From the Mouths of Babes….

Okay, so maybe not babes. Actually, graduate students.

Where I teach, at SPEA-IUPUI, students have the option of enrolling in “Directed Studies,” essentially, tutorials in which a professor supervises student research that culminates in a relatively lengthy and (hopefully) analytical paper on a subject that the student wishes to explore.

I recently worked with a student who wanted to understand why lower-income Americans so often vote against their own economic self-interest.

The paper he turned in gave evidence of considerable research, and it made a number of very good points. He gave me permission to share a couple of his more intriguing conclusions.

For example, he looked closely at Paul Ryan’s 2012 proposed budget, and the analysis of that budget by the Congressional Budget office. As widely reported, the plan proposed massive savings to be generated by “adjusting” Medicaid and turning Medicare into a “voucher” system. It also dramatically reduced corporate and individual tax rates, while purportedly “growing overall revenue…What was not included, however, was the way Mr. Ryan intended to grow this revenue.”

These specifics would seem to be particularly important, since the plan made very clear that tax receipts would plummet and defense spending would increase. As my student recognized, however,  actually identifying specifics–in this case, specifying the programs that would be cut and the extent of those cuts–would spell political doom.

“This is an example of calculated policy ambiguity. When presented to less educated voters or those who do not possess the means or time to fact-check its claims, it appears as a viable way to aid our country in the face of mounting debt. However, when examined closely it reveals a strategy of political gamesmanship and a budget plan that would hurt most those its simplified talking points are aimed to attract.”

A second tactic pinpointed in the paper revolved around the deliberate use of religion to divert focus from bread-and-butter issues–the use of hot-button “wedge issues” to obscure the economic harms likely to flow from other, less emotionally-freighted policies and positions. The paper cited research showing that religiosity is more important than income, sex, age or ethnicity in predicting support for conservative causes.

So. Bright shiny objects (Stop the “homosexual agenda”!! Birth control means sex without consequences!! War on Christmas!!) plus “calculated economic ambiguity.”

Sounds about Right.

And Now a Word from the Doctor

I’m relinquishing my space today to my cousin the cardiologist. As he notes, it should be possible to legislate restrictions that will save lives without running afoul of the 2d Amendment. Unfortunately, in our current bipolar political environment, where every issue is painted in black and white –where complexity and shades of gray are “elitist notions” and the most innocuous regulations are omens of the coming apocalypse–the prospects aren’t bright.

            FIREARM VIOLENCE IN THE UNITED STATES: A MEDICAL OPINION

Most people don’t realize that over 30,000 people are purposely shot to death each year in the U.S. Moreover, rates of firearm-related violent crimes continue to climb, having increased by 26% since 2008. To gain perspective on these numbers, firearm deaths have now reached a yearly rate that equals that of automobile fatalities. What we can do to stem such violence is urgent but hampered severely by the rabid supporters of the second amendment and, of course, the gun lobby. Some clarification recently has been shed on this problem by a study appearing in the prestigious medical journal, the AMA sponsored Archives of Internal Medicine. These authors explored the question whether more restrictive firearm laws in a given state are associated with fewer shooting deaths. To answer this question, using sophisticated statistical methods, they measured the association between the rate of shooting deaths in a state-by-state rating (divided into quarters) of strength of legislation designed to limit sale and use of firearms. Their results were very illuminating: Those states with the fewest firearm regulations, as exemplified by Utah and Louisiana (0-2 laws), suffered the highest rate of firearm fatalities, which included both homicides and suicides. The states with the strictest pattern of regulation, as exemplified by Hawaii and Massachusetts (9-24 laws) experienced the lowest fatality rates. Indiana fell into the second lowest category for regulation and, as expected, fell into the second highest incidence of firearm deaths.

These authors freely admitted that finding an association between two factors—gun laws and mortality—does not prove that these two are causally related. But it sure raises important thoughts about what we as a society can do about this problem. Further research is obviously needed, but it is quite likely that more restrictive gun laws can save lives.

More aggressive attempts to identify, treat and constrain the huge numbers of those who are mentally ill is an exercise doomed to failure. Widespread arming of teachers and/or police officers is equally ridiculous, especially since it would increase chances for erroneous shootings in the absence of any expected benefits.

With such limited options available, what are we left with? Although we need not scrap the second amendment, those who hold legislative power should seriously consider stronger laws restricting guns, while, at the same time, sponsoring and performing more comprehensive research on this urgent problem. If we value life, we cannot afford to wait!

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What We Don’t Know and How It Hurts Us

Remember the old saying, “what you don’t know can’t hurt you”? Unlike a lot of folk adages, it’s wrong. Very wrong.

A lot of folks–especially younger people–shrug off the suggestion that they need to follow what our political class is doing. They have lives to live, livings to earn, children to raise, parties to attend. Let the politicians tend to governing.

This morning’s New York Times–buttressed by an article from the Journal of the American Medical Association–offers a prime example of why it’s important to keep tabs on Congressional shenanigans.

In the wake of the most recent horrendous shootings, of children in Connecticut and firefighters in New York, fingers have been pointed at the Bureau of Alcohol, Firearms and Explosives. ATF is theoretically an agency with the authority to thwart gun violence. But it has been without a permanent director for six years, thanks to the persistent efforts of Republicans in Congress to block any and all Obama appointments. Furthermore, it is hampered by laws lobbied for by the NRA and dutifully passed by Congress. As the Times notes,

Under current laws the bureau is prohibited from creating a federal registry of gun transactions. So while detectives on television tap a serial number into a computer and instantly identify the buyer of a firearm, the reality could not be more different.

So–unlike many countries–the U.S. doesn’t have a gun registry database. The NRA thinks such information would “pose a threat to the Second Amendment.”

In fact, the NRA evidently thinks that information would pose a threat to their version of the Second Amendment.

A former student who went on to get his doctorate in medical informatics sent me a recent Viewpoint from JAMA, the Journal of the AMA. After detailing several of the most recent mass shootings, and noting that in the U.S. more than 31,000 citizens die annually from firearms, the authors note research findings that ready access to guns in the home “increases, rather than reduces” a family’s risk of homicide in the home.  Then they make their main point:

The nation might be in a better position to act if medical and public health researchers had continued to study these issues as diligently as some of us did between 1985 and 1997. But in 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the CDC. Although they failed to defund the center, the House of Representatives removed $2.6 million from the CDC’s budget–precisely the amount the agency had spent on firearm injury research the previous year.

The funding was restored in joint conference committee, but only on condition that it be earmarked for traumatic brain injury. And the following language was added to the final appropriation: “none of the funds made available for injury prevention and control may be used to advocate or promote gun control.”

Similar language has been added to funding for the National Institute on Alcohol Abuse and Alcoholism, after a research study was funded by that agency to determine whether carrying a gun increased or decreased the risk of firearm assault. The article went on to detail similar restrictions on other agencies.

A couple of rhetorical question: why doesn’t the NRA want the American public to have good information about gun violence? and why does a majority of Congress do its bidding?

A not-so-rhetorical question: when will citizens of this country say “enough!”

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