Two violent acts on Wednesday — the murder of conservative activist Charlie Kirk and the shooting of two high school students in Colorado — crystallize the threat gun violence poses to public health. Yet the Trump administration just shut down its biggest programs devoted to preventing such violence.
For decades, the Centers for Disease Control and Prevention led public health research and initiatives on the cause, persistence, and prevention of firearm violence. Cuts to budgets and the workforce have thrown the CDC’s Center for Injury Prevention into disarray, with funding withdrawn then renewed, reductions in force paused and then made final last month.
Experts say in the absence of the CDC expertise and support of local public health initiatives, government agencies’ messaging on gun violence, including from health secretary Robert F. Kennedy Jr., is becoming muffled and confusing.
CDC’s Injury Center has been devastated by cuts. Here’s what we’ve lost
“It is a cruel irony that just days after a gunman sprayed over 500 bullets across the CDC campus, the government fired over 150 violence and injury prevention specialists at the CDC,” said Tom Simon, who until his retirement in April was the senior director for scientific programs in the center’s Division of Violence Prevention, referring to a gunman’s attack on the agency’s Atlanta headquarters in August. “These are researchers and practitioners with unique expertise in violence prevention that does not exist elsewhere in the federal government.”
All employees in three of the four branches in the Division of Violence Prevention were fired, a spokesperson for the Department of Health and Human Services confirmed Friday, including all the program and research staff. Simon told STAT that their removal and the proposed budget cuts hamper CDC’s support of violence prevention programs across the country, including the translation of data and research into practice.
Kennedy’s views
The day before the firearm deaths in Utah and Colorado, Kennedy put forth a theory on school shootings. Asked in a briefing why gun violence was not included in the Make Our Children Healthy Again strategy report, he traced such violence to the 1990s and, without citing evidence, listed possible causes. In August he had linked antidepressants to a Minnesota school shooting.
“There are many, many things that happened in the 1990s that could explain these. One is the dependence on psychiatric drugs, which in our country is unlike any other country in the world,” he said, echoing his suspicion of medications such as SSRIs for mood disorders. “There could be connections with video games, social media, a number of things, and we are looking at that at NIH. So we are doing studies now, or initiating studies looking at the correlation and the connection, potential connection between overmedicating our kids and this violence and these other possible confounders as well.”
Simon, who led CDC’s firearm injury research portfolio and contributed to the first Surgeon General’s Advisory on Firearm Violence, pushed back.
“There is no evidence of a causal link between SSRIs and mass shootings,” he said. “We need to be careful not to do harm. SSRIs help millions of people. There is already too much stigma about mental health care and we need to be careful not to contribute to that.”
Sharon Gilmartin, chief executive of the Safe Streets Alliance, has been watching the CDC’s injury prevention work closely. Looking at the MAHA report on children, she sees violence prevention programs as vulnerable, despite language to the contrary.
“There were so many elements in there that are directly supportive of the prevention work that is happening, from the CDC injury center and certainly things around youth mental health and substance use,” she said. “It is puzzling that we’re seeing funding removed, yet it’s being explicitly called out as a priority from the administration.”
Roughly 80% of the CDC’s funding flows out to state and local public health departments, where violence prevention meets the street. “People love the work of these programs in their community,” Gilmartin told STAT. “They just have no idea that the funding source is the federal government.”
In the Tuesday briefing, Kennedy also called gun ownership in the U.S. and Switzerland the same, misstating statistics (in the U.S., 42% of households owned a gun versus 28% of households in Switzerland) and not mentioning stronger Swiss laws on obtaining, storing, and carrying firearms.
Former CDC official Simon urged action to stop the spread of false statements. “Misinformation and lies contributed to the shooting at the CDC campus,” he said. “What’s missing is an open exchange of ideas and actions to prevent people in crisis from accessing a firearm. This is where we need to act.”
Teasing out what works
Besides studying the factors that might tip young people into violence, the injury prevention center examined gun violence on an individual and community level. Examples of recent research that may not be possible now include a study that looked at the risk of suicide in Army soldiers and veterans. Another analyzed data from two cities to see how individual, family, and neighborhood risk factors for gun violence might predict later weapons use by young people. Still another looked at access to guns, opioid use, and suicide using a gun.
Previous research concluded that earned income tax credits can reduce violent crimes by about 10%, so testing affordable housing and child care subsidies to alleviate financial stressors have also drawn research attention.
Last year, CDC researchers reported on a pilot study in Atlanta of what’s known as the Cardiff Model, a hospital-based violence intervention using law enforcement and hospital data to say where violent injuries were coming from. There’s now a toolkit for communities to use and a network to join.
Before Debra Houry became CDC’s chief medical office and then one of four top CDC officials who resigned after CDC director Susan Monarez’s ouster, she was director of the National Center for Injury Prevention and Control. In 2022, she reflected on growing firearm deaths and disparities.
“Public health can’t do this alone. No one can do this alone,” she told STAT then. “This certainly requires law enforcement, education systems, parents, faith communities. The power of these comprehensive strategies is that it requires all these strategies.”
Both Simon and Gilmartin named another tool: safe storage. Gilmartin called it one of the most bipartisan mechanisms in injury and violence prevention because everyone can agree that there are people who should not have access to firearms. That includes support from the firearm industry, said Simon.
If families have someone who is in crisis — at risk of harming themselves or others — household members can voluntarily and temporarily store the firearm outside the home. Gun Storage Map.com offers storage options by ZIP code for gun owners, for example.
Other actions listed by the Johns Hopkins Center for Gun Violence Solutions include stronger requirements for licensing, domestic violence protection orders, laws on carrying firearms in public, and community programs focusing on people most at risk of being a victim of or committing an act of gun violence.
Shootings at the CDC last month and the attacks this week may stand out as unusual, but gun violence happens every day. It doesn’t have to be that way, Simon believes.
In all types of violence and suicide, there are dozens of opportunities to intervene long before the incident occurs, he said. “We need to invest in stopping violence before it happens. Violence prevention works.”
STAT’s coverage of chronic health issues is supported by a grant from Bloomberg Philanthropies. Our financial supporters are not involved in any decisions about our journalism.
