Politics and Government

Vin Gupta, affiliate assistant professor of health metrics sciences at the University of Washington, and Jonas Oransky, legal director at Everytown for Gun Safety, discuss gun-related deaths as a public health problem, approaches to preventing firearm-related deaths in the United States and abroad, and the recently passed bipartisan Safer Communities Act and specific provisions concerning states and localities.  TRANSCRIPT FASKIANOS: Thank you. Welcome to the Council on Foreign Relations State and Local Officials Webinar. We’re delighted to have participants from forty-seven states and territories with us today for this conversation, which is on the record. I’m Irina Faskianos, vice president for the national program and outreach here at CFR. CFR is an independent and nonpartisan membership organization, think tank, publisher, and educational institution focusing on U.S. foreign policy. CFR is also the publisher of Foreign Affairs magazine. And, as always, CFR takes no institutional positions on matters of policy. Through our State and Local Officials Initiative, CFR serves as a resource on international issues affecting the priorities and agendas of state and local governments by providing analysis on a wide range of policy topics. So we are pleased to have with us today Vin Gupta and Jonas Oransky to talk about “Gun Violence, Public Health, and the Safer Communities Act.” I shared their bios with you, but I will give you a few highlights. Dr. Vin Gupta is currently an affiliate assistant professor of health metric sciences at the University of Washington’s Institute for Health Metrics and Evaluation. And he is a chief medical officer of Amazon.com’s global COVID-19 response. He is a Harvard-trained lung specialist, with experience in the field of global public health, and has worked with the U.S. Centers for Disease Control, the Harvard Global Health Institute, and the World Health Organization. And Dr. Gupta is also a deployable critical care physician for the U.S. Air Force Medical Corps Reserves. Jonas Oransky is a legal director at Everytown for Gun Safety, the largest gun violence prevention organization in the country. He spent nearly a decade there working to develop and implement policies that curb gun violence in the United States and is an expert on the bipartisan Safer Communities Act, passed into law in June of this year. Mr. Oransky previously worked in the New York City mayor’s office and moved to Everytown in the days following the shooting in Newtown, Connecticut. So thank you both for being with us. Dr. Gupta, I thought we would start with you to give us an overview of gun policies around the world, how other countries have responded to gun-related deaths and mass shootings, and why this should be approached as a public health problem. GUPTA: Irina, as always, thank you for the privilege of being here with the Council on Foreign Relations. It’s great to be here with my co-panelist, Jonas, and with all of you. I recognize everybody joining in, has a really busy schedule. And thank you for all that you do for your communities. Gun violence is a public health emergency. This is—this is an issue that I know has been politicized, that is obviously controversial. And so I want to acknowledge that up front. We all have our own personal beliefs on gun ownership and what that means. And there’s a lot of history around this issue, irrespective of some recent tragedies. But let me try to frame this with some facts here that I think are incontrovertible. And I say this as an ICU physician that has seen what gun violence does to the human body, both as a civilian in civilian hospitals in the U.S. and also as a deployable doc that has seen what assault weapons do to the human body, to our deployed soldiers. I have actually cared for wounded warriors, and brought them back from downrange in places like Afghanistan in C-17s. And that’s what I do as a critical care or transport physician for the Air Force and try to save their life and transport them back home. So I come at this from the lens of looking at the data as an epidemiologist, but, you know, very—from an emotional lens and from a clinical lens as somebody that’s actually cared for individuals harmed by these weapons. And so what does the data say? You know, more than anything, I think—certainly over the last few years—we’ve seen a trend here in the United States that is worrisome when it comes to the impact of firearms on our children. And so firearms deaths now, into 2022, is the leading cause of death of children here in the United States, those less than eighteen years of age, across the United States. The first year that that’s actually been true since we’ve been tracking this data, since 1990. And so that’s a pretty seminal milestone here, and I think pretty alarming when you think about what our peer economies—those with—our peer nations with advanced economies. You know, when you look at what their data shows, the impact that firearms are having on childhood deaths in places like Japan and in Germany, it’s pretty alarming. Because in places like Japan and Germany, it doesn’t even—it doesn’t even rank in the top ten. In Japan, it’s the fifteenth-leading cause of death amongst children less than eighteen years of age. And the reason—there’s lots of reasons why. But I think the most explanatory reason is it’s hard to get—have access to firearms in places like Japan. In Japan, you need to go through three background checks, regardless of your age. And you have to also have a motivational interview with police. You actually have to explain to them why it is that you want to own a firearm. And so those stringent, upfront policies limiting who actually has access, making sure we have a thorough vetting of who’s seeking out firearms in places like Japan, something similar in Germany to a certain degree, is the reason why many of us believe that firearm deaths specifically amongst children are rare. And we’re talking about the fifteenth leading cause of death amongst children in Japan, the number-one leading cause of death—firearms, that is—amongst children here in the United States. That’s a sobering reality now. Usually, in most advanced economies especially, but pretty much in any country across the world, the leading cause of death of children—really, in most countries worldwide—is motor vehicle accidents. In some places, it’s cancer. In the United States, it’s firearm deaths. So I think we really have to wrestle with that as a country here. And when I say that this is a public health problem, I lead with that as reason number one, because that is avoidable. That is an avoidable tragedy. But I think, you know, some much has—so much of the focus has, appropriately, been on children, and the havoc that firearms have wreaked on them, that sometimes we lose sight of some of the broader trendlines that we’re seeing amongst, say, adult men, ages fifteen to forty-nine years of age. Suicide is the leading cause of death amongst men in that age group in many advanced economies. Not just here in the United States, in many. In the United States, what