups in society, or even all gun owners, equally. Accidents, particularly among the older "children" popular with anti-gun activists like HCI and the CDC, disproportionately affect persons who are reckless, abuse alcohol and drugs, engage in violent behavior, and the like. And, despite lower levels of gun ownership, such accidents disproportionately involve young black, rather than young white, males, and persons less likely to get pediatric care for reasons of age and social class than safer individuals. (Kleck, 1991:ch. 7) Popular Assertions Regarding Accidental and Total Children's Gun Injuries and Deaths The leading cause of death in both black and white teenage boys in America is gunshot wounds. (Koop and Lundberg, 1992) The statement is true for blacks, due to their high and increasing homicide rate. For whites, the statement is not true, even assuming one is adding suicides, accidents, and homicides with guns. Unintentional injuries rank number one, with enough involving motor vehicles alone for motor vehicles to rank first even if types of accidents are disaggregated. (NSC, 1991; Hammett et al., 1992:18) For each child killed in a firearm-related incident, another 100 are seriously injured. (Vinokur, 1992) The more common -- and more likely accurate figure -- is about ten injuries for each death, with the ratio varying based upon whether the incident was a suicide attempt, an assault, or an accident. The inaccurate figure is based upon an unrepresentative sample of ten police departments by the GAO (1991), in a study which found 5 deaths and over 500 injuries. Even if the figure were true for accidents, they represent a minority of gun-related deaths, and the 100 could not be applied to gun-related assaults or suicide attempts, the apparent means for achieving the absurd statement: "In the past decade, more than 138,000 Americans were shot just by children under the age of 6." (Hartford Courant, July 5, 1992) One child is killed accidentally with a handgun every day, according to the National Safety Council. Actually, it is according to HCI. The NSC reports about 230-250 accidental firearm-related deaths among children annually, which would work out to 4-5 per week. But that included rifles and shotguns, and it includes some homicides, most likely child abuse by parents, guardians, and their close acquaintances, disguised as accidents. (Kleck, 1991:ch.7) The actual figure is unknown but probably between 100 and 200, with "every other day" a more accurate rhetorical way to put the matter. The figure is declining, and would have been an understatement as applied to all firearms when HCI was first making the assertions -- with regard to handguns alone -- in the mid-1970s. A study of accidental shooting of children 16 and under indicated about 50% occurred in the victims' home, 38% in the home of a relative or friend, the handguns were most often found in bedrooms, and boys predominated as shooters and victims. (Center to Prevent Handgun Violence, 1991a) The study by an anti-gun advocacy group provides unsurprising data, which merely indicates that whatever size pie exists, it may be divided up into various categories. With the small and diminishing number of accidents, it indicates that a few gun owners should be more careful about storing their handguns; and that all young persons should have basic knowledge about firearm safety/avoidance, since accidents may involve children from households without gun owners. There is a need for "limiting access to firearms among children, in order to reduce unintentional injury and death....ready access to loaded firearms in the home for children under 15 is the chief contributing factor in unintentional shootings, with an increasing in the use of firearms paralleling an increase in violent deaths." (Novello, 1991) The basis for the Surgeon General's remarks is unclear. Firearm-related accidents are declining more rapidly than other types of accidents -- motor vehicle, other public accidents, home accidents -- rather than increasing with increases in suicide and homicide. The assumption that gun accidents involving children occur with loaded firearms in the home more than with unloaded guns or elsewhere is true but not a contribution to scientific debate. There is one interesting facet to the argument about guns in the home leading to firearms accidents. Overall, bicycle accidents kill more children under the age of 15 than do firearms-related accidents. But, whereas the arguments against firearms focus on what occurs in the privacy of the home, where regulation might be difficult or impossible to enforce, efforts to curb bicycle accidents would be aimed at public activities in public places. Unlike firearms, which are generally used by adults, children's bicycles are rarely used by anyone but children; and regulation of them would be aimed at public activity. Yet efforts to curb bicycle accidents among children by banning children's bicycles are rarely, if ever, heard, even among CDC researchers, who focus instead on the need for helmets. Guns are the fifth leading cause of death in young children. (Group Health Cooperative of Puget Sound, 1992) Other variations are that handguns are the nth leading cause, or that handguns or firearms are the nth leading cause of accidental death in a particular age group. Generally, the statement is arguably true, although it could be modified depending upon how other causes were defined (bicycles separated from other motor vehicle, and the like). Sometimes, they may be slightly off by one or two. In this example, "young children" is undefined, and is only true if (a) children below the age of one are excluded, and (b) children up to the age of 14 are included. For "young children" aged 1-4, firearms would come in 10th place, with about 100 deaths -- or 12th, if three different types of accidents were separated out from the total "unintentional injuries" category; for "young children" aged 1-9, the 230 deaths would come in 7th -- 9th if unintentional injuries were divided up into categories counted separated. (NSC, 1991; Hammett et al., 1992; FBI, 1992) A CDC study (1992a) reported that firearms accidents were third after motor vehicles and drownings among children 10-19, but then discussed the number of accidental shootings among those 0-19, leading some in the news media to misunderstand and report firearms third for all children (Associated Press, June 26, 1992), whereas they are fourth among the types of accidental deaths normally reported separately. It is unclear whether CDC's easy to misunderstand paragraphs are supposed to mislead the news media or merely combine so many different data sets that the news media are accidentally misled. The problem is that a rank-ordering might be accurate if said of all firearms but not if said of firearms accidents, or of all firearms, but not handguns, etc. For example, it was reported that "unintentional gunshots are the sixth-leading cause of death for children under 14." (O'Neill, 1990) The statement is not close to true, but could be with only a few changes in defining age, or redefining categories -- perhaps just making it "injury-related" so as carefully to include various unintentional injuries as well as homicide. One of the key points, as Kleck points out, is that, whatever the ranking, the number is small. For the most part, "causes" ahead are far ahead. Gun-related accidental deaths disproportionately affect youth. (CDC, 1992a) Firearms-related accidents, like accidents from risk taking in general (overall, accidents disproportionately affect geriatric Americans), most affect teenagers and young adults. As an overall rate for children 0-14, the rate of 0.5 is not much different from the overall rate of 0.6. (NSC, 1991; U.S. Bureau of the Census, 1991:18) For young children, aged 0-9, the rate is half the national rate. Eleven (or 12) percent of children who die are shot to death. The CDC study which came up with 11% (Fingerhut and Kleinman, 1989) carefully excluded those under the age of one. Including them, firearm-related deaths would have accounted for 4.5% of the deaths of "children," or one-sixth of one percent of all deaths of Americans annually. Firearm-related deaths of children 0-14 account for about 0.04% of American deaths. Of deaths in the 1-14 age group, firearms are involved in about 5% (NCHS, 1991). Redefining children as 1-19 allows the 11% figure from 1989 to be raised to 12%. More teenagers now die from firearms than from all natural causes put together. Thanks to modern medicine, that is how it should be. Persons who survive the killers of childhood -- perinatal conditions, birth defects, sudden infant death syndrome -- should be generally safe from natural causes until middle age. The change is not increased violence, but decreased deaths from infectious and parasitic diseases. And the main threat to alter that statistic, particularly among the young adults occasionally included in the "children" category, comes from infectious diseases, particularly the human immunodeficiency virus. Deaths of teenagers and young adults are tied to reckless and aggressive behavior. The costs of treating youthful gunshot wounds is threatening emergency rooms. In fact, the rate of injuries to persons 0-19 which might include firearms (unintentional firearms injuries, suicide attempts, assault/undermined) are not out of line in numbers compared to other causes of injury, appear to total less than sports injuries, falls, motor vehicle occupant injuries, bicycles injuries in number and to differ from them little enough in cost as to pose no proven excess burden. (Malek et al., 1991:1002-1003) SUICIDE Suicide is a more fertile field for alleging that unfortunate trends among youth justify restrictive gun laws. Unlike accidents, the trend is in the wrong direction. Unlike homicide, there is less contrary rhetoric that youth who have no trouble finding controlled substances like heroine or cocaine will have no trouble finding controlled firearms. Unfortunately, deception is still deemed useful in the cause of attacking firearms. Trends Both nationally and among children (10-14 or 10-19; younger children are presumed too immature willfully to take their own lives and attribution of suicide to them is quite rare -- NCHS, 1991), the suicide rate rose from the 1950s to the 1970s, and much if not all of the rise was in suicide by firearm. This provides a nice trend for saying how much worse things are getting, and that the cause is firearms availability, particularly handgun availability. (Boyd, 1983; AAP Committee on Adolescence, 1992) Again, changes can be reported for a variety of time periods, age groups, and either overall or including only firearm-related suicide. For example, the total suicide rate rose among teenagers 15-19 about 75% between 1968 and 1987 (Fingerhut and Kleinman, 1989), and the gun-related suicide rate between 1979 and 1988 rose 60% among younger "teens" (10-14) and 30% among the older teenagers (while generally falling for young adults) (Fingerhut et al., 1991). Certainly, this trend is considered relevant by HCI, the CDC, and other anti-gun advocacy groups, which tie it to the increase in handgun availability. One problem with reliance upon the trends is that, as Kleck has noted (1991:ch.6), most of the increase in gun-related suicide occurred prior to the increase in handgun availability, most of which occurred after the early 1970s, peaking by around 1980. The dramatic rises in suicide were not associated with dramatic increases in handgun availability. Trends are more convincingly associated with other factors trending in the same direction at some reasonably associated time. As an excuse for current interest in firearms restrictions, the citation of trends may best be called highly misleading. For the most part, the trends cited are over the past 3-5 decades (Center to Prevent Handgun Violence, 1991a; U.S. House of Representatives, 1989:45) or between 1970 and 1980 (AAP Committee on Adolescence, 1992), although the AAP press release announcing their support of a handgun ban went further, misleadingly asserting that "Adolescent suicides are rising sharply, and most involve handguns." (AAP, 1992) As Kleck has noted, there has been relative stability in gun involvement in suicides of young persons for about 15 years. (U.S. House of Representatives, 1989:64) And the rise in suicide has not been distinctively sharp. Another problem with crediting the suicide increase to an American phenomenon is that the suicide trend is apparently not. There is a reported increase in suicide among teenagers and young adults throughout the industrialized world (CJ Europe, 1991). The British reported a 78% increase between 1980 and 1990 in the suicide rate for young men aged 14-24 in England and Wales, credited to the "increase in the availability of cars" (Hawton, 1992). Although time frames and age groups are slightly different, it would appear that the recent rise in suicide rates among young men has been faster in gun- restricted Britain than in the United States. The CDC and its researchers and supporters would generally be unaware of such statistics. While occasionally comparing American homicide rates with those of different countries (Fingerhut and Kleinman, 1990; AAP Committee on Injury and Poison Prevention, 1992; Sloan et al., 1988; Ropp et al., 1992; Koop and Lundberg, 1992; Cotton, 1992; HCI, n.d.), discussions of suicide tend to focus on the United States. One of the few exceptions, comparing suicides in Seattle and Vancouver -- where the overall suicide rate was higher -- concluded with the curious suggestion that a restrictive gun law could reduce the suicide rate among one age group while having no impact on the total suicide