OHSU Hospital, 2019. (OHSU/Kristyna Wentz-Graff)

OHSU Hospital, 2019. (OHSU/Kristyna Wentz-Graff)

Kristyna Wentz-Graff / Courtesy of Oregon Health & Science University

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When Oregon Health & Science University’s new gun research collaborative launched in May, it was the culmination of the research that director Kathleen Carlson had centered her career around. Since the late ‘90s, federally funded research was halted by what’s known as the Dickey Amendment but resumed under the Obama presidency after the Sandy Hook massacre in 2012. Carlson successfully applied for the first federally funded gun research grant since the ban was lifted. She says research is needed now more than ever, as injuries and deaths from firearms have been rising in Oregon and nationwide in the last several years. We talk with Carlson about the new center and her research focus moving forward.

The following transcript was created by a computer and edited by a volunteer.

Geoff Norcross: This is Think Out Loud on OPB. I’m Geoff Norcross in for Dave Miller. In 1996, the National Rifle Association and their allies in Congress passed what’s known as the Dickey Amendment. It barred the use of federal funds to “advocate or promote gun control”. It effectively meant all federal funding for research into gun violence was halted. That funding was restored after the Sandy Hook massacre in 2012. Kathleen Carlson was awarded the first grant for gun violence research after the Dickey Amendment was rescinded, She’s leveraged that money into a new Gun Violence Prevention Research Center at Oregon Health and Science University. It just launched in May. Kathleen Carlson is an injury epidemiologist at OHSU and she joins us now. Kathleen Carlson, welcome to Think Out Loud.

Kathleen Carlson: Thank you, Geoff. Thanks for having me.

Norcross: An injury epidemiologist. Haven’t heard that before. What is that?

Carlson: So I’m trained in public health and as an epidemiologist, that’s the science of public health and where you often hear epidemiology used is in the realm of infectious disease. But we simply use the same tools and mechanisms that epidemiologists of infectious disease use. But we apply it to the study of violence and injury.

Norcross: Well, we certainly had a hard lesson over the last couple of years about public health and epidemiology and how virus can move through a population. Can gun violence move in a similar way?

Carlson: Yeah, there are some similarities that can be drawn. I mean there is kind of talk about a contagion effect in violence, but I think more objectively what we do is we study rates of disease or injury in a population and that could be gun injury. And then we study the factors that influence increases or decreases in those rates of injury. And ultimately, what we want to do is figure out what decreases that adverse outcome, whether that’s an infectious disease, a chronic disease or a violent event.

Norcross: Prevention being the key here. What did the Dickey Amendment and the halting of federal funding for research into gun violence mean for our understanding of gun violence in America?

Carlson: Unfortunately, we lost about 20-25 years of ground in the type of research that would just chip away at rates of injury and violence, and particularly using guns. So where we’ve made great strides in all sorts of other domains of safety, oftentimes we point to motor vehicle safety being kind of a showcase of that, but also fall safety, building safety or reduce drownings and fires, all sorts of things. When you look around, we haven’t been able to do that with gun safety. In fact, in the last 15 years, our rates of gun deaths and injuries have increased by 50%. Where we’ve made significant decreases in all the other injury types that I mentioned.

Norcross: You mentioned automotive safety as a possible analogy here. What did federal funding research into automotive safety mean for our safety on the roads and how did it make things better?

Carlson: It was an enormous effort. We had a federal level organization, the National Highway Transportation Safety Administration that took on motor vehicle safety and tracked rates of motor vehicle crashes across the country. We had a cadre of researchers that were studying motor vehicle crash prevention and we really tackled it from all angles. So no single action or no single law, no single organization, but every angle worked together on the reduction or the increase, making motor vehicles safe. And it’s not just the cars, the motor vehicles themselves, but it’s the roadways and it’s the drivers. If you think about how behaviors have changed over the last 20 years around driving, you think of how the policies have changed, but also kind of the expectations of drivers. We’ve kept, we’ve learned that having graduated driver’s licensing, so keeping kids a little bit more reigned in in terms of their freedoms around driving saves a ton of lives. And so a lot of states have implemented those graduated driver licensing laws now. You name it, we’ve made all sorts of progress in terms of motor vehicle crash reduction.

Norcross: Yeah, so research clearly counts. And so we have this new gun research collaboration center at OHSU. Can you give me a sense of some of the questions you’re trying to answer there?

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Carlson: I can. So, as an epidemiologist, I have my head in data a lot and really, that’s what excites me the most and that is something that is really needed in this area of gun injury. Because we’ve lost that 25 years of progress in that area. My focus as a native Oregonian and someone working here at OHSU and the V.A. in Portland is on driving those numbers for our region, for Oregon and then our region here in the Portland metro area. So we’re, in a lot of ways we’re starting from scratch. We’re assembling data so that we can understand the patterns of injury across our state, those patterns over time, who’s the most impacted and what might be influencing those rates of injury. Here locally, we’re working with several organizations to look at the increase in violence in the Portland Metro region and what might be driving that and how we can implement programs to reduce that or support the programs that have been working to reduce that as well.

Norcross: If you’re just tuning in, we’re talking about the new Gun Violence Prevention Research Center at OHSU. Kathleen Carlson is the center’s director. Kathleen, you’ve done quite a bit of work in this area already. You’re a research investigator with the V.A. Hospital and you looked into gun injuries in the veteran population. What did you find?