we saw here is that youth suicides have spiked by over 25 percent for every ten-percentage-point increase in gun ownership. That specifically is a finding here in the United States. That’s amongst children eighteen years of age and younger. But in the U.S., suicide is the leading cause of death amongst older men—fifteen to forty-nine years of age. And one of the clear reasons why, again, is easy access to firearms. Many studies have shown this—so I’m sure we’ll make sure that we share some of the relevant data for those that would like it—have shown a clear link between easy access to firearms and the reason why suicide is so common here, specifically amongst that demographic here in the U.S., but also in many of our advanced economies across—many of our peer economies across the world. And so there are many examples here in the data showing that the easier it is to access firearms, especially in the U.S., the trend lines here in terms of downstream impacts—whether it’s suicide in older individuals or firearm deaths in younger individuals—the data is pretty clear. I also did want to just emphasize here, as—you know, I often get questions about what is the impact. You know, as we have had some of these really wrenching debates on who should and should not have access to, say, an assault-type weapon—an AR-15-type weapon, especially after—in the aftermath of what happened in Texas recently. Is this the type of weapon that we should be—you know, anyone should potentially have access to, especially in states that don’t have background checks, that don’t have licensing requirements for gun dealers, places, frankly, where it’s easier to get your hands on a weapon like this. Is this something that should—is this a weapon that should be constrained in terms of access? Should we go back to the 1990s, when we had a ban on broad public access to these types of weapons? And, you know, I recognize here that, and especially in my military life, there are a lot of my fellow servicemembers who look at these types of weapons and say, you know, they are law-abiding citizens. That they feel that the right to have access, to utilize these weapons—especially since they’re law-abiding—should not be infringed upon. That they use it for recreational purposes alone, like hunting, and that they don’t want to see that in any way impacted. But then when you really look at it from a clinical lens, what is the impact of a bullet that’s emitted from an assault-type weapon, from an AR-15-type weapon versus from a handgun? And what is the impact that it has on the human body? It’s like a bomb—a mini-bomb is going off once that bullet has direct impact to the soft tissue, to your skin. And then once it pierces the skin, within your body the impact that it has—bullets from an assault-type weapon, an AR-15-type weapon—it’s like a bomb is going off in your body. Unlike, say, a bullet from a handgun, where pretty much there’s localized damage. There’s damage, there’s bleeding, there’s significant sort of potentially destruction of bone and major blood vessels from a bullet from a handgun, no doubt. But it’s localized to the area in which it enters and exists. Unlike a bullet from an AR-15-type weapon, where on impact you’re having a mini-explosion. So you’re not just having localized soft tissue damage. You’re destroying the tissue around it. That’s causing inflammation. It’s causing actually a systemic body response, where blood pressure starts to decrease, people start to lose a lot more blood than just the area in which there’s that direct injury. Which is why you’re seeing in many cases, if somebody has a bullet injury from that type of weapon their time—the time for medical intervention in which somebody’s life could be saved—we’re talking about a narrow window here. Maybe five minutes, maybe ten minutes, where you need to place a tourniquet, you need to get them to surgical intervention as quickly as possible. Versus a handgun and an injury from a handgun, where you have a little bit more time, potentially, to save that person’s life. That’s the key difference here. So when we think about the public health data, the statistics I mentioned just at the top—firearms being a leading cause of death amongst children less than eighteen years of age here in the United States, a trend that’s only getting worse and, frankly, deviating from global trends that we’re seeing amongst many of our allied countries like Germany and Japan—those public health figures should be alarming in and of itself. But then when you look at the impact that especially firearms like AR-15-type weapons have on the human body, it’s pretty extraordinary. And I’ve seen it with my own eyes here. There is no place, in my opinion, for these weapons of war in the general public. And that—you know, to go back to some statistics here and some of the evidence we saw from the mid-1990s when you limit access to these types of weapons mass shootings that are—in which an AR-15-type weapon are used—or, in which they’re used, those almost go down to essentially zero. We see mass shootings as a result of these assault-type weapons become very rare, almost go down to zero in places like New Zealand and the United Kingdom, once you place restrictions on who can access them. And in my belief, given what I’ve seen clinically, in terms of what the bullets do from these types of weapons to the human body, I don’t believe they have any place in society for general public access. They should be something that is limited to those in uniform, whether it’s police or military. And that’s coming from a clinical standpoint. However, I’m going to stop right there. I’m going to stop right there. I’m going to pause and send it back to Jonas. But I did just want to start off with some public health and clinical grounding. FASKIANOS: Thank you so much, Vin. And, Jonas, let’s go to you to talk about the new Safer Communities Act, and what was passed, and what officials and constituents can expect to see at the subnational level as a result of these new policies. ORANSKY: Yeah. Thanks so much for having me, Irina. Thanks to Vin. And thanks to this audience for tuning in. I’ve been working in the gun safety movement now for nearly a decade. I’ve seen many major successes, and also our fair share of disappointments at the local, state, and federal level. What I can say about this new piece of federal law is it’s a real landmark. It is very important for political momentum, certainly. And it’s given us real policy change and a lot of new funding to celebrate. While it is not everything we want—Congress certainly needs to do more—we’re confident that this new law is going to have a major impact. And in this field, a major impact means lives are saved. So now there’s a ton of work to be done to make the most of this law, much of which falls to folks like you—capable and caring officials at the state and local level. I’m going to give an overview now of what some of that state and local action should look like to implement the law well and will be happy to answer any questions. I’ll share my screen here. Bear with me. Great. Can