rate. (Sloan et al., 1990) At the very least, the question of how one reduces a subset without reducing the set calls out for some explanation. Firearms and the Risk of Suicide While the trend data are merely irrelevant to an argument for restrictive gun laws, and the data presented are generally probably accurate, the risk of firearms availability to suicide among children is one which has invited some outright lies by "gun control" advocates. Relying upon the American Association of Suicidology (a member of the NCBH/CSGV), Dr. Katherine K. Christoffel testified on behalf of the AAP before the House Select Committee on Children, Youth, and Families: "Every three hours, a teenager commits suicide with a handgun." (U.S. House of Representatives, 1989:45) It is a figure used as well by both an offshoot of the NCBH/CSGV -- saying "firearms" rather than "handguns" -- and HCI (Treanor and Bijlefeld, 1989:3; HCI, n.d.) In 1988, among persons under the age of 20 there were under 1,400 suicides involving firearms of all kinds -- less than 200 with handgun involvement reported, but most NCHS data on firearm-related deaths do not include the type of firearm (NCHS, 1991) -- while the AAP data would suggest 3,000 involving handguns alone. And, while it is alleged that some gun-related suicides may be misclassified as accidents to spare the feelings of parents, there are not enough such occurrences to explain more unreported suicides with handguns than suicides with firearms. More recently, advocates of restrictive gun laws have a new bogus figure: "teen-agers in homes with guns are 75 times more likely to kill themselves than teen-agers living in homes without guns." (Reeves, 1992) That particular invention had an interesting development. In a small-scale study of suicides, attempted suicides, and non-suicidal teenagers with psychiatric problems, firearms were roughly twice as likely to be in the homes of the suicides as in the homes of those western Pennsylvanians who unsuccessfully committed suicide or those who had psychiatric problems but were non-suicidal. (Brent et al., 1991) There was no suggestion, nor any study, of the possible risk factor of firearms in the home of teenagers who were not suicidal. Indeed, the ownership levels overall for the sample of mentally disturbed teenagers was lower than would have been expected in western Pennsylvania overall, based on the popularity of hunting in the area. The Journal of the American Medical Association (JAMA) frequently has an editorial, written in or out of house, accompany major articles. In this case, three employees of the CDC authored an editorial, asserting that "the odds that potentially suicidal adolescents will kill themselves go up 75-fold when a gun is kept in the home." (Rosenberg et al., 1991) There was nothing in either article or editorial to suggest that there was any increased risk for non-suicidal adolescents; and the suggestion that access to firearms by suicidal teenagers should be restricted was clearly not controversial (Blackman, 1992). But the 75-fold or 75 times figure was sheer invention, as was noted in unpublished portions of the letter published by JAMA (Blackman, 1992). Instead, the lie was withdrawn in a "correction" printed in JAMA. Unfortunately, corrections in JAMA are fairly well hidden compared to corrections in news media like the Washington Post, but the relevant portion read: "The second sentence of the Editorial should have read as follows: 'In fact, the odds that potentially suicidal adolescents will kill themselves more than double [not "go up 75-fold"] when a gun is kept in the home.'" (JAMA [April 8, 1992] 267:1922) Although the CDC corrected its lie, there is no indication that any steps have been taken to correct those misusing their figure. Certainly, this author has seen no letters to the editor correcting the falsehood when it appears, and in a discussion in Washingtonian Magazine offices in July 1992, HCI denied there was any correction, so the CDC apparently did not correct themselves to one of their most avid readers. And the lie lives on in congressional testimony by Senator John Chafee (1992). Popular Statements Regarding Suicide and "Children" The suicide rate of adolescents has tripled in the past three decades, making it the third leading killer of teenagers. (Center to Prevent Handgun Violence, 1991a) The trend occurred from the 1950s to the 1970s. It is not a recent trend, indicating an "epidemic," but the gradual increase following sharp increases from about two decades ago. (U.S. House of Representatives, 1989:64; Kleck, 1991:ch.6) Almost 3,200 pre-teens and adolescents take their own lives with guns every year -- one every three hours. (Center to Prevent Handgun Violence, 1991b) The figure is over twice the official figure from the National Center for Health Statistics (NCHS, 1991). It may be achieved either by counting all suicides, regardless of instrumentality, or by raising the age of adolescents to 24. Handguns account for 70 percent of all firearm suicides. (Center to Prevent Handgun Violence, 1991b) There are no national data on handgun involvement in firearm-related suicide. The study upon which HCI's Center is relying was based on an urban sample; handguns tend to predominate in urban areas more than in rural areas and small towns. Guns are the most lethal form of suicide method. (Center to Prevent Handgun Violence, 1991b) The statement is true, although firearms are on a par with hanging, CO exhaust, and drowning. The statement does not contribute to the real question, which is whether firearms are chosen because suicide was the intended result, or suicide resulted because firearms were chosen. Evidence tends to suggest the former, with little suggestion suicides would not occur if there were restrictions (Kleck, 1991:ch.6) -- a view supported by the high suicide rates in areas with far fewer firearms, including Canada, Japan, and much of Europe. HOMICIDE AND OTHER VIOLENT CRIME Homicide and other violent crime has presented the best opportunity to cite increases in firearm use as a reason to consider restrictive gun laws -- although, as others have said: "[I]t is useful to point out that nearly everything that leads to gun-related violence among youths is already against the law. What is needed are not new and more stringent gun laws but rather a concerted effort to rebuild the social structure of inner cities." (Sheley et al., 1992:682) Nonetheless, it is the criminal homicide trend, particularly among young persons -- often called "children" but emphasizing persons 15-24 -- which has justified the assertion that there is an epidemic of gun-related violence crying out for a public health solution. (Cotton, 1992; Fulginiti, 1992; Marwick, 1992; Mason and Proctor, 1992; Callahan and Rivara, 1992) Recent trends in homicide, particularly firearms-related homicide, in America have been discouraging (Law Enforcement News, 1990), although the push to tie restrictive gun laws to misuse by children began while reported trends were still moving the right direction. And, for the most part, the real sharp increase in homicide -- and firearms-related homicide -- occurred in the 1960s and 1970s, and went down during the early 1980s. (Baker et al., 1984:90- 91) As Kleck has noted, the homicide rate, and gun involvement in homicide, for persons 0-19, improved somewhat in the late 1970s and 1980s, and did not begin its upwards drift until 1987 (U.S. House of Representatives, 1989:60), by which time the anti-gun groups had already begun to emphasize children as the reason for needing more restrictive gun laws (Treanor and Bijlefeld, 1989:Unpaginated letter from Constance A. Morella), and after Congress had passed legislation calling upon the CDC to study injury-related deaths among children. This is true even in the areas where the involvement of children has received great publicity. Seventeen percent of homicide victims in the District of Columbia were aged 15 and under in 1980 (personal communication from D.C. police), and the figure for those 17 and under fell to 6% in 1986, rising to 11% in 1991. The suspected assailants were under 18 in about 6% of the homicides in 1986, rising to about 20% in 1989 and 1990, and falling back to 10% for the first half of 1991. (Johnson and Robinson, 1992) Trends in Violent Crime and Homicide Involving Children and Firearms Overall, the involvement of younger persons (under age 15, or 18) in violent crime was generally stable or declining from the mid-1970s to 1987, as has been demonstrated by Gary Kleck (U.S. House of Representatives, 1989:60-61). Since that time, there has been an increase, coincidentally beginning almost exactly the time Congress expressly authorized the CDC to begin addressing the issue of injury-deaths among youths. The rise has not been across the board, either in terms of who is apparently committing the crimes (based on arrest record), or on the types of criminal violence. (FBI, 1992:220-229,279-289). For most crimes, the 1980s saw stability in the arrest rates among white youth and other non-black races, except for slight very recent increases. Overall, and particularly for homicide, the black arrest rate rose dramatically. For all races, one of the more shocking aspects of the arrest trends is that there is a dramatically greater increase in arrests for homicide than for other violent crimes. Violent crime arrest rates were fairly stable from the late 1970s to the late 1980s, but then rose substantially, while property offenses dropped. (Snyder, 1992) Similarly, teenage victims in crime surveys indicate a decrease in theft but with a downward trend in violent victimizations during the early 1980s being replaced by a increase in violent victimizations more recently, up to levels reported around 1979-81. (Whitaker and Bastian, 1991:3) But clear and dramatic increases in crimes involving young persons, especially blacks, as perpetrators and victims, have occurred. The same trend is clear with CDC data. In order to show dramatic increases, the CDC has to be careful to use the mid-1980s for comparison, since the late 1970s and early 1980s will fail to show dramatic changes, or, for some age and racial groups, any changes, whether looking at homicide overall or at gun-related homicide. Compared to 1979-81, only the homicide rate for infants under the age of one has risen dramatically -- and almost none of those homicides (roughly 3%) involve firearms. (FBI, 1992:18; Hammett et al., 1992) For other youthful age groups (1-4, 5-9, 10-14, 15-24), the homicide rate remained fairly stable, and for all other age groups, the homicide rate declined during the 1980s. (Hammett et al., 1992) The same is generally true as well for firearm-related homicides, except among young black males up to the age of 25, and for black females aged 10-14. For most five-year age groups, homicide was fairly stable, declining, or rising only modestly, between 1979 and 1988. (Fingerhut et al., 1991:7-8) To find a clearly upward trend in homicide and gun-related homicide, it is necessary to use the mid-1980s at a starting point and to emphasize young black males (aged 10-24), for whom a decline in the early 1980s was followed by a much greater increase in more recent years. Even with recent homicide increases, the rates are generally lower for others than around 1979-81. (Hammett et al., 1992; Fingerhut et al., 1991) Furthermore, one has to emphasize young blacks from central cities, since the firearm-related homicide rates for other black teenagers are dramatically lower. (Fingerhut et al., 1992) The response of the CDC and other anti-gun organizations is to blame the increase in homicide with firearms among this small subgroup of the population on the increasing availability of firearms. Indeed, even though the CDC's mandate was especially to be concerned with the problem of homicide among minorities (U.S. Public Health Service, 1979; Smith et al., 1986), in studies the CDC has glossed over the fact that all differences between groups' homicide rates are because of different rates among different ethnic groups. (Sloan et al., 1988) Even the upward trends, however, cannot be blamed on the increased availability, primarily because there has been no such increase. The percentage of households with firearms has remained stable for decades, and the percentage of households with handguns stabilized by the mid-1970s. In addition, the fluctuation in criminal and other misuse of firearms has been inconsistent with any increases in firearms per capita. And black gun ownership, and handgun ownership levels, have been and remain lower than the levels for whites. (Kleck, 1991) And the firearm market -- handgun and long gun -- was flat during most of the mid-to-late-1980s. (Howe, 1992) If firearms, or handguns, are only a risk factor for criminal homicide victimization among young, black, inner-city males, some other explanation might reasonably be expected for the stringent limitation of the risk factor. And to play up the threat to "children," it is essential to use data from the 15-19 age group, or 15-24 age group, or a 10-19 age group. For young children, the homicide rate and the gun-related homicide rate no major trend, with the greatest overall rise among infants, where firearms are not a factor. And even the upward trends among some age/race/sex groups below the age of 15 are all with very small numbers and rates. Indeed, the homicide rates are higher for children below the age of five than for children aged 5-14, for whom the homicide rates have remained around 2 per 100,000 and the gun-related homicide rates around 1 per 100,000, although gun-related homicide has risen faster than other homicide for those 10-14 years of age. (Hammett et al., 