Barriers to Firearm Injury Research


      Firearm injuries and motor vehicle injuries are 2 leading causes of fatal injury in the U.S., each accounting for approximately 35,000 deaths annually. Research on firearm injuries is under-represented compared with research on motor vehicle collisions. This study seeks to identify perceived barriers to firearm injury research versus motor vehicle injury research.


      This was a mixed-methods survey of corresponding authors of a minimum of 1 study, archived in PubMed, related to firearm injury or motor vehicle injury between 2014 and 2018. Analyses were performed in 2019. Electronic surveys included both closed- and open-ended questions to assess barriers to research. Bivariable and multivariable logistic regression was performed to identify differences in perceptions to barriers between the 2 groups. Qualitative analysis of free-text responses was performed through inductive derivation of themes.


      Surveys were distributed to 113 firearm injury researchers (42% response rate) and 241 motor vehicle injury researchers (31.5% response rate). After adjustment, firearm injury researchers were less likely to cite institutional support (AOR=0.3, 95% CI=0.1, 0.8) as a factor contributing to their success, than motor vehicle injury researchers. Firearm injury researchers were more likely to report fear of personal threats (AOR=10.4, 95% CI=2.4, 44.4) and experiencing personal threats (AOR=16.1, 95% CI=1.6, 165.4). Thematic analysis revealed 4 themes: career, political, funding, and harassment.


      When compared with motor vehicle injury researchers, firearm injury researchers are significantly more likely to report limited support and threats to personal safety as barriers to research. Further research to understand the impact of these barriers and methods to overcome them is needed.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. CDC. Web-based Injury Statistics Query and Reporting System (WISQARS). Updated September 18, 2019. Accessed October 23, 2017.

      2. CDC. Cost of injuries and violence in the United States. Updated January 23, 2020. Accessed November 15, 2018.

        • Wallace L
        Why is there so little research on guns in the U.S.? 6 Questions Answered.
        The Conversation. February 21, 2018;
        • National Center for Statistics and Analysis
        2016 Fatal Motor Vehicle Crashes: Overview.
        National Highway and Traffic Safety Association, Washington, DCPublished 2018
        • National Highway and Traffic Safety Association
        Quick facts 2016.
        Published 2018
        • Heron M
        • Hoyert DL
        • Murphy SL
        • Xu J
        • Kochanek KD
        • Tejada-Vera B
        Deaths: final data for 2006.
        Natl Vital Stat Rep. 2009; 57: 1-134
        Date accessed: November 23, 2018
        • Xu J
        • Murphy SL
        • Kochanek KD
        • Bastian B
        • Arias E
        Deaths: final data for 2016.
        Natl Vital Stat Rep. 2018; 67: 1-76
        Date accessed: November 23, 2018
        • Sloan JH
        • Kellermann AL
        • Reay DT
        • et al.
        Handgun regulations, crime, assaults, and homicide.
        N Engl J Med. 1988; 319: 1256-1262
        • National Rifle Association
        Medical journal's article seriously flawed.
        American Rifleman. 1989; 137: 55-56
      3. @NRA. Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves. November 7, 2018. Accessed January 24, 2020.

        • Wintemute GJ
        Gun shows across a multistate American gun market: observational evidence of the effects of regulatory policies.
        Inj Prev. 2007; 13: 150-155
        • Wadman M
        Firearms research: the gun fighter.
        Nature. 2013; 496: 412-415
        • Corbin J
        • Strauss A
        Basics of Qualitative Research: Techniques and Procedures for Developing Grounded Theory.
        3rd ed. Sage, London2008
        • Foley G
        • Timonen V
        Using grounded theory method to capture and analyze health care experiences.
        Health Serv Res. 2015; 50: 1195-1210
        • Stark DE
        • Shah NH
        Funding and publication of research on gun violence and other leading causes of death.
        JAMA. 2017; 317: 84-85
        • Kellermann AL
        • Rivara FP
        • Rushforth NB
        • et al.
        Gun ownership as a risk factor for homicide in the home.
        N Engl J Med. 1993; 329: 1084-1091
        • Kellermann AL
        • Rivara FP
        Silencing the science on gun research.
        JAMA. 2013; 309: 549-550
        • Alcorn T
        Trends in research publications about gun violence in the United States, 1960 to 2014.
        JAMA Intern Med. 2017; 177: 124-126
        • Douglas DM
        Doxing: a conceptual analysis.
        Eth Inf Technol. 2016; 18: 199-210
        • Enten H
        The U.S. has never been so polarized on guns.
        FiveThirtyEight. October 4, 2017;
        • Metzl JM
        Repeal the Dickey Amendment to address polarization surrounding firearms in the United States.
        Am J Public Health. 2018; 108: 864-865
        • Cunningham RM
        • Carter PM
        • Ranney ML
        • et al.
        Prevention of firearm injuries among children and adolescents: consensus-driven research agenda from the Firearm Safety Among Children and Teens (FACTS) Consortium.
        JAMA Pediatr. 2019; 173: 780-789
        • Galea S
        • Branas CC
        • Flescher A
        • et al.
        Priorities in recovering from a lost generation of firearms research.
        Am J Public Health. 2018; 108: 858-860