we have thumbs up, that folks can see that? Great, thanks. Great. I’ll just also put in a plug. We have a large law and policy team at Everytown. Really unmatched experience in these issues. We’re ready to help on the nuts-and-bolts level, including to help figure out how to prioritize among these really many pieces of policy work for a given state or locality. So onto my first slide here. When it comes to federal action, the gun safety movement has had its best year, really, in a generation. So you see on the page here is a short list of the accomplishments to date, including, as you can see, regulatory success on the issue of ghost guns, along with confirmation of the first ATF direction since President Obama was in office. The last, and really most impressive, item on here is the passage of the bipartisan Safer Communities Act, which is the most impactful federal legislation on gun safety in twenty-five years. It is the first major step forward in federal legislation since the movement’s efforts really intensified in the wake of Sandy Hook, nearly now ten years ago. Next slide here. You can see that the SCA has several sections and several policy areas. It aims to reduce gun violence in all of its pernicious forms, including not only mass shootings but also the suicides that make up nearly two out of every three U.S. gun deaths, along with domestic violence homicides, as well as the gun violence that’s concentrated in our city and falls most heavily on Black and brown Americans in U.S. cities. In the wake of the bill passing, Everytown made a primer for state and local actors that’s really focused on what’s next. I think we plan to send it to this group after this session is complete. Recommend folks look at that document in detail. I’ll do my best in my remaining opening minutes here to name some of the important highlights, and go through these issues one by one. I hope you will forgive the laundry list. There’s a lot to cover here. Happy to hone in on any individual policy afterwards. So, first, up here, taking the issues one by one, the law funds $750 million, as you can see here, for crisis intervention, including so-called red flag petitions, which empower law enforcement and family members to ask a court to temporarily restrict gun access for a person in crisis, a person who poses a danger to themselves or others with a firearm. These have been a major focus of the movement in Everytown now for several years. These programs are proven to have especially strong impacts on reducing suicide. In the nineteen states with these laws in place, officials should be applying for this money as soon as possible. We expect the solicitation from the government to be released any day now, really shortly. Folks should be using that money to set up really statewide efforts to design best practices and technical assistance for identifying these cases, along with tools really to help people in crisis into the resources that they need—behavioral health resources, mental health resources, and the like. These laws are all new, and they all need really tender, loving care from state and local actors to increase the uptake. We are very confident this new money is going to increase use of this lifesaving tool pretty considerably. We’re hoping to see more full-time staff at the local and state level dedicated to looking for warning signs and taking out these petitions. That’s a model that’s been successful in several localities in these states. We’re hoping that states that have resisted passing red flag laws in the past will take this opportunity—you know, really new, bipartisan support for these—for these petition processes—to go ahead and pass these laws. And you’ll see here a link, it says gunlawrankings.org. That’s an Everytown website. We catalog fifty top policies for all fifty states and, among other things, show a correlation between strong policy and lower rates of gun violence. You can actually consult that site to understand several of the policies on here. Next, the new law creates an additional background check identification process for gun buyers under twenty-one years old, with federal background check operators reaching out to state and local officials to look for records that are not already in the federal system. That’s an extra effort to ensure there are no illegal sales of young people, who we know can pose a special danger with a firearm. So state and local officials can help now to implement the law by building out in their states a centralized process to respond to those inquiries from federal operators. It's especially important because the law does not give much additional time to track down those records. The clock is effectively always ticking once someone tries to buy a gun, to find those disqualifying records. Separately, states should take this opportunity, if they haven’t yet, to update their laws, raising the age for all gun purchases to twenty-one years old, where we believe it should be. Several states have done that, including Florida, which did that after the Parkland shooting in 2018. Next up—again, please forgive the laundry list; there’s a lot to cover—community violence intervention programs. So the bill funds $250 million for these programs, which will flow chiefly through local governments and also directly through organizations that specialize in group-based intervention, in violence interruption, in hospital-based services—all that focused on breaking the cycle of violence in the hardest-hit communities. These programs are really a crucial part of the gun violence prevention puzzle and a growing piece of the movement. This is money that will help to scale up their work. So state actors can also help. They can add in more money of their own, which several states have done. They can also help play a role as technical assistance providers, as conveners, as advocates. Some states have set up stand-alone offices of violence intervention to help fund and coordinate this type of work. Onto slide six, domestic violence. The bill partially closes the infamous loophole that has often been called the boyfriend loophole. So it finally bars gun possession by dating partners who are convicted of abuse, rather than allowing those abuses to hold onto their guns, as the law had done for really a generation. This is a major policy breakthrough. It will certainly disarm abusers and save lives. The main value that in-state officials can provide here is twofold. One is looking at their state criminal codes and condition of their own court records, clearly identifying which people are newly prohibited from gun possession under the law, now that it’s been updated in the right direction. The second piece is all about relinquishing illegal guns. Folks have probably heard a lot about this policy in the past. It’s been a major priority of the gun safety movement. With federal momentum, this is the moment to make those gun laws really work, to make gun removal programs thorough and consistent. This can be really in-depth programming with courts and law enforcement. Folks can also consult, I’ll put it on the screen