1992; Fingerhut et al., 1991) Yet homicide rarely involves firearms for those youngest of children with a homicide rate about 8 per 100,000 (3% firearms), and almost as rarely for the next youngest age group, at about 15% for 1-4 year olds. (FBI, 1991) On the Nature of Youthful Homicide To support the idea that everyone should be concerned, the CDC likes the myth that homicide threatens everyone. "It's not limited to the inner city" (Cotton, 1992), "this onslaught of childhood violence knows no boundaries of race, geography, or class." (Henkoff, 1992) The statements are true only in the sense that dramatically lower levels of violence are not the equivalent of no violence at all in small towns, suburban, and rural areas. One might as well suggest that private airplane crashes can threaten anyone -- but available evidence suggests that the rate for persons on board private airplanes is vastly higher than for those on the ground or in commercial airliners. Homicide, and particularly escalating homicide rates, largely, are limited to the inner city, and, indeed, to low-income minorities within inner cities. (Fingerhut et al., 1992) The AAP's explanation for youthful homicides is sheer invention: "A common misperception is that teen homicides are largely related to crime, gang activity, or premeditated assault, when in fact the majority of shootings are committed by friends or relatives. The most common event precipitating a shooting is an argument, often over something later seen as trivial. Such shootings are usually impulsive, unplanned, and instantly regretted." (AAP Committee on Adolescence, 1992) As is common in medical writings, a source is cited. As is also common in such writings, the source cited does not support the statement. The source mentioned only the relationship between homicide victim and assailant. On inquiry, an AAP representative changed sources to a talk by the CDC's Patrick O'Carroll. Dr. O'Carroll responded that he had not made any study on the subject, and if he made any such statements, they were based on his impression rather than research; if the shootings were over "something later seen as trivial," that is, it was later seen by Dr. O'Carroll to be trivial. He had no explanation for the assertion concerning the time frame for regret, and cited general impressions of Zimring for the lack of planning for firearms-related homicides in general. (Letter from Patrick W. O'Carroll to Paul H. Blackman, March 18, 1992) Dr. O'Carroll's impressions are inaccurate. The shootings are frequently gang related, sometimes planned. Compared to adult killings, juvenile killings are more likely to involve multiple offenders, are more apt to involve an accompanying felony, and, a fact also noted by the CDC, are more apt to involve shootings. (Cheatwood and Block, 1990) While Dr. O'Carroll's impressions may be that the shootings are instantly regretted, what has fascinated the news media and shocked adults is that the adolescents -- generally not really children, after all -- have no regret at all regarding the taking of a life. The lack of remorse, the indifference regarding the use of violence, the utter lack of respect for human life, the general approval of using violence is what is most striking to observers of the shocking trend in homicide. (Sheley et al., 1993; Butterfield, 1992) A study of incarcerated and non-incarcerated inner-city youth shows this frightening trend. A large portion of the incarcerated teenagers approve of killing to get what one wants -- and this is true, too, of a (in some ways a more frighteningly) large minority of the inner-city high schoolers questioned. (Sheley et al., 1993) It has also been alleged that the victims are, by and large, "innocent children." (Shumaker, 1992) There are clearly occasional innocent children slain, partly because the adolescent killers are indifferent about whether unintended victims are hit while aiming at intended victims. But, for the most part, victimization is related to victimizing. And the persons most apt to be the victims of crime from teenagers are those who themselves associate with gangs and otherwise participate in the victimization of others. (Sheley, 1992; Lauritsen et al., 1991) And, despite assertions by Dr. Christoffel and others that the killers are still children -- even if they are, for the most part, over the age of 14, and able to be tried as adults, however sad it may be that these children lost their childhood early (Butterfield, 1992) -- they are not children in the sense that a restrictive gun law is apt to impress them very much. Youthful gang members may grow up to be organized gangsters, but they were largely heartless thugs from early on. This has been noted with regard to persons like Sam Giancana, and it is merely more true of a larger segment of a disadvantaged portion of society now. Criminals, for the most part, do those things which are part of growing to manhood at an earlier age than persons who do not become criminals. And more of their activities seem to be tied to peer relationships than to parental relationships. (Sheley et al., 1992; Sheley et al., 1993; Wright and Rossi, 1986; Warr and Stafford, 1991) But socialization into crime involving guns is different from socialization into guns without crime. It has also been found that socialization into legal and illegal gun use are separate and insular phenomena. Socialization into legal gun use originates from the family and places teenagers at no increased risk of involvement in crime, drugs, or gangs. Socialization into illegal gun use derives from peer influences outside the home, and increases the risk of criminal activity. (Lizotte and Tesoriero, 1991) To use the "politically incorrect" terminology, they lack "family values," and they lack parental, especially fatherly, guidance. Restrictive gun laws are unlikely to supply these. As a recent survey of inner-city high-school students has noted: Our findings point away from intervention at the individual level and toward changes in the larger familial, communal, and social situation of those most involved in gun-related violence.... Structurally, we are experiencing the development of an inner-city underclass unlike any in our past. In a shrinking industrial economy, we are witnessing the disintegration of the traditional family, increasing poverty and homelessness, diminishing health, and deteriorating educational institutions. The desperation of this situation is enhanced by the apparent enormity of the drug problem and the ready availability of firearms to all. Given all this, perhaps the surprising result is not that there is so much violence in the inner city, but that there is so little. These structural ingredients have fostered a culture of violence that, unfortunately, may survive even after the structural situation has improved. Inner-city youths know they are at risk for violent victimization, and they are now accustomed to arming themselves for protection (from violence in general or from violence associated with illegal activities)....Guns have become a part of the culture of the inner city, underclass youths. As a cultural element, the desire to carry firearms will last long beyond the need to carry firearms (even assuming, perhaps unrealistically, that the need itself would be reduced by structural improvements). (Sheley et al., 1992:681-82) And, as Kleck has noted, those who most feel the need to acquire, own, or carry firearms for protection, would be among the last to allow themselves to be impacted by restrictive gun laws. (Kleck, 1991) WEAPONS IN THE SCHOOLS Among the most popular myths justifying further restrictions on adults based on the misuse of firearms by children relates to the schools. It has been reported that an "estimated 135,000 boys carried guns to school daily in 1987. An estimated 270,000 others carried guns to school at least once during the year....With an estimated 400,000 boys carrying handguns to school yearly, there is a tremendous potential for even greater rates of death, injury, and violence." (Center to Prevent Handgun Violence, 1990:7) It has also been asked, "How did it get to the point that, as one federal agency [the CDC] estimates, one out of every 20 American students packs a gun in school?" (Boss, 1992) That figure would project to about roughly 600,000 high school students carrying guns to school. (U.S. Bureau of the Census, 1991) In highly restrictive New York City, the New York Times has editorialized as fact that every other school child has a gun. (New York Times, 1990) To further indicate the scope of the alleged problem of guns in the school, data are frequently cited showing that more and more children, in a variety of jurisdictions, have been found with weapons in the school. (Center to Prevent Handgun 1989) Violence, "Between 1987 and 1991, the fastest-growing crime by juveniles was loaded gun possession, and metal detectors and spot police checks had become routine in some inner-city high schools." (Kramer, 1992) How Many High School Students Carry Guns to School? No one knows how many high-school students, male or female, carry guns, or handguns, to school, either on a daily, monthly, or annual basis. In 1990, the CDC began surveying high-school students regarding weapons carrying, and that report has served as the basis for some of the disinformation publicized. (CDC, 1991) If follow-up surveys do not improve the question wording, little is likely to be learned. The CDC survey of high school students asked about carrying weapons for protection or because it might be needed in a fight, and then asked about the type of weapon. The time frame was the preceding 30 days, with frequency asked. Unfortunately, the question did not ask about carrying onto school grounds, nor about carrying on the person. Other surveys regarding carrying of firearms or handguns have made it clear that carrying in a motor vehicle is included by respondents as carrying for protection. (Kleck, 1991:117-119) And most of the carrying found by the CDC was infrequent; nearly 60% who carried did so at most three of the 30 days. With mathematical sleight of hand, the 4.1% of students who carried or transported firearms someplace for protection became, in the CDC editorial, "Approximately one of 20" rather than one of 25. The news media were left to put the guns in the schools. In addition, as Kleck has noted (private communication), the percentage of students carrying regularly for protection is far lower than the percentage of adults carrying regularly for protection, despite a substantially higher violent victimization rate for the teenagers. Only a minority of the violent victimization occurs on school grounds (37% for those 12-15, and 17% for those 16-19). (Whitaker and Bastian, 1991:8) A more recent survey, too, suggests that the place most threatening to students is not apt to be school. (Sheley et al., 1992 and 1993) How much of the carrying is on school grounds is unknown and unknowable from the CDC survey. Assuming rationality in choosing when to carry for protection -- and most students who carry apparently choose to do so rarely -- the fact that only a minority of offenses which might require weapons for protection occur at school, that victimization in general is more common at times when students are rarely in school, that much carrying normally is in motor vehicles rather than on the person, and the like, Kleck has estimated that the number carrying firearms might drop to one in 200 carrying part of the average day, with half of that on the person, and half of that half on school grounds. The number carrying guns on the person onto school grounds any given day would then be about one in 800, or roughly 15-20,000 nationally. That figure is far lower than the 135,000 daily carriers, plus some portion of the other 270,000 from HCI's material. Ignoring the frequency issue, the CDC survey would suggest that 500,000 high school students carry a firearm for protection at least once per month, but the figure would fall by at least three-fourths by subtracting the estimated portion carrying in motor vehicles and not onto school grounds. As with other practices, carrying of firearms for protection (wherever and however) was not something affecting everyone equally. Males were more than twice as likely to carry for protection as females, and blacks and Hispanics more likely to carry than other whites. And, while overall only one-fifth of those who carried a weapon identified it as a firearm, the majority of black male students who carried a weapon identified it as a firearm. Trends in Weapons Carrying No one knows the trends in firearms carrying. If the HCI and CDC surveys were both accurate and roughly comparable, then there was a slight drop in the number carrying guns to school on any given day or during any long period of time. HCI reported, after all, about 135,000 carrying daily, while the CDC study noted only that 36% carried one-fifth of the time or more; unless two-thirds of that 36% carried daily, then carrying declined. It is, of course, unclear whether the HCI survey dealt with handguns only or all firearms; the CDC survey covered all firearms, noting that most were handguns. Additionally, the CDC survey between 1990 and 1991 suggests a drop in handgun carrying, but a rise in carrying other weapons. (CDC, 1992d; Rosenberg, 1992b). The 1990 survey indicated about 20% carrying a weapon of some kind during the preceding 30 days, and 4% carrying a firearm, with the comment that "[m]ost students who reported carrying firearms carried handguns." (CDC, 1991) More recent testimony indicated 26% carrying a weapon, but "[a]mong students who carried a weapon, 11% most often carried a handgun." That would project to about 2.5% handgun