Economics and Public Health: Two Perspectives on Firearm Injury Prevention

• Published date: 01 November 2022
• DOI: http://doi.org/10.1177/00027162231168738
• Author: Nathaniel J. Glasser,Harold A. Pollack,Megan L. Ranney,Marian E. Betz
• Date: 01 November 2022
• Subject Matter: The Changing Composition of Gun Violence

44 ANNALS, AAPSS, 704, November 2022

DOI: 10.1177/00027162231168738

Economics and

Public Health:

Two

Perspectives on

Firearm Injury

Prevention

By

NATHANIEL J. GLASSER,

HAROLD A. POLLACK,

MEGAN L. RANNEY,

and

MARIAN E. BETZ

1168738ANN THE ANNALS OF THE AMERICAN ACADEMYECONOMICS AND PUBLIC HEALTH

research-article2023

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-

lence.

Keywords: gun violence; firearm injury; economics;

public health; cross-sectoral interventions;

harm reduction

Introduction

Firearm injury prevention efforts face signifi-

cant challenges, with widespread and largely

unregulated access to lethal weaponry and

Correspondence: Nathaniel.Glasser@bsd.uchicago.edu

Nathaniel Glasser is a general internist, pediatrician,

and health services researcher at the University of

Chicago.

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.

ECONOMICS AND PUBLIC HEALTH 45

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.