again here, gunlawrankings.org, to see which states have more statutory changes that they can still make. One more slide to run through here. I’m watching my clock. Next is the piece that expands which gun sellers will run background checks on their buyers. So the federal bill adds new language to the law on where that threshold is for being, what’s called in the law, engaged in the business of dealing firearms. We hope this is going to narrow that loophole where illegal gun buyers, guy buyers who are not allowed to buy guns, try to skip the background check that’s supposed to be required under the law. I’ll only say for now, for the impact at the state and local level, that very interested state officials can help identify those sellers that have failed to get dealer licenses, and can also, you know, do their own work—states can do their own work to pass or improve their own licensing laws, those are pretty common as well in some of the bluer states, to increase industry oversight with a state regulatory process. Separately, and it’s not even on this page but there’s so much in the bill, there’s new $200 million in grant funding for states to use their own—for their own criminal mental health records. There’s been a lot of money used—a lot of federal money used over the years to do this. This is a new $200 million to ensure that records are well-marked, consistently entered into federal databases that are used for background checks. I’ll spend just one moment on two final policies here. Trafficking—here we have the first law ever that makes it a crime to engage in straw purchasing or interstate gun trafficking. So state and local officials can now make themselves available to the feds to help investigate trafficking in their communities. They can also take a bigger and bolder step, following the lead of innovators, like the city of Baltimore, that have built their own data intelligence tools to look at illegal guns on their own streets to identify and map where those guns are coming from in their own communities. And finally, the law funds $300 million for preventing violence in schools with evidence-based strategies such as educating parents on secure storage, standing up threat assessment teams that intervene when students are at risk, along with more nuts-and-bolts policies, school security upgrades, and emergency planning. Local leaders can play a leadership role here as well, disseminating information on secure firearms storage through the schools, as cities like Los Angeles have done. Finally, all states that don’t have strong secure storage requirements should cast those into law as soon as possible. OK. I appreciate I covered a lot in a short time there. Hopefully, there’ll be some follow-up questions for folks, and hopefully, folks see that the new law touches on a lot of issue areas, many opportunities here it creates for investment of time by state and local actors. As I concluded here, I just want to shout out the amazing movement that helped build toward this federal legislation over years, that has helped pass so much great legislation at the state and local level. We have really an incredible collection of organizations and community leaders across the country. I’ve been inspired by the many state and local officials, including many of you, who have stuck their neck out for these issues. So I’m really grateful for you all. And now I’ll just kick it back to Irina. FASKIANOS: Great. Thank you both very much. And there have been already a couple of questions written. Can we get a copy of this webinar and the slides? And, yes, we will be sending out a link to the webinar, the transcript, the Everytown report, as well as Jonas’ presentation so you can refer to it after the fact. So now let’s go to questions. We hope that you will write in the Q&A box your questions. When you do so, please identify yourself so that I—and I will do my best to also look you up if you don’t do that. So I’m going to first go to Rex Scott, who is a country—sorry—county supervisor in Arizona, which has a statute in place, ARS 13-3108, that prohibits local jurisdictions from enacting laws or regulations dealing with guns that are stricter than state laws. Our board passed a resolution calling on the state to repeal the law and directing our county attorney to present us with options for challenging the constitutionality or legality of the statute. Could Everytown help us with this challenge? ORANSKY: Great. Thanks for the question, Rex. Yes, this type of law, which may be shocking to some folks, is actually in place in some states in the country. I think the count is north of forty states that have laws that attempt, at least, to block localities from doing their own good gun safety work. They do not—sometimes they do not stand as a complete bar. Sometimes they’re poorly written. We have had conversations about whether they are constitutional in the past, but these types of preemption laws, from our perspective, are really pernicious because they block local leaders from doing their own work. I know that Arizona has one in place, and I remember there were a few years in a row there where the Arizona legislation kept strengthening the state’s firearm preemption law. They just kept adding to it and trying to do more work to block localities. It was depressing because it was—particularly depressing because it was in the wake of the Tucson shooting where Gabby Giffords was shot. So what I can say, Rex, is we are absolutely opposed to that type of law. And if—you should certainly feel free to reach out. We have folks on the ground in Arizona and a team that lobbies in Arizona and would be happy to talk about it. FASKIANOS: Great. Our next question from Willie Rachford, who is the community relations executive director in Charlotte, North Carolina. When you consider our collective reaction to gun violence and the impact on young people, is it that we don’t get it or we just do not care? And what hunter needs a gun that will blow the head off the animal they are hunting? So I think maybe you both could answer that one. ORANSKY: Yeah, I mean, I’m happy to jump in. I think that people—honestly, I think that people do care. If you—if you poll the public on major gun violence prevention issues, you typically find extremely high support for the main issues that my organization works on. If you poll on universal background checks, for example, you get numbers—you know, 90 percent of the public thinks that they’re a good idea. We’ve always believed that the public passion is there for the issues. Obviously, we have, you know, shocking gun violence, mass shootings that make the news and shock the nation’s conscience. And the total number of people killed in gun violence is truly staggering. You know, the work of advocates like myself—and we have, you know, 6 million folks who are supporters of the org—is really to convince legislators to care as much as the people do, and convince legislators that might be scared of gun lobby pushback that they shouldn’t be. That they’re covered, that they’re not going to get voted out of office for taking action. And