carrying, compared to 4% gun carrying. But neither the published report nor the testimony presented data in the same way as the 1991 report. And, while overall carrying of a weapon was up, for handguns, the CDC goal of a 20% reduction in weapon carrying by the year 2000 (Rosenberg and Mercy, 1991:9) was met in 1992. The way the CDC chose to determine the amount of weapons carrying is based on estimating the number of episodes per month per 100 students, so that more frequent carrying by the same student would raise the ratio, and a reduction in the amount of carrying would achieved most easily by reducing the frequency of carrying by those who carry rather than a reduction in the percentage of students who carry weapons for protection at all. However, the estimated number of instances per student assumes that a reported "six or more" equals six. The result is certainly an underestimate, but it may still be useful for establishing trends -- except that neither a massive reduction nor a massive increase in the number of days the most active carriers carried would be noticeable. Unfortunately, overall carrying went from a reported 71 episodes per 100 students in 1990 to 107 episodes per 100 students in 1991. Perhaps to make its goal for the year 2000 more reachable and its efforts more impressive, the CDC seems to be taking the 1992 figure as that which is to be reduced by 20%, to 86 (CDC, 1992d:762), although one might have thought, based on the original determination that the baseline would be set in 1991, at which time it was reported to be 71, and as noted in 1991 (CDC, 1991:683): "To achieve the year 2000 objective, this incidence rate must be reduced to 57 episodes per 100 students per month." And the original goal said the baseline data would be available in 1991, not that it would be based on a 1991 survey. (U.S. Public Health Service, 1991:101) It is unclear what other Year 2000 goals will be revised to make the CDC's goals achievable and its efforts more impressive looking. At any rate, the only pretense at a similar survey over time suggests that handgun carrying dropped between 1990 and 1991, despite rhetorical flourishes on how today's children are switching from fists to guns; it appears the switch may be to knives. The statement that "loaded gun possession" was the fastest growing juvenile crime between 1987 and 1991 might possibly be true in New York City (Kramer, 1992), but it is unlikely to be true, since weapons arrests between 1987 and 1991 rose less than those for homicide for males and less than for robbery, assault, and motor-vehicle theft for females. (FBI, 1992:220) FBI data does not even identify which of the carrying offenses involve firearms, however, much less whether the firearm was loaded; most public firearms possession by juveniles would be unlawful regardless of whether the gun were loaded. Another issue with trends, of course, relates to time frame and enforcement. It is undoubtedly true that more and more high schools are using more metal detectors, and searching more students, belongings, and lockers. Should increased searching result in increasing arrests or seizures, it would not indicate an increase in carrying so much as an increase in enforcement. There was, for example, a dramatic increase (from zero) in the number of explosive devices found in aircraft and at airports once airport screening was established (BJS, 1984:410) -- which did not necessarily mean more explosives were being carried, only that more were being found. A further problem is the time frame, and the relevance of protection as a reason for carrying. Decades ago, carrying firearms onto school grounds was common, since rifle competition was a normal scholastic sporting activity. Similarly, while the CDC survey found that 11% carried knives or razors for protection some of the time, the author cannot remember knowing any male suburban junior high or high school students in the 1950s who did not carry a knife to school regularly. Absent protection as the expressed reason, it is possible that, long term, the carrying of what would now be considered a weapon is down, simply because it is prohibited now and the ban has some enforcement. At the present time, it is impossible to know the trends on carrying to school, and unless the CDC survey specifies school grounds, trends will not soon be known. Trends on arrests or seizures, by school, police, etc., merely indicate trends in enforcement, which may or may not reflect trends in actual behavior by teenagers. And, of course, there are no data on carrying to school by actual children, in the common pediatric sense, since the CDC survey of 14-17 year olds, and the HCI survey report, dealt with high school students, most of whom are 15 and over. To the extent carrying for protection may possibly be increasing, it is not clear how offensive it should be viewed or the degree to which laws against it ought to be enforced. It appears to predominate among blacks, who are much more apt to be victimized by violence and much less likely to live in areas with effective police protection. It seems to be universally agreed that there are ways for students to evade even metal detectors to get knives, razors, and guns into school, indicating that students needing some form of protection are not likely to be adequately protected even by those extreme measures. Finally, in terms of policy recommendations, it bears repeating that all of the activities attacked by the CDC, HCI, and the media in terms of "children" possessing, carrying, and using guns and other weapons are already unlawful. Popular Assertions Regarding Guns in the School There has been a dramatic rise in weapons incidents in our nation's schools, hitting cities of every size and in every region of the country. (Biden, 1992) Usually, the evidence is merely rhetorical, but Sen. Joseph Biden did obtain an estimate on the rise in the numbers of weapons seized in big cities between 1989 and 1992, with changes from declines (Minneapolis, Washington, D.C.) to quadrupling (Indianapolis). Unfortunately, the numbers only tell about increases in seizures, with no information as to whether that reflects more carrying of weapons (or the kinds of weapons) or increases in enforcement. The statement does not indicate any early efficacy for the Gun Free School Zone Act of 1990. On the other hand, recent testimony suggests there may have been a decline between l990 and 1991 in protective firearm carrying by high school age students (CDC, 1992d), in which case the Act may be working but the rhetoric on dramatic rises may be flawed or limited to the carrying of weapons other than firearms. The guns children use are no longer cheap "Saturday Night Specials" but powerful 9-mm. semi-automatics, machine pistols, and military assault rifles. (New York Times, 1990) As with all shooters, there was a change in the 1980s from revolvers accounting for about three-fourths of new guns to semi-automatics accounting for about 70% of new guns. (Howe, 1992) Similar trends, lagging behind manufacturing, of course, are noted in firearms seized. Just as there was never evidence children preferred so-called "Saturday Night Specials," there is no evidence they are changing. Most weapons seized from school children are knives. (Stephens, 1992) Although the testimony before the Senate Committee on the Judiciary was unclear, a Chicago police officer was indicating that 9-mm. pistols accounted either for about 1% or about 10% of handguns seized (Byrne, 1992); they currently comprise about 20% of the new manufacture of handguns. (Howe, 1992) Assertions that police are "outgunned" by juveniles and that "kids are coming up with Uzis and other high-powered weapons" (Newark Star-Ledger, February 24, 1992, p. 8) are simply unfounded invention by imaginative police department spokesmen. REVIEWING ANTI-GUN POLICY RECOMMENDATIONS Most of the academic and news-media discussion of children and firearms include a number of policy recommendations. To both their credit and discredit, many of the policy recommendations by the CDC and public health professionals have never been considered extensively by legislative bodies or advocacy groups. It is to their credit since it means they do not have to defy extensive research on ordinary "gun control" proposals (Kleck, 1991). It is to their discredit since many of the proposals involve an appalling ignorance of firearms, ballistics, and the realities of what might be acceptable to persons wanting firearms for sport or protection. Rhetorically, however, the most commonly proposed policy is adoption of the Brady Bill, a one-week waiting period on dealer transfers of handguns during which time local police would have the option of running a background check on the person identified as the prospective purchaser (Prothrow-Stith, 1991; NSC, 1990). Indeed, noting the dramatic increase in juvenile involvement in trauma, columnist Jack Anderson denounced Congress's failure in 1992 to enact "the best trauma care legislation ever invented. It's called the Brady bill...." (Washington Post, September 7, 1992) The second most common proposal appears to be a ban on so-called "assault weapons" (AAP, 1992). The Brady Bill The Brady Bill, as generally proposed, would impose a one-week delay on the transfer of a handgun by a federally-licensed firearms dealer unless the transfer was occurring in a state which already had a wait of at least that long or already had a background check on prospective handgun buyers. The background check envisioned was a fairly short one, most likely involving telephone calls to determine whether there were warrants outstanding, or whether and what sort of criminal record the prospective buyer had. Monetary and time constraints would have ruled out extensive background checks of where a person actually lived or how valid his driver's license (or other form of identification) was. The relevance to the general public would be rather limited. Over 70% of the population lives in a state which is exempt from the terms of the Brady Bill either because of its own waiting period or its background check (and a number of other states with substantial numbers of pro-gun legislators would adopt an "instant background check" system, where most firearm transfers are delayed for less than ten minutes, were the Brady Bill to be adopted). Regardless of state laws, only about 16% of felons acquired their handguns by purchase from a licensed dealer (either directly or through a so-called "straw man" sale where a qualified buyer makes the purchase) -- and the percentage drops to 7% for repeat handgun abusers (Wright and Rossi, 1986). With only 10% of violent crime involving handguns (Rand, 1990), the initial aim of the Brady Bill was thus at about 0.2% of violent crime (assuming most is committed by the repeat offenders). But federal law bars the sale of handguns by licensed dealers to persons under the age of 21, making the Brady Bill irrelevant to the issue of children and firearms, even with a fairly broad definition of "children." And purchases by qualified adults for children would either constitute a proscribed "straw man" sale (if the dealer knew for whom the firearm was being purchased) or remain unaffected, since the adult transfer would not be a dealer transfer and would thus not be covered by the Brady Bill. The Brady Bill is clearly irrelevant to the issue of children and firearms. "Assault Weapons" Since only a fraction of a percent of violent crime involves the use of military style semi-automatic firearms generally called "assault weapons" (Kleck, 1991:ch.3; Kleck, 1992; Morgan and Kopel, 1991), different definitions of "assault weapon" would only vary the size of the fraction of a percentage. It is unclear what percentage of that fraction involves children, but it is probably small, particularly with regard to the long guns designated as "assault weapons," since they are fairly expensive and difficult to conceal. Rhetorical references, whether by the news media, the CDC, the AMA, or police departments, to children using Uzis and other "assault weapons" are largely imagined. Even HCI blames rifles on only 2% of gun-related violence in the schools. (Center to Prevent Handgun Violence, 1990:6) As with non-passengers being killed by private planes, while it is not inconceivable that some children misuse so-called "assault weapons," it is not a common occurrence. Unfortunately, it is difficult to cite references for what does not happen, and no way to limit free-flowing rhetoric from police administrators. Redesign Guns with More Safety Devices As noted above, among other problems with redesign is that redesigning firearms without unacceptable retrofitting could increase accidents by diminishing normal precautions. Even the leader of the AAP effort to restrict handguns recognizes that "the net result of marketing a 'safer gun' could be to increase household arsenals and decrease vigilance about firearm safety, because people might have the impression that they now own 'safe'guns." (Christoffel, 1991:301) In addition, the improvement sought is minimal. The most significant misuse of firearms -- by children or adults -- involve intentional misuse in suicide or homicide. As the AAP has noted, "Modifications in gun design are unlikely to reduce injury, since those at greatest risk are preteen and teenage boys, both of whom possess adult abilities to circumvent gun safety features." (AAP Committee on Adolescence, 1992) Develop and Promote Less Lethal Means for Protection, and Less Lethal Ammunition One risk with less lethal means for protection is the political one: when an item is produced which could be misused, someone is apt to seek to ban it on the grounds that it has or will be misused. And