Carlson: Yeah that was my first foray into this area. I’ve always been an injury and violence researcher. But in 2015, it was after the Sandy Hook shooting in late 2012, when federal funding for this type of research started to loosen up and I submitted a grant proposal and got this grant to examine firearm injuries and veterans in Oregon by linking several big databases maintained across our state with V.A. data which we work with daily here in the V.A. And one of the things that struck me, we’re really focused on suicide prevention in the V.A. and firearms play a big role in in suicide among veterans, unfortunately. But when we looked at the spectrum of firearm deaths and firearm injuries among veterans, what really stood out was a large number of nonfatal injuries and we weren’t talking about these and also a large number of unintentional injuries, particularly the non fatal ones. But the whole spectrum of firearm related injuries and just what that meant for us in terms of potential targets for reducing harm to veterans by firearms.

Norcross: How do you think gun violence within the veteran population is different from the population as a whole?

Carlson: Okay. You know it’s probably more similar than dissimilar but veterans have a higher risk of death by suicide than the general population and a higher proportion of veteran deaths involved firearms and that’s nationally speaking. Here in Oregon, a larger portion of our firearm deaths involve suicide than you might see in other states across the region. So here in Oregon we have higher rates of suicide, higher rates of firearms involved in those suicides. And then that’s true among our veterans as well.

Norcross: Part of your work is storytelling and you have developed online videos of veterans describing their gun injury experiences in their own words, Why is that important?

Carlson: We are working on those. It’s really important as I think, especially as someone working in public health and might be considered in the ivory tower, although I grew up in small town Oregon and grew up with guns around me and have firearms in my own household. I’m not a firearm enthusiast or an avid sportsman with firearms. And I want people to be able to tell their own stories. In this realm, in particular, veterans talking to veterans, firearm owners, firearm enthusiasts, talking to firearm enthusiasts, we think could be the most effective in making change, making inroads in this otherwise politically strife area. So we’ve, we’re hearing lots of stories, I think in particular, I mentioned the veterans who are non fatally injured, and unintentionally injured. So we haven’t been talking about these traditionally. And so part of our storytelling right now is just capturing those stories like, what happened? How were you injured by your own firearm? What might you do differently? What would you tell other veterans or other firearm owners about this? And just hearing their stories and for us, we’re always listening to those stories with an ear toward prevention and what might be the programs or the system changes that we could make to reduce those types of injuries or those types of scenarios in the future.

Norcross: You talked a little bit about your own personal history and your background with guns. What drew you to this area of research?

Carlson: I have always been really passionate about injury prevention. It’s kind of the underdog of public health. A lot of us go into public health to study chronic disease, like cancer, heart disease or infectious disease, especially in the last couple of years. We have lots of students coming in to study infectious disease like COVID, but injury has always been my thing. I always cheer for the underdog, I went to Oregon State. So I was just used to being the underdog. So, in sports I should clarify.

Norcross: Go Beavers!

Carlson: Yeah, go Beavs! But anyway, I’ve always loved injury, but we knew from the get go that firearms was a real hush hush area and that was due to what you mentioned earlier, the Dickey Amendment. So there was just this real chilling effect, even though firearms have always been one of the primary causes of injury deaths in our country, one of the leading causes of death overall, so we knew not to go near that if we wanted to have a funded research career. What drew me to it personally and at the point of time when I entered into it was the series of mass shootings and shootings of children and it was really Sandy Hook that sticks out most poignantly in my mind. That in time with the loss of my own family member from a firearm suicide and just feeling that experience and thinking, what the heck am I doing? I have the tools to provide science, to provide data, to provide information in this topic area and I should forge ahead and do that. And when the public is ready to move on this, then we’ll have the data ready for them. And so that’s what got me started with that very first grant proposal back in 2015, 2015 is when we ultimately started that project.

Norcross: You can’t deny the environment that we’re in right now. It’s a strange political moment when it comes to guns. The Supreme Court recently struck down New York’s law governing the carrying of handguns. Here in Oregon, there’s a ballot measure coming together that would require permits to buy firearms and ban high capacity magazines. How do you work in this environment? How do you conduct research about gun violence in a country that has such a range of views about guns?

Carlson: I know that’s a $1 million dollar question and I would say for me personally, I keep my head down. I mentioned earlier, I love data, I love the science, I love the scientific process. So I think I have a ton and my team has a ton to contribute around building evidence that policymakers and advocates can then work with and we can help translate what the evidence means. But when it comes to getting into the political fray, I think we can leave that to others, just providing them the best evidence possible. And in terms of coming at this from a public health perspective, I think that’s a real strength for my team and my colleagues and I, and that we know that there’s this, there’s the politics of any given issue, even COVID got hot and motor vehicle crashed, motor vehicle safety was a hot topic back in the day as well. We always used to say, this is a sideline, but we always used to say that infectious diseases don’t have lobbyists, but a lot of tools, equipment and machinery do. And so when it comes to that, we can keep our head down and get the work done in the middle of the spectrum. Right? So there’s one extreme end, and there’s another extreme end, in this case might be gun control versus gun rights. And then we have this whole spectrum in the middle where you can maneuver to make change and maybe you’ll get some of the extreme ends joining you at some point in time. Maybe you never will. But I think most of us and I would say most Oregonians want improved safety and want to decrease rates of firearm death, firearm injury in our communities and so we can all work together on that. In fact, we are working with firearm owning groups and advised by firearm enthusiasts and they’re coming to us also to ask questions about looking at this issue using the tools of public health, which is fantastic.

Norcross: Kathleen Carlson, thank you so much for this.

Carlson: Thanks for having me.

Norcross: Kathleen Carlson is the director of the New Gun Research Collaboration Center at OHSU.

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