The research community’s understanding of the role of social factors in the protection of health and promotion of safety has significantly grown over the last 40 years. In particular, there is now a body of evidence on the social determinants of gun violence. This research has demonstrated that the risk and distribution of gun violence across different people and places are closely tied to the social conditions in which individuals are born, live, learn, and work. For example, the literature has demonstrated associations of gun violence with poverty, income inequality, and concentrated disadvantage (neighborhoods with a high proportion of residents who live in poverty and experience substantial stress). Economic hardship and its downstream effects can lead to a higher risk of firearm violence through multiple pathways. These effects include reduced access to high-quality education, housing, healthcare, social services, and well-resourced neighborhoods; exposure to toxic stress (i.e., prolonged physiologic response to stressors); and relationship conflict. The association between gun violence and the downstream effects of economic hardship can also be reciprocal since gun violence further perpetuates intergenerational cycles of trauma, disadvantage, and harm.

Changes in state policies that govern resources and programs related to social determinants of health and safety, such as income, food, housing, education, healthcare, employment, and transportation, could therefore conceivably alter the frequency or intensity of gun violence. Several state social policies (e.g., health insurance coverage, earned income tax credits, substance-use policies) have been evaluated for their impact on violence broadly or on specific forms of it. However, our knowledge of the particular impact of state social policies on gun violence is relatively limited. Some of the circumstances that lead to gun violence may be different from those that cause other forms of violence—clearly, for example, the availability and accessibility of firearms is a necessary component for the occurrence of gun violence. Additionally, existing surveillance data demonstrate that trends in the rates of gun violence and other forms of violence are not the same. Therefore, there is good reason to believe that, in evaluating the impact of interventions, distinguishing gun violence from other forms of violence is useful. State gun policies are typically considered an important means of influencing the rates of gun violence, and the evidence for their impact on different outcomes such as firearm homicide, firearm suicide, and unintentional shootings has been systematically examined. The impact of other criminal legal system policies on gun violence has also been synthesized, and new opportunities to evaluate such policies have been proposed.

The risk and distribution of gun violence across different people and places are closely tied to the social conditions in which individuals are born, live, learn, and work.

What has been less frequently and systematically researched is the impact of state social policies that were not originally designed to influence gun violence, but which may do so by affecting a host of its determinants. Some research investigations have begun to examine the impact of certain state social policies, as the main explanatory variable of interest, on gun violence. For instance, studies have examined the relationship between gun violence and income support policies, minimum wage, Supplemental Nutrition Assistance Program, public welfare spending, alcohol policies, Medicaid benefits generosity, and worker protection laws. While relatively smaller in number (than the studies of gun policies and gun violence, or the studies of state social policies and violence broadly or other forms of violence), these studies collectively suggest that gun violence prevention may be best achieved by also considering broader policies that target its social determinants. Most of these studies focused on firearm homicide and firearm suicide since reliable data on those outcomes are available. Further research about the potential impact of a range of state social policies on different types of gun violence, including fatal and nonfatal injuries and harm, is needed.

In describing the determinants of different types of firearm-related harm (e.g., community gun violence, firearm suicide), the social-ecological model is often used as a framework. This model demonstrates the individual, relationship, community, and societal levels that shape the contexts in which gun violence occurs and provides insight into specific points of prevention and intervention. But, compared to the other three levels (individual, relationship, and community), we know less about the role of broader societal factors, including state social policies, in influencing gun violence and specific initiatives that reduce its consequences.

Socio-Ecological Model

SOURCE: US Centers for Disease Control and Prevention.

Supporting this area of research is particularly imperative because we already know that societal factors lead to profound inequities in gun violence with large, disproportionate, and lasting impacts on racialized and minoritized communities. Specifically, structural factors (e.g., racism) that drive social determinants of health (e.g., access to housing) can perpetuate striking racial and economic disparities in terms of who is most impacted by gun violence. For instance, the intersection of historic redlining policies (that prevented mostly Black families from obtaining mortgages and living in certain neighborhoods) and contemporary socioeconomic disadvantages as they relate to current rates of community gun violence has been documented.

Research to better understand the impact of equity-driving state social policies on gun violence, as well as their interactive effects with one another (including when those are adopted as a “bundle” together), is especially timely because researchers are developing methodological approaches to estimate the impact of co-occurring state social policies. This further research should not only focus on the presence of state policies, but also their design and implementation. State policies that are built on structurally unequal systems may reproduce, rather than redress, health inequities if their design and implementation are not fully examined. Therefore, it is essential to understand if the impact of state social policies on gun violence varies across different groups in the population. Recent evidence has demonstrated the current gaps in our understanding of racial and ethnic differences in the effects of state gun policies. The same areas of opportunity exist for enhancing our knowledge of the potentially differential impacts of state social policies on gun violence.

… these studies collectively suggest that gun violence prevention may be best achieved by also considering broader policies that target its social determinants.

Within the policy realm, one promising approach to gun violence prevention may be the adaptation of systems synergy that has been advocated for promoting health and preventing harm among youth. In that context, systems synergy is a model that avoids siloed policy structures and jointly centers the care of youth by multiple human services agencies (e.g., cash assistance, employment, food support, housing, education, family support, transportation, and medical assistance). A synergistic model of state social policies specifically designed for promoting the health and safety of youth may in turn translate into strengthening protective factors that reduce the risk of perpetrating or experiencing gun violence within communities. It is important to realize, however, that such coordinated initiatives would likely still be insufficient to sustainably reduce the rates of gun violence without interventions at the other levels of the social-ecological model. For instance, evidence demonstrates that youth living in poor households in moderate-high collective efficacy neighborhoods have a similar risk of firearm homicide exposure as middle-high income adolescents living in low collective efficacy neighborhoods. Collective efficacy is a measure of mutual trust among neighbors along with their willingness to intervene for the common good based on their shared values. These findings suggest that socially-centered gun violence prevention strategies may not only need to help individuals and families via income support but also, among other approaches, increase community strengths by fostering collective efficacy and empowering neighborhoods to enhance and leverage social ties.

Policy recommendations to increase collective efficacy include investments in understanding the priorities of neighborhood residents, co-developing solutions to identified challenges alongside community leaders, and promoting community organizations’ and residents’ involvement in advisory boards and neighborhood safety programs. Further research should assess the impact of improving collective efficacy on gun violence and the potential modifying role of state social policies in that relationship.

Gun violence is an enormous public health and public safety challenge in our society. Discussions and debates about which specific prevention and intervention strategies, at what levels of the social-ecological model, and over what timelines could best work to reduce gun violence continue to include diverse viewpoints. Nonetheless, there is greater consensus that only multi-pronged approaches could meaningfully and sustainably achieve this goal. As it relates to state policy specifically, further investment in equitable social initiatives that empower the most impacted communities, center their experiences, and enhance their access to resources should be considered alongside other solutions.

ABOUT THE AUTHOR

Ali Rowhani-Rahbar is a Bartley Dobb professor for the study and prevention of violence at the Department of Epidemiology at the University of Washington and an affiliate scholar with the Regional Gun Violence Research Consortium.