newer technology is harder to defend politically. That which is owned by virtually no one has few persons personally threatened by restrictive legislation. Constitutional arguments regarding the right to own commonly owned "arms" do not apply to those which are not commonly owned. And if it is not an actual firearm, protective public interest groups are apt to be weaker than when the target is a real firearm. Hence, "ballistic knives" were banned after Congressman Mario Biaggi was shown an advertisement for one. "Stun guns" and taser guns have been sharply restricted on the grounds they could be used to commit robberies and assaults, even though most of the actual misuse reported in the news media have been misuses by law enforcement officials who are exempt from state and local restrictions -- although there has also been some suggestion that they are used in child abuse. (Frechette and Rimsza, 1992) The "exploding bullets" used by John Hinckley in his assassination attempt (which were promptly removed from the civilian market), were developed to increase stopping power while reducing penetration and likely lethality. And the ammunition used in so-called "assault weapon" rifles is generally less powerful than ordinary big-game hunting ammunition, and, indeed, was designed for military purposes to wound more than to kill (Fackler et al., 1990) -- a dead soldier reduces enemy forces by one; a wounded soldier adds to the reduction of enemy forces those needed to retrieve and care for the wounded soldier. In 1992, the Maryland legislature considered, and the Florida legislature enacted, legislation banning incendiary shotgun ammunition, which amounted to a rather expensive firework, but with a much shorter range of risk than ordinary shot or slugs. The imaginative argument was that it would be used against law enforcement officers and burn their clothes while penetrating their bodies. It was not reported that it had ever been used in a crime. And, of course, handguns are generally less lethal than long guns, yet are the primary target for the CDC, AAP, and HCI. And, among handguns, the lower caliber and shorter-barreled -- and hence less lethal -- so-called "Saturday Night Special" has long been singled out. Less lethal weaponry may remain lethal. (Crime Victims Digest, 1992a) With liability suits common for any product which misperforms (such suits have occasionally been brought against products for doing exactly what they were designed to do), such lethality could result in lawsuits threatening the business life of any such manufacturer of less lethal weaponry. Nonetheless, less lethal ammunition is apt to be produced. (Crime Victims Digest, 1992b) Its effectiveness and popularity -- and availability to others than the law enforcement community -- is open to question. If available, its popularity with gun owners interested in the protective benefits of firearms has yet to be determined. Such ammunition would not, of course, have any impact on criminal misuse of firearms -- it is the firearm itself, not the ammunition, which enhances cooperation with robbers and assailants. Nor, in all likelihood, would criminal homicide be reduced. Criminals would prefer the traditional ammunition which would still have to be available for sporting purposes, and new ammunition would not affect the will to kill which is all too apparent in shootings by young criminals. (Webster et al., 1992a) And less lethal ammunition might well be fatal to small children. There would be the concern, at least, that calling ammunition less lethal or non-lethal could encourage more careless storage of a loaded firearm than might occur if parents and guardians knew that ammunition were lethal. The development of less lethal weaponry will continue because, although ideal non-lethal devices do not exist, police will continue to experiment with them to reduce their liability. (Meyer, 1992) Pediatric Counselling of Parents Against Firearms Pediatricians were called upon by the AAP and the CDC to counsel the parents of patients to keep their guns safely away from the children, carefully locked up, or, better still, to remove all firearms from the home. They were to do this by emphasizing the cost-ineffectiveness of keeping guns for protection, noting the mythological ratios of protective use to destructive gun misuse in the home. (AAP Committee on Adolescence, 1992; Webster et al., 1992b; Rosenberg et al., 1991) Aside from the fact that pediatricians were being called upon to tell lies about the ineffectiveness of firearms (Kleck, 1991), the policy recommendation is apt to fail for a number of reasons. First, as has been noted, most of the gun-related violence is not done by pediatric patients, but by persons older than those patients and not apt to avail themselves extensively of pediatric or other medical care -- except in emergency rooms, where their reception to counseling has not been noteworthy. (D. Simon, 1992; Smith et al., 1992) Second, neither gun owners nor non-gun owners are apt to turn to pediatricians or other medical personnel as a source of information on firearms and firearms safety. Non-gun owners might turn to law enforcement personnel, and gun owners to gun organizations. But gun owners are not even likely to respond as the pediatric profession would like to pediatric warnings about the hazards of gun ownership even if the gun owners believed the pediatricians. (Webster et al., 1992c) Third, pediatricians do not feel comfortable counselling about guns, and the more apt their patients are to own guns, the more likely the pediatricians are as well. Where there is the greatest opportunity for anti-gun counselling, pediatricians are most apt to be pro-gun. (Webster et al., 1992b) Tax Firearms and Ammunition to Fund Trauma Centers The idea is that gunshot wounds by uninsured victims are part of the reason trauma centers have monetary problems, so gun buyers should pay. (Skolnick, 1992) In general, gunshot wounds account for 10-33% of patients in urban trauma centers, and are normally far outnumbered by motor vehicle-related injuries. Taxing motor vehicles has not similarly been proposed, even though a substantial portion of motor vehicle injury victims would involve accidents caused by persons who buy motor vehicles and gasoline at retail and would pay any taxes. Sometimes called a proposed "user fee" for firearms and ammunition buyers, it is misdirected -- as is seen partly from the very fact that only a minority of gunshot wound victims are covered by medical insurance or able to pay the bills themselves. Retail purchasers of firearms are almost never the misusers of firearms which lead to penetrating trauma requiring emergency-room or trauma center treatment. Even accidents disproportionately involve the irresponsible and less affluent members of society (Kleck, 1991), whose medical coverage is apt to be minimal. Virtually all of the tax would be paid by those not requiring the service; virtually all of the service would be required by those who would not be paying the tax. The tax has also been praised as a way to gradually ban firearms out of existence. Says Dr. Christoffel: "the taxation of manufacturers and purchasers was a part of a pattern of government regulation that moved Japan over a several hundred-year period from being the world's leading purveyor of firearms to being a virtually firearm-free society." (Colan, 1992) Obviously, such an argument would not appeal to gun owners opposed to a ban on firearms. It is also interesting that Dr. Christoffel, who assumes the Founding Fathers did not envision a society where children would be as vulnerable to firearms violence as today (U.S. House of Representatives, 1989:40) praises the Japanese system, which was admittedly designed to preserve the anti-democratic despotic power of the Samarai, and to prevent the loss of such power to the peasants. (Christoffel, 1992) Dr. Christoffel and the Founding Fathers apparently represent dissimilar philosopies of government. Require Handguns, or all Firearms, to be Stored Safely Although HCI originally proposed this as a means to limit accidents, they seem to have suggested to some reporters that the reason is to prevent criminal misuse by teenagers. Among the best arguments in favor of the legislation is that, properly limited in details of how firearms must be stored in the home, the proposal amounts to little more than a call for an item-specific criminal negligence law. As such, however, the measure is also largely redundant. With specifics, the legislation might arbitrarily force a particular method of storage upon firearms owners, many of whom might generally have rather more effective methods. Indeed, because CDC-type legislators have little knowledge of firearms, their proposals could promote potentially risky forms of storage. A locked safe is more expensive and effective than a trigger lock, the installation of which on a loaded firearm is a safety hazard. As with most proposals, it is not really aimed at those involved in large portions of firearms misuse by "children," since such proposals are generally directed at those younger than the group now intentionally misusing firearms. Aside from penalizing parents for the criminal actions of their children, or for accidents physically or psychologically devastating their own children, little is apt to be gained. The legislation is probably promoted largely to score legislative points for lobbies counting legislative victories and defeats, and to make the ownership of firearms gradually appear to be more troublesome than it is worth. The legislation is openly promoted more as an effort to remind gun owners of safe storage practices than in the hopes of enforcement of criminal provisions. Establish "Gun Free School Zones" On its face, the proposal is superfluous. The federal government has already outlawed carrying firearms (with various exceptions) on or near school grounds. For the most part, state law already exists, and there have been no studies indicating a need to enhance the penalties for doing that which is unlawful if it is done near or on school grounds. An educational risk is imposing criminal sanctions on matters which might more properly have been dealt by normal school administrative sanctions. A constitutional risk is posed by the issue of due process, particularly notice. After all, "gun" -- and, for that matter, "drug" -- "-free school zones" are usually announced with a large sign near the school property, with small print (if any) announcing the zone applies to within 1,000 feet of the school grounds. Nearby, there is normally a sign, with a different purpose, misleadingly announcing "end school zone." School attendance requirements, combined with the threat of metal detectors to find weapons, and an enhanced sentence for having a gun (or drugs) should, at least, raise constitutional concerns. CDC-commended ways to reduce firearms on school grounds "include random locker searches, walk-throughs with metal detectors, and policies requiring that students use only clear plastic or mesh bookbags so that weapons cannot be readily hidden." (CDC 1992c:215) The use of metal detectors raises concerns on its own. While the courts are likely to allow sharp restrictions on rights in order to enforce gun laws and drug laws, the existing Supreme Court case on searching students (New Jersey v. T.L.O., 105 S.Ct. 733 [1985]) required individualized suspicion -- something lacking with metal detectors. The airport security system assumes a voluntary waiver not really present when education is obligatory. And the systems are renowned for "false positives" -- keys, coins, calculators, three-ring binders, etc. -- while evasion is believed commonplace, and many knives and razor blades can easily escape most detectors' notice (since they're set to avoid too many false positives). The equipment is also expensive, and devising a system to force all entrants into a school to go through screening programs could invite locked doors and windows in conflict with fire codes. Privacy concerns are also involved in locker searches and requiring that that which is carried be visible to all, along with questions regarding the extent to which purses are exempt and other carriers are not. The misuse aimed at is generally sufficiently more serious that criminals would be unlikely to be deterred by the enhanced sentence. It is possible that some students needing protection will become more fearful of their government than of the young criminals they fear, and conform to such laws. It is unclear to what extent that is desirable, or whether it will increase or diminish the amount of violence or the degree of innocence of those swept up in it. Sharply Restrict or Prohibit Adult Access to Firearms Constitutionally, the Supreme Court has made it clear that adult rights cannot be reduced to that which is suitable for children. (Sable Communications of California, Inc. v. Federal Communications Commission, 109 S.Ct. 2829 [1989]) Laying constitutional issues aside, it is not normal legislative practice to limit adult access to that which is suitable for children, be it athletic equipment, alcohol and tobacco products, cleaning equipment, motor vehicles, or pharmaceutical products. Again, it is interesting to note that there is virtually no call for a ban on children's bicycles -- which would be easy to enforce since no violation except in public would involve a threat to child safety -- even though there are more fatal bicycle than firearms accidents among children (Baker and Waller, 1989), and children's bicycles are not used by adults, whereas firearms are intended primarily for adults. Similarly, there is no call for bans on swimming pools, involved in more accidental