we’re really hopeful, frankly, that the federal law is a huge momentum shifter, showing that you can get, you know, nearly seventy votes for common-sense gun reform at the federal level. FASKIANOS: Great. Vin. GUPTA: Yeah. I’ll just 100 percent agree with Jonas. And I’m grateful for Everytown’s work and commitment, and, Jonas, your commitment to this day over day. You know, I’ll just add that it often seems like solutions that get proposed from elected officials who are resistant to restrictions on access, particularly to assault-type weapons—AR-15s or AR-15-like weapons—want to rely on solutions that, you know, frankly are not scalable, like increasing the provision of mental health services to more places in the United States, to more children that may need it, to more adults that may need it. That is not a short-term solution, because we have—and this is for medicine across the board, not just mental health providers—but we don’t have enough providers. There is a shortfall of at least 7,000 mental health professionals right now as we speak. Sixty to 80 percent of the U.S. population doesn’t have durable access to a mental health provider. Over 45 percent of mental health conditions right now are not getting treated. And that’s amongst those are just diagnosed. There’s a lot of undiagnosed mental health burden across the country. We don’t have the services to be able to really intervene on that. Even with the new resources in this—in this new legislation, if you don’t have trained professionals to render services, to prescribe therapy, to do the monitoring, you can’t—there isn’t a silver bullet here to say, let’s improve the nation’s collective mental health. That is something that’s easier—that’s far easier said than done, and yet that’s often what’s talked about in the absence of meaningful action on limiting access to firearms, particularly AR-15-like weapons. And so that’s also part of the problem here. That often the policy debate on those most resistant to meaningful change lean in on these tools or prescribe these solutions for which there actually isn’t a scalable solution. FASKIANOS: And just to follow on that, how has the—that gap widened with the COVID-19 pandemic? The shortfall  mental health professionals? GUPTA: It’s only worsened. So, Irina, the expectation here is that we were going to lose about 30 percent of all health care providers, including in that mental health providers, by end of—by the end of the decade, by 2030. That there’s going to be natural attrition, people are going to retire. That number has now increased to about 45 percent. We expect—there has been almost a 50 percent increase in the proportion of health care providers—mental health and others—that are going to leave the workforce because of burnout, because they’re just done with it, exacerbated by the pandemic because of the ways in which the pandemic has really—had made the lives of providers really difficult. And so when you think about that supply-demand imbalance getting worse, and mental health—the prevalence of mental health disorders likely only increasing as a result of the pandemic, then this is a pretty terrible asymmetry here. And, you know, tele-mental health, all this revolution in virtual care, is only going to be able to close that gap so much. And so we—this is not—sure, I am all for supporting innovative solutions and increasing access to mental health. I think tele-mental health, making sure that we have durable access to telehealth more broadly across all fifty states, is vital. There’s a lot of policy changes that we can do to improve access to telehealth services, mental health, and otherwise. Having said that, that is only a partial solution. If we do not have enough human resources to provide these types of services, it doesn’t matter what we do on the policy side. And we’re lacking the human capacity, the human capability here. We don’t have enough workers in the pipeline, mental health providers, to replace those that are going to leave. So this is the true crisis here. And as we talk about gun violence and solutions that will achieve bipartisan support, we have to keep these realities in mind here. It’ll be favorable and easy to talk about addressing mental health issues as a solution we can all agree to. And yet, when you really double-click here, we have to incentivize people to go into and become mental health providers. We have to make sure that we can retain them. And that’s a broader discussion, of course. FASKIANOS: Thank you. So the next question comes from Misty Perez, who’s a councilmember of Port Hueneme, California—excuse my pronunciation. It got two up-votes. Now, how do we get access to the funding mentioned in this law? Who should we contact? I think that one is for you, Jonas. ORANSKY: That’s a great question. And I think it’s a good problem that, as you look through even the slide show, we’re talking about several different types of funding to put to several different types of purposes. So there isn’t one single answer. If there’s one single answer probably, Misty, it’s feel free to get in contact with Everytown and we can talk about any of these individual sources of funding and how to start accessing them. But for—you know, I can just, you know, take a couple of them one by one. For extreme risk protection orders, for that crisis intervention funding, we really need state leadership to do that work first, to pull that money down. I think that solicitation will be coming out imminently. We certainly expect—I think we hope and expect—all my team—extreme risk protection order states, all the red flag states, will be using that money. For city leaders, I think it probably is important to be talking to your governors’ offices, to be talking to your AG’s offices, and saying we want access to some of this money. I think that we will be—certainly be saying to governors and to state leaders who are—who are most likely to be dispersing it, that they should be looking for local leaders who want to lead red flags. That could be setting up your own staff to focus on it as, you know, great leadership in places like King County, Washington. They have dedicated teams that focus on red flag petitions full-time. I think that probably it will be smart to talk to the state folks about how to access some of that money. Whereas, for community violence intervention funding—for violence interrupters, or street outreach, or hospital-based programs—that money actually flows directly to locals and to community-based organizations directly. So that’s money that can be sought by locals, like yourself, directly from the federal government. I won’t run through all the different types of funding, but I’m very happy to talk about any one in particular. And if you wanted to get in touch with the California folks, or with me and I can connect you to our California folks, I’m happy to—happy to help with the individual pots of money, talking about how to access them. FASKIANOS: Fantastic. We will confer with you, Jonas, and you can give us a contact list of, you know, what we can send out to the group. So, Diane Goldring, chief