Commercial risk will be a critical catalyst of progress – it’s complicated, but is it possible? We think so.


March 7, 2018

What researchers know—and don't know—about the effectiveness of firearm policies

Daily Briefing

    There is only limited scientific evidence on firearms policies in the United States, according to a RAND analysis released Friday.

    Members ask: How can our hospital prepare for disasters?

    For the analysis, RAND spent two years reviewing thousands of studies to find "all available evidence" on the effects of 13 firearms policies on eight outcomes. The researchers looked at the following policies:

    • Background checks;
    • Bans on the sale of assault weapons and high-capacity magazines;
    • Stand-your-ground laws;
    • Bans related to mental illness;
    • Lost or stolen firearm reporting requirements;
    • Licensing and permitting requirements;
    • Firearm sales reporting and recording requirements;
    • Child-access prevention laws;
    • Surrender of firearms by individuals prohibited from having them;
    • Minimum age requirements;
    • Concealed-carry laws;
    • Waiting periods; and
    • Gun-free zones.

    The researchers looked at the following outcomes:

    • Defensive gun use;
    • Gun industry outcomes;
    • Hunting and recreation;
    • Mass shootings;
    • Officer-involved shootings;
    • Suicide;
    • Unintentional injury and death; and
    • Violent crimes.

    The researchers also surveyed 95 firearms policy experts of different political backgrounds on how 15 policies would affect 12 outcomes. In addition, the researchers built a database on state firearms laws dating back to 1979.

    Key findings

    Overall, the researchers were able to identify just 63 studies that establish a causal relationship between specific policies and outcomes. Further, out of the 13 policies the RAND researchers reviewed for their analysis, six had either no studies on the effects or the outcomes.

    Andrew Morral, a behavioral scientist at RAND and the leader of the project, noted that research was stronger for certain categories. For instance:

    • There is relatively strong evidence that policies designed to keep children away from firearms reduce suicide as well as unintentional injury and death;
    • Previous research has shown that requiring law enforcement-issued permits for firearms purchases reduces violent crime;
    • There is evidence that laws that ban individuals with diagnosed mental health issues reduce violent crime; and
    • Evidence suggests that "stand your ground" increase violent crime.

    Nonetheless, the researchers noted there was a scarcity of clear or strong evidence on the effects of any firearms policies on hunting and recreational firearms use, officer-involved shootings, mass shootings, or defensive use by civilians. In addition, the researchers pointed out that the federal government has spent considerably less on firearms violence research than on issues that are comparably lethal, such as motor vehicle accidents, sepsis, and liver disease.

    Meanwhile, the overwhelmingly majority of experts RAND surveyed said the main objective of firearms policies should be to reduce suicide and homicide. Privacy protection, enabling hunting and sport shooting, and preventing mass shootings were considered secondary objectives. Morral called that finding "a surprise." He said, "I think people on either side of gun policy debates think that the other side has misplaced values—or that it's a values problem, in any case. But that's not what we find. We find people prioritize the same things in the same order."

    That said, the experts had differing opinions about how the policies would affect the outcomes under consideration. "Where they disagree is on which laws will achieve those objectives. So this is a disagreement about facts," Morral said. "And the facts are sparse" (Hersher, "Shots," NPR, 3/2; RAND study, 3/2).

    Next, join us to learn more market trends for 2018

    These trends are just a few pieces of the puzzle. Join us today at 3 pm ET for a webconference where you'll learn the three most important policy trends we're watching in the year ahead, how hospitals are faring under pay-for-performance, and get an update on the growing outpatient market.

    Register Now

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.