fatalities than with children (Kates, 1990:50-51), nor for sports in general, which are associated with more injuries and higher medical costs (Malek et al., 1991:1002-1003). CONCLUSORY COMMENTS For a number of reasons, excessive violence has long been endemic in the United States, with a very high rate of homicide, gun- and non-gun related violent crime, albeit with a mid-level rate of suicide. Efforts to tie that general violence to firearms availability and the lack of restrictive gun laws have failed (Wright et al., 1983; Kleck, 1991), and current efforts are more tangential ones claiming a current "epidemic" of violence requires major new initiatives. There is no "epidemic" in general affecting gun owners or most citizens in the United States. Trends on homicide, suicide, and firearms misuse in those activities are either stable or trending in the right direction for most age groups and most ethnic groups. Firearms accidents are falling faster than accidents in general. And none of the trends is tied to firearm or handgun availability, which are fairly stable over time. There is one group for whom one might with some accuracy -- ignoring the fact that violence is not a disease -- say there is an epidemic, in the sense of a sudden upsurge. Homicide among black inner-city males aged 10-24 could honestly be described as at epidemic proportions. Beneficial trends from the 1970s and early 1980s ended abruptly and dramatically. Calling the hopeless, remorseless killers "children" or "kids" and denouncing the tools they use is neither honest nor likely to be effective. The killings involve persons who have been deprived of moral training by their parents -- and often deprived of supervision by more than one parent, if that many -- and by their over-politicized ministers. Their non-violent television and motion picture shows glamorize insults, with most of television and motion picture programming, and the music which entertains them, glamorizing physical and sexual violence -- against society and its representatives, against women, and against each other. Efforts seriously to address the issue face a number of obstacles. One is the concern by black leaders that studying the causes of violence in America will result in racist conclusions. (Stone, 1992) Other black leaders -- "Sister Souljah," Rep. Maxine Waters, and Bryant Gumbel -- defend criminal violence. Tightened government budgets do not allow for expanded social services or punishments, With more black males incarcerated than in college, and more of their females unwed mothers than wed, the future is similarly bleak. CDC researchers observe this and denounce firearms availability among persons not at risk, say that violence threatens small town and suburban America, and that we have to do something about the children. And their researchers think of the infant in the HCI/NCBH literature, playfully pointing a pistol at its head -- its white head. REFERENCES AAP [American Academy of Pediatrics] 1989a Members voice their opinion in two recent surveys. AAP News (April):3. 1989b Findings from Periodic Survey #3: Gun Control. 1992 News Release (January 15): AAP Proposes Handgun Ban, Other Measures to Curb Firearm Deaths, Injuries. n.d. Fact Sheet on Handgun Control. AAP Committee on Adolescence 1992 Policy Statement: Firearms and Adolescents. AAP News 20-21 (January). AAP Committee on Injury and Poison Prevention 1992 Policy Statement: Firearm Injuries Affecting the Pediatric Population. AAP News 22-23 (January). AMA Council on Scientific Affairs 1992 Assault Weapons as a Public Health Hazard in the United States. JAMA 267:3067-3070. Baker, Susan P., Brian O'Neill, and Ronald S. Karpf 1984 The Injury Fact Book. Lexington, Mass.: Lexington Books. Baker, Susan P. and Anna E. Waller 1989 Childhood Injury State-by-State Mortality Facts. Johns Hopkins University School of Public Health. BJS [Bureau of Justice Statistics] 1984 Sourcebook of Criminal Justice Statistics -- 1983. U.S. Department of Justice. Blackman, Paul H. 1992 Firearm Access and Suicide. JAMA 267:3026. Boss, Suzie 1992 Young Guns. Oregonian, April 5, pp. L1 and L6-7. Boyd, Jeffrey H. 1983 The Increasing Rate of Suicide by Firearms. New England Journal of Medicine 308:872-874. Brent, David A. and Joshua A. Perper 1992 Firearm Access and Suicide. JAMA 267:3026-3027. Brent, David A. et al. 1992 The Presence and Accessibility of Firearms in the Homes of Adolescent Suicides: A Case-Controlled Study. JAMA 266:2989-2995. Breslin, Patricia 1992 Toward the Solution: Regulations Can Facilitate Positive Change. Talk delivered at the annual meeting of the American Trauma Society, McLean, Virginia, May 8. Bruner, Richard W. 1992 With the Market Economy Comes More Crime. Budapest Week 2(July 2-8):9. Butterfield, Fox 1992 Seeds of Murder Epidemic: Teen-Age boys With Guns. New York Times, October 19. Byrne, Lt. Thomas 1992 Testimony before the Senate Committee on the Judiciary, on Children Carrying Weapons: Why the Recent Increase, October 1. Callahan, Charles M. and Frederick P. Rivara 1992 Urban High School Youth and Handguns: A School-Based Survey. JAMA 267:3038-3042. Center to Prevent Handgun Violence [Handgun Control, Inc.] 1989 Facts about...Kids and Handguns. Flyer. 1990 Caught in the Crossfire: A Report on Gun Violence in Our Nation's Schools. 1991a Facts about...Children & Handguns. Flyer. 1991b Facts about...Teen Suicide & Handguns. Flyer. n.d.[1] A School Program to Prevent Handgun Violence Among Today's Youth. Flyer. n.d.[2] Handgun Violence: An American Epidemic. Fundraising flyer. CDC [Centers for Disease Control] 1991 Weapon-Carrying Among High School Students -- United States, 1990. Morbidity and Mortality Weekly Report (MMWR) 40:681-684 (October 11). 1992a Unintentional Firearm-Related Fatalities Among Children, Teenagers -- United States, 1982-1988. JAMA 268:451-52. 1992b Trends in Ischemic Heart Disease Mortality -- United States, 1980-1988. JAMA 268:1837. 1992c Firearm-Related Deaths -- Louisiana and Texas, 1970- 1990. Morbidity and Mortality Weekly Report 41 (April 3):213-221. 1992d Behaviors Related to Unintentional and Intentional Injuries Among High School Students -- United States, 1991. MMWR 41:760-772. Chafee, John 1992 Testimony before the Senate Committee on the Judiciary on Children Carrying Weapons: Why the Recent Increase. October 1. Cheatwood, Derral and Kathleen J. Block 1990 Youth and Homicide: An Investigation of the Age Factor in Criminal Homicide. Justice Quarterly 7:265-292. Christoffel, Katherine K. 1991 Toward Reducing Pediatric Injuries from Firearms: Charting a Legislative and Regulatory Course. Pediatrics 88:294-305. 1992 Controlling Injuries Due to Firearms. Paper delivered at the annual meeting of the American Trauma Society, McLean, Virginia, May 6. CJ Europe 1991 Suicide: Teenage Deaths Increasing Across Europe. CJ Europe 1(2):4 (November-December). Colan, Bernard J. 1992 Health care practitioners urge others to educate children about guns. ADVANCE for Physical Therapists (March 30):14-15. Cotton, Paul 1992 Gun-Associated Violence Increasingly Viewed as Public Health Challenge. JAMA 267:1171-1174. Covington, Deborah L., J. Gary Maxwell, and Thomas V. Clancy 1992 Geriatric Transportation Injuries and Trauma Cetner Resource Utilization. Paper delivered at the annual meeting of the American Trauma Society, McLean, Virginia, May 8. Crenshaw, Albert B. 1992 Health Care Fraud Costs $70 Billion. Washington Post/Health (May 12):7. Crime Victims Digest 1992a Women Killed by "Non-Lethal" Rubber Bullet Fired by Officer. Crime Victims Digest 9(9):6-7 (September). 1992b Non Lethal and the Stopping Power of a 38 Special! Crime Victims Digest 9(9):7-8 (September). Davis, David Brion 1957 Homicide in American Fiction, 1798-1860. Ithaca: Cornell University Press. DeClaire, Joan 1992 Kids & Guns. In View 34(6):30-35 (Sept./Oct.). Fackler, Martin L., John A. Malinowski, Stephen W. Hoxie, and Alexander Jason 1990 Wounding Effects of the AK-47 Rifle Used by Patrick Purdy in the Stockton, California, Schoolyard Shooting of January 17, 1989. American Journal of Forensic Medicine and Pathology 11:185-189. FBI [Federal Bureau of Investigation] 1992 Crime in the United States, 1991. Washington, D.C.: U.S. Department of Justice. Fingerhut, Lois A. and Joel C. Kleinman 1989 Firearm Mortality Among Children and Youth. NCHS Advance Data No. 178 (November 3). CDC National Center for Health Statistics. 1990 International and Interstate Comparisons of Homicide Among Young Males. JAMA 263:3292-3295. Fingerhut, Lois A., Joel C. Kleinman, Elizabeth Godfrey, and Harry Rosenberg 1991 Firearm Mortality Among Children, Youth, and Young Adults 1-34 Years of Age, Trends and Current Status: United States 1979-1988. Monthly Vital Statistics Report 39(11 Supplement)(March 14). CDC National Center for Health Statistics. Fingerhut, Lois A., Deborah D. Ingram, and Jacob J. Feldman 1992 Firearm and Nonfirearm Homicide Among Persons 15 Through 19 Years of Age: Differences by Level of Urbanization, United States, 1979 through 1989. JAMA 267:3048-3053. Fiske, John 1892 The Discovery of America, Volume II. Boston and New York: Houghton Mifflin. Frechette, Alan and Mary Ellen Rimsza 1992 Stun Gun Injury: A New Presentation of the Battered Child Syndrome. Pediatrics 89:898-901. Fulginiti, Vincent A. 1992 Violence and Children in the United States. American Journal of Diseases of Children 146: 671-672. GAO [General Accounting Office] 1991 Accidental Shootings: Many Deaths and Injuries Caused by Firearms Could Be Prevented. Report to the Chairman, Subcommittee on Antitrust, Monopolies, and Business Rights, Committee on the Judiciary, U.S. Senate. Goldfarb, Bruce 1992 Current Research: Violence in America. Journal of Emergency Medical Services 17(9):41-42 (September). Goldsmith, Marsha F. 1989 Epidemiologists Aim at New Target: Health Risk of Handgun Proliferation. JAMA 261:675-676. Graves, Edmund J. 1992 1990 Summary: National Hospital Discharge Survey. Advance Data 210:1-11. National Center for Health Statistics. Group Health Cooperative of Puget Sound 1992 Kids and Guns: A deadly mix. Flyer. Hammett, Marcella, Kenneth E. Powell, Patrick W. O'Carroll, and Sharon T. Clanton 1992 Homicide Surveillance -- United States, 1979-1988. Morbidity and Mortality Weekly Report 41(SS-3):1-33. Hammond, J.S. et al. 1990 HIV, Trauma, and Infection Control: Universal Precautions are Universally Ignored. Journal of Trauma 30:555-561. Harvard Medical Practice Study 1990 Patients, Doctors, and Lawyers: Medical Injury, Malpractice Litigation, and Patient Compensation in New York. Hawton, Keith 1992 By their own hand: Suicide is increasing rapidly in young men. British Medical Journal 304:1000 (April 18). HCI [Handgun Control, Inc.] n.d. Handgun Facts. Heins, M., R. Kahn, and J. Bjordnal 1974 Gunshot Wounds in Children. American Journal of Public Health 64:326-330. Henkoff, Ronald 1992 "Children in Crisis: Kids are Killing, Dying, Bleeding." Fortune (August 10): 62-29. Houk, Vernon N. 1991 Welcome. Keynote Speeches for the Third National Injury Control Conference: "Setting the National Agenda for Injury Control in the 1990s." U.S. Department of Health & Human Services. Howe, Walter J. 1992 Firearm Production, Imports, and Exports. Shooting Industry (January):91-118. Hunter Education Association 1991 Hunting Accident Report with Graphics of 1986- 1990 Data. Jackson, Cheryl 1992 Gun-safety backers shun NRA material. Cleveland Plain Dealer, March 27. Johnson, Claire M. and Marla T. Robinson 1992 Homicide Report. Washington, D.C.: (D.C.) Office of Criminal Justice Plans and Analysis. Kates, Don B., Jr. 1990 Guns, Murders, and the Constitution: A Realistic Assessment of Gun Control. Policy Briefing. San Francisco: Pacific Research Institute for Public Policy. Kellermann, Arthur L., Roberta K. Lee, James A. Mercy, and Joyce Banton 1991 The Epidemiologic Basis for the Prevention of Firearm Injuries. Annual Review of Public Health 12:17-40. Kellermann, Arthur L. et al. 1992 Suicide in the Home in Relation to Gun Ownership. New England Journal of Medicine 327:467-472. Kleck, Gary 1991 Point Blank: Guns and Violence in America. New York: Aldine de Gruyter. 1992 Assault Weapons Aren't the Problem. New York Times, September 1. Koop, C. Everett and George D. Lundberg 1992 Violence in America: A Public Health Emergency: Time to Bite the Bullet Back. JAMA 267:3075-3076. Kramer, Rita 1992 Juvenile Justice is Delinquent. Wall Street Journal, May 27. Lauritsen, Janet L., Robert J. Sampson, and John H. Laub 1991 The Link between Offending and Victimization among Adolescents. Criminology 29:265-292. Law Enforcement News 1990 Youth and guns: a murderous mix. September 30:1. Lawrence, N.S. 1990 Fatal Nonpowder Firearms Wounds: Case Reports and Review of the Literature. Pediatrics 85:177-181. Lee, Robert[a] K. and Jeffrey J. Sacks 1990 Latchkey Children and Guns at Home. JAMA 264:2210. Ling, Louis 1992 Contempo 1992: Emergency Medicine. JAMA 268:361-362. Lizotte, Alan J. and James M. Tesoriero 1991 Patterns of Adolescent Firearms Ownership and Use. Albany, N.Y.: Hindelang Criminal Justice Research Center, State University of New York, Rochester Youth Development Study Working Paper #11. Malek, Marvin, Bei-hung Chang, Susan S. Gallagher, and Bernard Guyer 1991 The Cost of Medical Care for Injuries to Children. Annals of Emergency Medicine 20:997-1005. Martin, Michael J., Thomas K. Hunt, and Stephen B. Hulley 1988 The Cost of Hospitalization for Firearm Injuries. JAMA 260:3048-3050. Marwick, Charles 1992 Guns, Drugs Threaten to Raise Public Health Problem of Violence to Epidemic. JAMA 267:2993. Mason, James and Robert Proctor 1992 Reducing Youth Violence -- The Physician's Role. JAMA 267:3003. Morgan, Eric and David Kopel 1991 The Assault Weapon Panic: "Political Correctness" Takes Aim at the Constitution. Golden, Colo.: Independence Institute. Meyer, Greg 1992 The Sorry State of Police Tactics: What to Do? Crime Control Digest 26(June 8):1,3-5. NCHS [National Center for Health Statistics] 1987 Vital Statistics of the United States, 1983, Volume II, Mortality, Part B. Washington, D.C.: U.S. Public Health Service. 