of staff for Illinois State Representative Gabel: Is there any momentum whatsoever behind repealing the Protection of Lawful Commerce in Arms Act? ORANSKY: There is momentum. I don’t expect that it will happen in this—in this Congress. But we’re pressing hard to try to do that. And there was nearly a House vote on repealing what we call PLCAA last week. For folks that don’t know, this is a really ugly piece of federal law that was passed in 2005. It creates a really unique type of immunity for the gun industry, where it becomes extraordinarily difficult to bring them to court for gun violence survivors, to hold them accountable for, you know, really extreme, you know, negligent behavior that, unfortunately, is a matter of course in the gun industry, that ended up landing guns into our community, onto the black market, in the hands of children. PLCAA has made it very difficult to hold the industry to account. And it was passed in 2005 after there had been a rash of lawsuits that were actually proving effective to create some change in the gun industry. One thing I will say, we have states that are leading on PLCAA now. New York was the first to pass this type of law last year. And we now have had new action in places like California and Delaware to pass similar laws that effectively are broadening the escape hatches in PLCAA and making it easier in those states to try to work through the federal PLCAA bill and do some of that accountability work in court. So we’re seeing really hopeful strategies in state legislatures to try to—to try to work around or through PLCAA. FASKIANOS: Thank you. I’m going to group two questions, the first from the chief of police, Patrick Finlon, Cary Village, Illinois, and Carey Jansen of Crawford County, Michigan, commissioner District Four. So for the chief of police: In Dr. Gupta’s introductory comments, it sounds like the issue is the destructive effective of supersonic rounds. Is the restriction of the ammunition a control method that is being sought? And then for—from Carey Jansen—which I just lost in this—here we go. Dr. Gupta, interested to hear your perspective on the sociological/psychological reasons why Americans love guns. What is it ultimately tied to? GUPTA: Well, I appreciate both those questions. I should say that I am a—I’m a pulmonologist, so I will do my best to try to weigh on that second question. I will say for question one, capacity limitations—if that’s sort of—if I’m understanding the question correctly—so how many rounds can you fire, you know, from, say, an assault-type weapon, and AR-15-type weapon? You know, or capacity limitations, say, you know, sort of small magazines. They only have five to ten rounds of ammunition versus sort of large-scale magazines that can—(audio break)— FASKIANOS: Something just popped. GUPTA: You guys are— FASKIANOS: There we go. You’re back. GUPTA: You can hear me? OK. So while I—while I do think that capacity limitations of how many rounds you can have, you know, in one—in one magazine will hopefully be able to mitigate the loss of life in any particular mass shooting, it’s not going to—you know, one bullet from one of those—one of those AR-15-type weapons can kill somebody. So while capacity restrictions will hopefully mitigate the loss of life—and in Washington State, for example, you can only carry small-capacity magazines that have five to ten rounds, versus in some states, you know, that magazine can carry up to thirty rounds. While I think that’s a partial solution to this issue, really one bullet from any of these types of weapons can still kill easily one individual. So you’re talking about sort of the magnitude of loss of life there if we were to limit the size of magazines, which some states have done. So, again, partial solution. To the second question—at least from what I’ve seen in the spheres of life in which, you know, I directly experience—I do feel that there is a lot of the messaging and marketing of these weapons—AR-15-type weapons—speaks to a machismo that it’s really been effective in sort of channeling or appealing to that sentiment—that machismo sentiment, that sort of feeling like there’s masculinity that you would be able to recuperate or to channel if you were to own one of these weapons. I think it’s been very effective at drawing people in that may otherwise not have been tempted to even think about utilizing or seeking out these weapons. So I do think that thread has been quite strong and that marketing tactic very effective. FASKIANOS: Thank you. I’m going to go to Representative Keturah Herron from Louisville, Kentucky. There are a lot of different policy solutions to assist in preventing gun violence. Do you recommend more conservative states, like Kentucky, to start small, like establishing an office of gun violence prevention, before going to gun restrictions? If not, what recommendations do you have for more conservative states? ORANSKY: Yeah, it’s a great challenge for conservative leaders—for leaders in conservative states that care about these issues. We’ve had a lot of folks in state legislatures, you know, banging their head against the wall because they, you know, have been unable to do some of the most basic gun safety work in those states. For a couple of years. we were seeing a lot of progress on domestic violence issues in the more conservative states. And some of the reddest states in the country passed pretty strong and impressive domestic violence laws over several years. I think we hope to do more of that work going forward. Another major priority in those places has been community violence intervention funding, which in some conservative states has been able to free up some state money to do that work in cities. And now with a lot of new money flowing federally to do that work, I think localities like yours could perhaps focus on pulling down some of that money and building that work—the street outreach work, the hospital-based interventions, the group-based interventions, working with credible messengers. That could be a really important priority and, you know, there isn’t a state preemption bar on doing that type of work, usually. And, like I said, the federal money is going to flow a lot to locals directly to do that work. So not—that’s not a comprehensive list, but there are some places to start. And if you want to talk more about opportunities for Louisville, we’d be certainly happy to connect and think it through. FASKIANOS: So I’m going to take the next question from Kristen Edgreen Kaufman, deputy commissioner at the New York City Mayor’s Office of International Affairs. What are your thoughts on the role of data sharing amongst municipal, state, and federal law enforcement agencies on confiscated guns used in violent crimes? How can we break down the silos of data at the local and federal level to allow information to be shared among relevant parties to better address gun violence? ORANSKY: Yeah. It’s a really important question and a really important gap in our knowledge. And when it comes to planning smart policy solutions, the fact that we don’t know—we can’t map in detail