Economics and Public Health: Two Perspectives on Firearm Injury Prevention

Published date01 November 2022
AuthorNathaniel J. Glasser,Harold A. Pollack,Megan L. Ranney,Marian E. Betz
Date01 November 2022
Subject MatterThe Changing Composition of Gun Violence
44 ANNALS, AAPSS, 704, November 2022
DOI: 10.1177/00027162231168738
Economics and
Public Health:
Perspectives on
Firearm Injury
Firearm injury is a major cause of death, disability, and
other harms to community well-being across the U.S.
Economics and public health offer two complementary
perspectives to conceptualize gun violence and formu-
late strategies to mitigate related harms. Economics
offers methods and procedures for tabulating costs of
firearm injury and offers an explicit, albeit imperfect
normative framework to evaluate proposed interven-
tions. Economics’ focus on incentives, trade-offs, and
resources constraints provides useful mechanisms for
understanding illegal firearm markets and firearm use
that can inform crime reduction efforts. Public health
methods and interventions help to measure patterns of
illness and disease, identify risks and protective factors,
and inform prevention efforts for the most vulnerable
individuals and communities. Public health also focuses
attention on social determinants and structural factors
in designing and evaluating interventions to prevent,
address, and mitigate the consequences of gun vio-
Keywords: gun violence; firearm injury; economics;
public health; cross-sectoral interventions;
harm reduction
Firearm injury prevention efforts face signifi-
cant challenges, with widespread and largely
unregulated access to lethal weaponry and
Nathaniel Glasser is a general internist, pediatrician,
and health services researcher at the University of
Harold Pollack is Helen Ross Professor at the Crown
Family School of Social Work, Policy, and Practice,
University of Chicago.
Megan L. Ranney is an emergency physician-researcher
and deputy dean of the Brown University School of
Public Health; she will be assuming the role of dean of
the Yale School of Public Health in July 2023.
Marian E. Betz is an emergency physician-researcher
and director of the Firearm Injury Prevention Initiative
at the University of Colorado School of Medicine.
inadequate funding for interventions being two prominent barriers (Cunningham
et al. 2019; Ladapo et al. 2013; Wintemute 2013b). The academic literature also
highlights the challenges posed by a lack of timely, complete, accurate epidemio-
logic data on gun-related injury, death, and related risk factors. The data chal-
lenge is driven by structural issues, such as a lack of standardized injury coding
and common variable definitions (Mercy, Ikeda, and Powell 1998; Comstock,
Castillo, and Lidsay 2004), and political barriers, which can lead to data suppres-
sion and disguise whether firearms used to injure were legally purchased
(Webster 2015). Underresearched barriers to firearm injury prevention include
the issue’s politicization and the structural and social health determinants under-
lying the gun violence epidemic.
Firearm injury is a multistream problem that has been investigated from a
number of disciplinary perspectives. Economics and public health provide a use-
ful starting point to formulate and rigorously evaluate interventions to prevent,
address, and mitigate the consequences of firearm injury. This article provides an
overview of economic and public health perspectives, exploring areas of investiga-
tion that are synergistic and likely vital to reducing firearm injury. (Note that
throughout, we use the term firearm injury to refer to the full spectrum of injuries
and deaths, including homicide, suicide, and unintentional shootings; we use gun
violence to refer specifically to community violence and public mass shootings.)
The Economics Perspective
Economics focuses on incentives, trade-offs, and resource constraints—financial
and otherwise—to predict and explain individuals’ behaviors and choices. The
field also offers an explicit, normative framework for evaluating policies and pro-
grams by accounting for individuals’ preferences and willingness to pay for goods
and services and to avoid burdens and costs. Through the emerging discipline of
behavioral economics, economists also seek to incorporate insights from cogni-
tive psychology and other fields to explore behaviors, particularly those of indi-
viduals acting with imperfect information in situations where the neoclassical
framework, which is predicated on humans being relatively sophisticated utility
maximizers, provides a poor empirical guide. In the gun control debate, for
example, one might consider confrontations leading to violence in which personal
honor is at stake, or individuals purchasing firearms legally for illegal transfer
when they imperfectly understand the probability of detection and punishment
(Pickett 2018; Pogarsky, Roche, and Pickett 2018).
Though imperfect, economics provides a useful lens through which to scruti-
nize and address the American gun violence epidemic:
1. Through its focus on value and valuation, economics has developed tools to
quantify and monetize the otherwise intangible burdens firearm violence
imposes on society.
2. Economics provides an incomplete but valuable lens for conducting cost-
benefit and distributional analyses of crime control measures.

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