1991 Vital Statistics of the United States, 1988, Volume II, Mortality, Part A. Washington, D.C.: U.S. Public Health Service. 1992 Births, Marriages, Divorces, and Deaths for March 1992. Monthly Vital Statistics Report 41(July 31): 1-24. National Committee for Injury Prevention and Control 1989 Injury Prevention: Meeting the Challenge. New York: Oxford University Press. NSC [National Safety Council] 1990 Position Statement on Children and Firearms. Draft, July. 1991 Accident Facts: 1991 Edition. Chicago: National Safety Council. New York Times 1990 Every Other 14-Year-Old, Armed. November 10, p. A22. Newman, Barry 1989 Crime and Punishment Is Our Business: Soviets License Private Eyes as Murder, Robbery Soar. Wall Street Journal (August 31):A12. Novello, Antonia C. 1991 Keynote Speeches for the Third National Injury Control Conference: "Setting the National Agenda for Injury Control in the 1990s." U.S. Department of Health & Human Services. O'Connor, Karen G. 1991 Periodic Survey of Fellows Findings. Child Health Care. AAP Research Update #7. O'Neill, Catherine 1990 Guns Are Not Toys. Washington Post/Health, February 20. Organ, Claude H., Jr. 1992 Trauma: The Motor End Plate of Violence. Archives of Surgery 127:651-652. Organ, Claude H., Jr. and William R. Fry 1992 Contempo 1992: Surgery. JAMA 268:413-414. Prothrow-Stith, Deborah 1991 Deadly Consequences. N.Y.: Harper Collins. Rand, Michael R. 1990 Handgun Crime Victims. U.S. Dept. of Justice, Bureau of Justice Statistics. Reeves, Richard 1992 Give Gun Control a Chance. Baltimore Sun, September 25. Ropp, Leland, Paul Visintainer, Jane Uman, and David Treloar 1992 Death in the City: An American Childhood Tragedy. JAMA 267:2905-2910. Rosenberg, Mark L. 1992a Testimony before the U.S. Senate Committee on Labor and Human Resources' Subcommittee on Children, Family, Drugs, and Alcoholism, July 23. 1992b Testimony before the U.S. Senate Subcommittee on Social Security and Family Policy, Committee on Finance, on Bullet-Related Violence and Its Impact on Family and Federal Entitlements. October 23. Rosenberg, Mark L. and James A. Mercy 1991 Introduction, pp. 3-13. In Mark L. Rosenberg and Mary Ann Fenley (eds.), Violence in America: A Public Health Approach. New York: Oxford University Press. Rosenberg, Mark L., James A. Mercy, and Vernon N. Houk 1991 Guns and Adolescent Suicides. JAMA 266:3030. Rosenberg, Mark L., Patrick W. O'Carroll, and Kenneth E. Powell 1992 Let's Be Clear: Violence is a Public Health Problem. JAMA 267:3071-3072. [stopped editing here] Schetky, Diane H. 1985 Children and Handguns: A Public Health Concern. American Journal of Diseases of Children 139:229-231. Sheley, Joseph F., Zina T. McGee, and James D. Wright 1992 Gun-Related Violence in and Around Inner-City Schools. American Journal of Diseases of Children 146:677-682. Sheley, Joseph F., James D. Wright, and M. Dwayne Smith 1993 Firearms, Violence and Inner-City Youth: A Report of Research Findings. U.S. Department of Justice, National Institute of Justice, forthcoming. Shumaker, Rob 1992 Editor's Corner: Commentary. Michigan Psychologist. July-August. Simon, David 1992 A Journalist's Eye View of the Trauma Physician's Dilemma. Archives of Otolaryngology-Head & Neck Surgery 118:577-579. Simon, Stephanie 1992 It's 'Make My Day' in Moscow. Los Angeles Times (July 20):A1, and A12. Skolnick, Andrew A. 1992 Congress Acts to Resuscitate Nation's Financially Ailing Trauma Care Systems. JAMA 267:2994-2996. Sloan, John Henry et al. 1988 Handgun Regulations, Crime, Assaults, and Homicide: A Tale of Two Cities. New England Journal of Medicine 319:1256-1262. 1990 Firearm Regulations and Rates of Suicide: A Comparison of Two Metropolitan Areas. New England Journal of Medicine 322:369-373. Smith, Jack C. et al. 1986 Suicide and Homicide Among Hispanics in the Southwest. Public Health Reports 101(May-June): 265-270. Smith, R. Stephen, William R. Fry, Diane J. Morabito, and Claude H. Organ, Jr. 1992 Recidivism in an Urban Trauma Center. Archives of Surgery 127:668-670. Snyder, Howard N. 1992 Arrests of Youth 1990. U.S. Dept. of Justice Office of Juvenile Justice and Delinquency Prevention. Stephens, Ron 1992 Testimony before the Senate Committee on the Judiciary, on Children Carrying Weapons: Why the Recent Increase. October 1. Stone, Richard 1992 Race and Public Policy: HHS 'Violence Initiative' Caught in a Crossfire. Science 258:212-213 (October 9). Taubes, Gary 1992 Violence Epidemiologists Test the Hazards of Gun Ownership. Science 258:213-215 (October 9). Teret, Stephen P. and Garen J. Wintemute. 1983 Handgun Injuries: The Epidemiological Evidence for Assessing Legal Responsibility. Hamline Law Review 6:341-350. Treanor, William W. and Marjolijn Bijlefeld 1989 Kids & Guns: A Child Safety Scandal, Second Edition. American Youth Work Center and the Educational Fund to End Handgun Violence [NCBH/CSGV]. U.S. Bureau of the Census 1991 Statistical Abstract of the United States: 1991 (111th edition). Washington, D.C. U.S. House of Representatives 1989 Children and Guns. Hearing before the Select Committee on Children, Youth, and Families. 101st Congress, 1st Session. U.S. Public Health Service 1979 Healthy People: The Surgeon General's Report on Health Promotion and Disease Prevention. Washington, D.C. 1986 Surgeon General's Workshop on Violence and Public Health: Report (Leesburg, Va., October 27-29, 1985). 1991 Healthy People 2000: National Health Promotion and Disease Prevention Objectives. Washington, D.C. Vinokur, Jack 1992 Testimony before the Senate Committee on the Judiciary, on Children Carrying Weapons: Why the Recent Increase. October 1. Warr, Mark and Mark Stafford 1991 The Influence of Delinquent Peers: What They Think or What They Do? Criminology 29:851-866. Webster, Daniel W., Howard R. Champion, Patricia S. Gainer, and Leon Sykes 1992a Epidemiologic Changes in Gunshot Wounds in Washington, DC, 1983-1990. Archives of Surgery 127:694-698. Webster, Daniel W., Modena E.H. Wilson, Anne K. Duggan, and Lawrence C. Pakula 1992b Firearm Injury Prevention Counseling: A Study of Pediatricians' Beliefs and Practices. Pediatrics 89:902-907. 1992c Parents' Beliefs About Preventing Gun Injuries to Children. Pediatrics 89:908-914. Weil, Douglas S. and David Hemenway 1992 Loaded Guns in the Home: Analysis of a National Random Survey of Gun Owners. JAMA 267:3033-3037. Wenzel, Richard P. 1988 The Mortality of Hospital Acquired Bloodstream Infections: Need for a New Vital Statistic? International Journal of Epidemiology 17:225-227. Whitaker, Catherine J. and Lisa D. Bastian 1991 Teenage Victims: A National Crime Survey Report. U.S. Department of Justice, Bureau of Justice Statistics. Wilson, Modena Hoover et al. 1991 Saving Children: A Guide to Injury Prevention. New York: Oxford University Press. Wintemute, Garen J. 1987 Firearms as a Cause of Death in the United States, 1920-1982. Journal of Trauma 27:532-536. 1991 Public Health Action in a New Domain: The Epidemiology and Prevention of Violence. Langmuir Lecture, 1991. EIS Bulletin (June):8-9. Wintemute, Garen J. et al. 1987 When Children Shoot Children: 88 Unintended Deaths in California. JAMA 257:3107-3109. Woodwell, David 1992 Office Visits to Pediatric Specialists, 1989. Advance Data No. 208 (January 17). CDC National Center for Health Statistics. World Health Organization 1977 Manual of the International Statistical Classification of Diseases, Injuries, and Causes of Death. Geneva, Switzerland. 1989 World Health Statistics Annual. Geneva, Switzerland. Wright, James D. Peter H. Rossi, and Kathleen Daly 1983 Under the Gun: Weapons, Crime, and Violence in America. New York: Aldine. Wright, James D. and Peter H. Rossi 1986 Armed and Considered Dangerous: A Survey of Felons and their Firearms. New York: Aldine de Gruyter. __ The budget of the CDC's division on injury control and prevention -- concerned primarily with motor vehicle accidents and intentional injury (largely focusing on firearms) -- is larger than the budget of the Institute for Legislative Action, the lobbying arm of the National Rifle Association (NRA). (Houk, 1991) In public speeches, CDC personnel make it clear they want more restrictive gun laws. In talks with the media, it is made clear they want their research to be used to get restrictive gun laws and a voluntary reduction in firearms ownership. One of its workshops, chaired by a CDC grant recipient with a CDC employee overseeing activities, called for a ban on the private possession of handguns in 1985. (U.S. Public Health Service, 1986; Goldsmith, 1989; Taubes, 1992) And its anti-gun policies preceded its research. (U.S. Public Health Service, 1979) Grants appear to be given as rewards for previous anti-gun work, as in the case of Arthur Kellermann, Garen Wintemute, Colin Loftin, and Stephen Teret. A CDC-funded conference in Iowa featured the nation's leading anti-gun lobbyist as keynote speaker. It may not lobby any more than the "educational" offshoots of the two major anti-gun lobbies, but it is assuredly as much an anti-gun organization as they, and with more money. James Madison is rumored to have said, "Some degree of abuse is inseparable from the proper use of everything." Washington Post, October 26, 1992, p. D2. Public Law 99-649 essentially calls upon the CDC to study the issue of injury to children, without defining that which is to be studied. The bipartisan legislation has not been claimed as a lobbying victory by HCI, but was instead presumably simply the CDC and the Department Health & Human Services asking Congress to authorize it to do that which it wanted to do. The measure was enacted at a time when the data available to Congress would have shown trends moving in the right direction. At the press conference, the allegation that the problem of violence had spread to the suburbs and rural areas, thus spurring greater interest by the AMA and the CDC, was ill received by some of the black reporters present. They did not doubt the trend, but perceived some racism if violence spreading to white suburbs is what made violence a serious concern to public health professionals. Firearms seem to bring out some of the least appropriate teaching behavior by persons who should know better. It is generally considered risky to teach by negative example. So a coloring book for children put out by the Pennsylvania Division of the American Trauma Society generally observes this in a series of two-page messages on a variety of topics. The first page of the smoke alarm message shows the boy being awakened; the second indicates he got his family out safely and then called "911," an example of proper behavior. With a first page indicating a child burning her hand on a hot pot, the second shows proper treatment for the minor wound. When the first page shows a ball going into the street and a child about to run after it, the second shows another child properly warning the child to stop, that a car is coming. But when the first page shows children finding a parent's gun, the second page showed one playmate shooting the other. "Ouch!": Anybody Can Get Hurt. Mechanicsburg: n.d. Public health professionals, for reasons long since outdated, do not like the use of the words "accident" or "accidental." They prefer to distinguish between intentional and unintentional injuries. It is unclear what is gained by saying unintentional injury, except when one wishes to distinguish accidents from both inner- and other-directed violence with a dichotomy. For criminological purposes, using "unintentional" solely to describe accidental injuries risks occasionally misleading where the outcome of an intentional action is an unintentional injury or death. In addition, unless "injury" or "trauma" or the like follows, the distinction may be misleading. Intentional deaths include suicide and homicide, but unintentional deaths might include heart disease, cancer, etc., and one could certainly consider infectious diseases unintended. "Accident" has long since lost any connotation of inevitability the public health profession might once have feared. And accident, better than unintended, would seem to describe that small fraction of accidental shootings which involve an intentional shooting of someone mistakenly thought to be a threatening intruder. (Kleck, 1991:ch.7) It is unclear to what extent careful categorization is used deliberately to mislead, and to what extent it is merely a rhetorical benefit when public health professionals deal with an incredibly sloppy news media. Bias does not necessarily affect the carelessness of reporters, who are perhaps the only persons other than public health professionals (AMA Council on Scientific Affairs, 1992) who consider the news media to be reliable sources of information. When Fortune magazine chose to do a cover story on "Children in Crisis," one of the reporters interviewed anti-gun activist Stephen Teret, of Johns Hopkins University, regarding how to keep guns away from children. Teret explained both his position and that of the National Rifle Association. The magazine attributed to Teret his statement regarding the NRA's position: "What we need to do is gun-proof children rather than child-proof guns." (Henkoff, 1992:69.) The legislative history of a bill to study children's injury deaths also noted that injuries were the leading cause of all deaths of persons aged 1-44 -- a defensible statement, but