what trafficking networks look like, how guns are moving from the legal market to the illegal market, and ending up in crime, makes it very difficult to find the best-fit solutions. So we’re extremely excited to have the first confirmed ATF director in several years. He just took his office a couple weeks ago. And we’re very hopeful and have already been impressing the ATF to focus on trafficking networks. They already have had some projects that are, you know, effectively regional centers to try to pool this type of information. And we’re hopeful that the feds will redouble efforts to try to bring some sunshine to, you know, what trafficking networks look like, how crime guns are coming into being, how they’re ending up on our streets. There do exist, and folks may know this, some restrictions in the federal law that the gun lobby helped put in place now almost fifteen years ago, that block ATF from doing certain publication of data on firearm traces, which are—which are awful, and help—and have helped to build, you know, this kind of, like, opaque—this veil over trafficking. And we’re hoping—have been lobbying to try to remove those restrictions. We’ve also seen work at the local and state level to try to get data directly from the feds and build the type of tool—I mentioned the city of Baltimore earlier built a tool, Everytown helped work on it, to try to do some of that mapping work on their own. There have been others like the Crime Lab at the University of Chicago, that have done some of that work, that really should be ATF’s work. but it’s been hard for them to do. So we think that the role of local and state actors to try to effectively pool that information and build their own—build their own maps and networks is critical. We would be happy to talk about it more detail. Hard to describe too much in a few minutes here. But would be happy to talk about it in detail. FASKIANOS: There’s a question from Kathleen Willis, who’s a representative in the House for the State of Illinois. Illinois has many gun laws in place, including red flag laws and background checks. But we get frustrated that people can cross state lines and have easy access to guns. Any chance of seeing a federal law that prohibits out-of-state purchasers? ORANSKY: Yeah. Folks may know because it’s been so—it’s been such a frequent refrain in the press now for years. A city like Chicago, and just brought up Baltimore earlier, may be two of the cities that are really most plagued by the weak gun laws of their neighbors. The Illinois laws are pretty strong, Chicago’s gun laws are pretty strong. But it is really not difficult to get into Indiana and try to effectively sneak around the strong laws of Illinois. Unfortunately, a lot of folks from Chicago go across state lines and buy guns illegally. They do it in private sales where gun—where background checks are not required. And that’s extremely difficult to crack down on. It’s one of the reasons why our belief that crime has remained so high in Chicago—gun crime has remained so much. There also is very, very poor supervision of the gun shops in Indiana, where there are a lot of, you know, unscrupulous or negligent gun dealers, poorly supervised by ATF, that are helping to create that problem across state lines in Illinois. You are actually—to your specific question, you are not currently allowed to travel across state lines and buy handguns. You can go across state lines and buy long guns, rifles, and shotguns. But federal law does not typically allow you to do that for handguns. Even if it did, you would have to show a FOID card, you know, the Illinois ID card. So if folks are able to do that with handguns, they are effectively also violating federal law at this point. So obviously has been a very pernicious problem for Chicago, in particular. And one we have tried to make quite a lot of hay of federally when we’ve talked, among other things, about the importance of comprehensive background check requirements for the country. So we are trying to make Chicago and Illinois a major focus of our work recently and in the time to come. Illinois has been very, very focused on gun safety issues. So we hope—I don’t want to leave you with pessimism. We hope to see some real change in Illinois over the coming years—months and years. FASKIANOS: Great. Next question from Fonda Brewer, who is a trustee at the Delta Charter Township in Michigan.  Do you have any sample gun violence is a public health issue resolutions that can be shared with us? And just as sort of for even how can public health institutions get involved to help control gun violence? GUPTA: Absolutely. I’ll take the second part of that question. I’m curious, Jonas, if you can weigh in on the first in terms of resolutions maybe framing gun violence as a public health issue. I don’t know of anything formal. You know, organizations like—I’ll plug the Institute for Health Metrics and Evaluation at the University of Washington. Go to healthdata.org. And, you know, I’ll make sure that we share these resources with CFR, and that they’re cascaded down to all of you. But there’s—there you’ll find statistics on the global burden of death and disability from firearms and can compare it across countries. And I think that tells a story that’s really important to be able to share and message on to all of your constituents, whether you’re talking about what’s happening in your jurisdiction or across the country. And so that’s particularly top of mind. I will say that in terms of—and this goes back to the data question that was asked earlier, and I know Jonas was referencing this, was talking about better data would help us understand the flow of guns and, you know, help us better characterize gun trafficking and the volume of it. But I feel like telling—using data, having better data to demonstrate the impact of, say, red flag laws also is very compelling. And so when you take the cases of Indiana and Connecticut, they implemented red flag laws recently. And the rates of suicide decreased by 7 and 14 percent, respectively. And so being able to—and, of course, it may not just be in isolation, sort of the implementation of red flag laws, but that was a key driver of those decreases in suicide rates. And so when you’re seeing evidence of impact framed in that type of compelling data, that’s really helpful as well. So we do need more—we need to be messaging more on the ways in which all these policies that Jonas is talking about, that we know already exist, can compel states that—the thirty-one states that have not implemented red flag laws to do so. ORANSKY: Yeah, just want to second what Vin said. It’s critical that we increase and professionalize the data infrastructure here. Some of that work can be done by a federal government. Finally, we have removed restrictions on CDC doing some of this critical work to investigate the causes and the techniques to prevent gun violence. A couple of states have moved in this area in the last couple years. There now is a New Jersey Firearm Research Center at Rutgers and California just funded a similar center that will likely be at UC Davis. Very eager to increase the number of public health institutions that are dedicating some of their research time and dollars and manpower to this work. We’ve actually seen quite a lot of growth, but very eager to get others involved. Particularly looking for folks in communities to study the impact of, you know, state and local laws locally. There was a second question about resolutions. We’ve worked quite a bit with localities on resolutions, including to ask their state or federal counterparts to do the work they need to be doing, or otherwise. So would certainly be happy to help. I don’t think we have a model like the one you asked for, but would certainly be happy to help if you’re interested. FASKIANOS: There’s so many questions. All right. So I’m going to group a few. From Rudy England, who is legal counsel for the Texas State Senator Nathan Johnson: Is there language in the act regarding school resource officers? A few others asked that as well. And then from Representative Scott Holcomb, who’s in the Georgia House of Representatives: I’m curious as to which measures seem to have the biggest public safety impact, recognizing that studies are likely ecological and data can be difficult to come by. How would you rank order the policies that would likely provide the most benefit? ORANSKY: Yeah, those are both really good questions. On the first question on the school safety money, I don’t believe there is any new language on SROs. But I do suspect that some of the money, particularly I suspect—and I’m not sure—I think some of the money flows through the existing COPS Program, which I believe can be used to SROs. I suspect—and I would have to confirm it—but I suspect that it is possible to use that money for SROs. I don’t know exactly why the question was asked, but I would say to this group that Everytown does not support having armed SROs in schools that are doing—you know, in the school, or officers that are doing disciplinary work at all. Would be happy to elaborate on our position, if folks are interested. But it has been controversial, but it has been a major subject of conversation because I think there’s some real evidence that SROs, if used poorly, can really contribute to the school-to-prison pipeline and can have a pretty deleterious effect on kids, particularly children of color. The other question—sorry, trying to race through the issues. The other question was about the relative impact of these policies. It’s a really important question. It’s why we need better data surveillance. It’s why we need to build bigger, better research evidence. And I don’t have a rank order here. I would actually direct folks to the gun law rankings website, where we have tried to do some effort at grading or tiering the impact of the different policies. Really aimed at state legislating but talking about foundational policies that affect if they have a higher score when you’re talking about individual states’ policy, infrastructure, and other policies that are important but, potentially, less impactful. We focused in particular on domestic violence, on secure storage, on community violence intervention funding, on background checks, and on stopping the gun lobby’s effort to do away with concealed carry permits, as kind of top priorities that we think will have the most impact. FASKIANOS: Yeah, just to clarify on that—the SRO question—he clarified he wanted to know if the federal legislation did anything to remove SROs. Noting that given the relationship between the presence of SROs and the prevalence of mass shootings. So that was the context for the question. ORANSKY: Understood. Yeah, I don’t want to give a firmer answer than I know, but I don’t think that’s the case. I do believe that at least the COPS portion of the money, Community Oriented Policing Services, that office—the money that flows through that office could still be used for SROs. So in that sense, no. The federal law has not changed to reduce the presence of SROs in schools, to my knowledge. As I said, we do oppose armed SROs in schools. FASKIANOS: Great. So I just want to give you each—and we’re at the end of our time, sadly. We’ll download the questions and try to get back to you with some answers. I will ask Jonas to help with some of those answers, since we couldn’t get to them. But I want to give each of you a minute or so just to wrap up. And so, Jonas, we can start with you and then we’ll close with Vin. ORANSKY: Yeah. I just want to thank you all for being here and coming in large numbers to hear about the policy here. And, you know, thank you all for your passion. Repeat again that we’re very interested in helping folks identify the right opportunities to work in this area. And, you know, if we can—if we can help with local willpower, if we can help with capacity building, would be excited to do that as well. So just thank you to you all, and thanks to Irina and Vin. FASKIANOS: Vin. GUPTA: Well, thank you, everybody, as well. And second everything Jonas just said. Jonas, great to be here with you. On what in policies are most impactful, I recognize that that data—the data here on policy impact, we’re still building on that here in the United States. But it’s pretty clear, at least from the global perspective, on what works. Western Europe, most of Asia, they have gun safety courses that are mandatory. If you want to buy a gun, you meet eligibility. If you pass multiple background checks and a mental health assessment, you have to take a gun safety course as well. So those upfront friction points, if you want to call them friction points, do help. Making sure that we have clear guidance on safe gun storage, also a critical component of gun safety. In all these—in all of our peer advanced economy—or, all of our allies that have advanced economies where we do not see the rate of death from gun violence that we do see here, they make ample use of these, what I think, are pretty streamlined policy steps here. Mental health assessments, gun safety courses, and durable background checks. Those work. We have clear evidence from the global—from a global context that they are helpful in reducing morbidity and mortality from gun violence. And we should be—we should hopefully see more uptake of those policies here in the United States. Thank you. FASKIANOS: Thank you both very much, and to all of you for what you’re doing in your communities and for giving us your time today. We will be sharing out these resources, as promised, in a follow-up email. You can follow Dr. Vin Gupta on Twitter at @vinguptamd. And you can follow Jonas Oransky’s work on the Everytown website, which is everytown.org and on Twitter at @everytown. So again, for our resources, we encourage you to visit CFR.org, ForeignAffairs.com, and ThinkGlobalHealth.org for more expertise and analysis. And you can email us [email protected] to let us know how we can support the work that you’re doing, and with any other suggestions of issues you would like us to cover. So please stay safe and well, everybody. Thank you for joining us. And we look forward to our next conversation. Take care. (END)