perhaps a misleading suggestion about possible definitions of children. U.S. Code Congressional and Administrative News, 99th Congress, 2nd Session (1986) 6:6162. It has been estimated that there were approximately 25 air-gun related deaths in the United States among persons of all ages during the 1980s. (Lawrence, 1990) It has been reported that the AAP has a voting membership of approximately 26,000. JAMA 267:221 (January 8, 1992). The unpublished data were provided by the AAP on the request of the author, clearly identified as affiliated with an organization not in agreement with the official policy of the AAP, but with no hesitation by the AAP beyond the traditional stamp reading: "Not for citation or quotation without permission of the author." (Permission was given in a letter from the AAP's Holly S. Ruch- Ross, Director of Public Health Research, September 30, 1992.) This dissemination of material a private organization had no obligation to supply contrasts sharply with the refusal of the CDC to comply with requests for information, even though the data collected at the expense of the taxpayers are, under law, supposed to be disseminated to those filing Freedom of Information Act requests. Instead, CDC researchers "complain that FOIA requests are aimed only at frustrating their research." (Taubes, 1992) The AAP correctly notes that gunshot wounds are more apt to be treated in emergency rooms and child abuse in office visits, making comparisons dubious: more pediatricians will treat child abuse but a few pediatricians may treat many gunshot wounds. Letter from Dr. Ruch-Ross. Interestingly, of pediatricians who rode bicycles, 55% indicated that they never wore a helmet; of those with children under age 18 who rode bicycles, 35% of the children never wear a helmet. Relativity is an issue generally ignored as well when costs are involved. It has been estimated, for example, that treating gunshot wounds cost more than $1-billion in 1984 (Martin et al., 1988). But that figure ignored the fact that it represented approximately one-quarter of one percent of medical expenses that year, or that hospital caused blood infections costs an estimated $5-billion (Wenzel, 1988) or that health care fraud costs an estimated $70-billion (Crenshaw, 1992). Even with the increased number of shots, 92% of the shooting victims still had fewer than five wounds, a number capable of being inflicted with either revolver or semi-automatic pistol. The lifetime risk of an emergency room physician contracting AIDS in a 20- year career of medical service is about one in 70, while the chance of a child being accidentally shot to death during a similar period of (extended) childhood is about one in 8,000. (Ling, 1992; NSC, 1991) But physicians feel more compelled to lobby against firearms than to personally use protection. By the time the statements were printed, AIDS was the eighth leading cause of death, supplanting suicide, but remaining behind "firearms" as a "cause" of death. (NCHS, 1992:19) There is an inconsistency in the call for childproofing handguns and some other policies of anti-gun activists. Generally speaking, semi-automatic pistols are safer from accidental misuse than revolvers. In addition to having more and more potential variety of safety devices, chambering a round is generally more difficult for small children. The springs in some military-style semi-automatic pistols and rifles make it difficult even for weaker adults to chamber a round. The second sentence would seem to suggest that hunter and target-shooting education are effective, contrary to the conclusion of the AAP. While not generally enthusiastic about the National Rifle Association, the Washington Post described the NRA's "Eddie Eagle" book on firearms safety education for children as "[a] must for any parent who keeps a gun in the home." (January 7, 1992, p. B5) Others have refused to consider using the "Eddie Eagle" program, while admitting it to be a good program, because of the policies of the NRA. It is apparently more important to avoid the appearance of endorsement of NRA policies than to promote child safety. (Jackson, 1992) Data on the ages of the victims was provided by the Office of Policy of the Assistant Comptroller General of the United States in a letter sent to the author May 31, 1991. The Sturm Ruger company issued a recall for its old model single-action revolvers many years ago, offering to retrofit them, free, with a transfer bar so that a dropped gun with a round in the cylinder under the hammer, would not accidentally discharge. Ruger even assured gun owners that the older parts would be returned with the revolver, so that collector value would not be lost. The company wrote to all known owners and advertised extensively and is still advertising this policy regularly. It is not known, of course, how many of the 1.25-million revolvers produced still exist, but just over 10% of those produced have been retrofitted. (Personal communication) Competitive shooters frequently permanently disengage the grip safety on Colt semi-automatic pistols. When having some improved grips put on a semi-automatic pistol by friends, the author had to plead with them not to remove the magazine safety (a device which should prevent the gun from being fired with a round chambered if the magazine is not in the pistol). Many gun owners do not wish excessive safety devices on their firearms. One of the reasons for the popularity of the Glock pistol with law enforcement is that it has fewer safety devices than competing semi-automatics. In order to associate an increase in handgun availability to women with an increase in gun-related deaths by women, the CDC's James Mercy and Mark Rosenberg, and the CDC-funded Garen Wintemute simply lied about timing. Accompanying a box saying: "The rate of firearm-related deaths among women is increasing," Dr. Wintemute notes that "Gun sales plummeted in the 1980s, and the gun companies went looking for new markets. They found the same markets that the tobacco industry did in the 1950s -- overseas markets and women." (Wintemute, 1991) And Mercy noted that "Firearm death rates in the 1980s were ...the highest ever for females and teenage and young adult males." (Cotton, 1992) And "Firearm mortality rates for women...have been higher during the 1980s than at any time previously." (Rosenberg and Mercy, 1991:5) The problem is that the source for the statement regarding a peak in women's gun-related death rates was an article which stopped collecting data in 1982, and which demonstrated that firearm-related deaths among women peaked in the early-mid 1970s, and that gun-related death rates for women declined irregularly after that. (Wintemute, 1987) During the 1980s, the firearm-related death rate for women fell. (NCHS, 1991) Dr. Christoffel complained at the 1992 meetings of the American Trauma Society that she should not be cited for what she admits is an erroneous statement, asserting that she was shocked when she read the written testimony which had been prepared for her by the AAP. It might be noted, however, that there was nothing in her oral testimony which either corrected the false statement or presented any data which would contradict it. (U.S. House of Representatives, 1989:37-39) The basis for the study was 47 suicides in western Pennsylvania (Brent et al., 1991), and a letter to the editor described it as a small-scale study (Blackman, 1992). The authors responded that it was not really small scale, since it replicated an earlier study involving 27 suicides (Brent and Perper, 1992). Blackman suggested that perhaps the higher level of gun ownership among non-disturbed teenagers than, overall, among the mentally disturbed, might mean there is a positive relationship between firearms in the home and mental health, suggesting more study of the hypothesis. The authors responded, oddly, ignoring the fact that none of their study involved any mentally healthy teenager, that: "Both the suicide victims and suicide attempters were psychiatrically ill, but the rate of firearm ownership was higher in families of suicide victims, suggesting that there is no relationship between psychiatric illness in an adolescent and gun availability." (Blackman, 1992; Brent and Perper, 1992) Doctors sometimes have trouble with simple arithmatic. When a representative for the anti-animal testing Physicians Committee for Responsible Medicine wrote to the JAMA claiming to speak for 3,000 physician-members, the official AMA response was to belittle the figure by noting that "its membership represents less than 0.005% of the total US physician population." (JAMA 268:789[1992]) Criminologists working for the CDC adopt similar problems. For testing a model using monthly data, it was asserted that two years prior to October 1976 was January 1974. (New England Journal of Medicine 326:1160[1992]) The anti-gun researchers at the CDC also have trouble concerning themselves with seeming inconsistencies, as preliminary studies tend to be cited as if results are definitive. For example, the CDC is unconcerned about the seeming inconsistency of saying that the risk of suicide is doubled for suicidal teenagers if a gun is in the home, but tripled for adults as a whole, from a rather skewed sample. (Kellermann et al., 1992) Nor does it concern them that the invented "75 fold" comes close to being the (uncalculated) crude odds ratio for increased likelihood of suicide if there is a history of depression or mental illness (Kellermann et al., 1992:470) while noting the serious problem with suicide now was with young men and dismissing depression as a relevant factor. (Rosenberg and Mercy, 1991:4) It is worth noting, however, that the increase in homicide and other violent crime is not limited to the United States, but is also occurring in those European nations with economic problems. (Bruner, 1992; Newman, 1989; S. Simon, 1992) The raw numbers from the FBI (which are generally minimally lower than NCHS data) for 1991 indicate stability or slight decreases in homicides between 1988 and 1991 for those under 1, 1-4, 10-14, 35-44, and 45-54, a clear decrease for those 5-9, 25-34, and over 54, and a significant rise only for those 15-24. (Hammett et al., 1992, and FBI, 1992.) The medical profession is rather careless in the spelling of names. Kellermann's name is frequently misspelled, even in an article co-authored by Kellermann (Kellermann et al., 1991:39), and JAMA misspelled another author's first name, changing her apparent gender (Lee and Sacks, 1990). The CDC is not as likely to note that younger killers are more apt to use firearms than older killers, so much as to ignore the FBI data on use of firearms and cite the prevalence of firearms in teen killings and project it to all homicides, with Dr. O'Carroll, for example, noting that three fourths of homicides "are caused by firearms," rather than the FBI figures for all ages in the 58-65% range. (Goldsmith, 1989) While it is clear that 400,000 represents for HCI the sum of 135,000 daily plus 270,000 non-daily, it is unclear whether it refers to only to males and only to handguns or to both sexes and all firearms. And it is sometimes reported as if the 135,000 is part of the 270,000. The 135,000 figure has been used referring to youngsters and referring to males. Center to Prevent Handgun Violence, 1989, 1991, and n.d.[1]. The source for the estimate was improved by the New York Times ("America's Future," July 6, 1990, p. A25): "A commission established by the American Medical Association and the National Association of State Boards of Education reported last month that American teen-agers have profound problems of physical and emotional health. The commission was made up of medical, educational and business leaders, including former Surgeon General C. Everett Koop. "On an average day, the commission said, 135,000 students bring guns to school." If, and to the extent, survey questions are improved, trend knowledge will be distorted or delayed. HCI has credited the survey to the Department of Health & Human Services. Curiously, while setting a goal of reducing the amount of carrying of weapons by teenagers, the HHS and its CDC said the baseline for determining how many now carried would be established in 1991 (the 1990 survey -- CDC, 1991) rather than indicating there was a previous baseline possible. (Rosenberg and Mercy, 1991:9) On March 30, 1991, the Washington Post editorially reported that there was a 61% rise in the number of weapons confiscated during the preceding two years. Sen. Biden reported a 1% decline between 1989 and 1992. Both statements could, of course, be accurate. The version passed by the House of Representatives in the 102nd Congress (1991-1992) called for a seven-day waiting period. The Senate version called for a wait of five working days, with working days defined in terms of government offices, which are generally closed two days each week, plus holidays. The Senate "compromise" would thus mean a wait of 7-10 days. It is a federal felony to acquire a handgun in a state other than one's state of residence, and doing so through a licensed dealer and bringing it back into one's home state would normally entail the commission of a few felonies each punishable by up to five years imprisonment and/or up to a $5,000 fine. 18 U.S.C.921 et seq. Ironically, many politicians most stridently calling for the government to tell people how to store their firearms at home also rhetorically call upon government to "get out of the bedroom," a room commonly used for the keeping of home-protection arms. In general, the U.S. suicide rate is exceeded by most formerly Communist and by non-Catholic European nations, as well as by Canada and Japan. World Health Organization, 1989.