Arthur Kellermann
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Dr. Arthur L. Kellermann, M.D., M.P.H. (born 1955) is a professor and chairman of the department of emergency medicine at Emory University. He is also currently director of the Center for Injury Control of the Rollins School of Public Health at Emory University School of Medicine, as well as co-chair of the Committee on the Consequences of Uninsurance of the Institute of Medicine of the National Academies. Kellermann is also known for shaping the identity of the Center for Injury Control. He has published multiple papers on various aspects of emergency cardiac care, health services research, and the role of emergency departments in the provision of health care to the poor.
Kellermann is best known for his research on the epidemiology of firearm related injuries and deaths. Kellermann states ("I grew up around guns. My dad taught me how to shoot when I was eleven or twelve years old. Firearms are fascinating pieces of equipment. I enjoy the sport of shooting, although I rarely shoot anymore." [1]); however his studies which quantify the risk of mortality associated with gun ownership have earned him the wrath of the National Rifle Association and other gun-friendly organizations and individuals, who portray him as a dedicated anti-gun zealot and often accuse him of scientific malpractice.
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[edit] Kellermann's published studies on gun ownership
Kellermann states that as an emergency room doctor, he noted that the number of gunowners injured by their own gun or that of a family member seemed to greatly outnumber the number of intruders shot by the gun of a homeowner, and therefore he determined to study whether or not this was in fact true.
[edit] 1986
In his first publication on the subject, in 1986, Kellermann studied all gunshot related deaths in Seattle over six years, and found that
- 54% of firearm-related deaths occurred in the home where the gun was kept
- 70.5% of these (firearm-related deaths in the home where the gun was kept) involved handguns
- 0.5% of these (firearm-related deaths in the home where the gun was kept) involved an intruder shot while attempting entry
- 1.8% of these (firearm-related deaths in the home where the gun was kept) were judged by police as self-defense
- there were 1.3 times as many accidental firearm-related deaths in the home where the gun was kept as self-protection shootings
- there were 4.6 times as many criminal firearm-related homicides in the home where the gun was kept as self-protection shootings
- there were 37 times as many suicides in the home where the gun was kept as self-protection shootings.
He concluded that "the advisability of keeping firearms in the home for protection must be questioned". This study design was criticized as flawed, however, because it implied that the homicides were performed with the decedent's gun rather than an intruder's gun and failed to account for attacks that were foiled without killing the attacker. The homicide data was also criticised for being self-selecting. The only gun owners that were included were those that had been involved in a homicide of some sort- a rare occurrence for the population at large, but relatively common for people engaged in certain criminal activities. Kellermann noted that many of the slain gun owners in his study were likely involved in dangerous criminal occupations and may have owned the guns for protection.
[edit] 1988
In 1988, Kellermann published a study comparing robberies, burglaries, assaults, and homicides in Seattle, Washington and Vancouver, British Columbia, a city "similar to Seattle in many ways" that had "adopted a more restrictive approach to the regulation of handguns." The study found that
- both cities had similar rates of burglary and robbery
- in Seattle, the total rate of assaults with any weapon was modestly higher than that in Vancouver
- rates of homicide by means other than guns were not substantially different in the two study communities
- the rate of assaults involving firearms was seven times higher in Seattle than in Vancouver
- the rate of being murdered by a handgun was 4.8 times higher in Seattle than in Vancouver.
The study concluded that restricting access to handguns may reduce the rate of homicide in a community by reducing the lethality of assaults.
[edit] 1993
In 1993, Kellermann responded to the criticism of his 1986 paper with a case-control study of the rates of all homicides in the victim's home in Cleveland, Ohio, Memphis, Tennessee, and Seattle over five years, in homes where a gun was kept versus homes where a gun was not. This study found that
| Variable | Adjusted Odds Ratio | 95% CI |
|---|---|---|
| Any household member used illicit drugs | 5.7 | 2.6-12.6 |
| Home rented | 4.4 | 2.3-8.2 |
| Any household member hit or hurt in a fight in the home | 4.4 | 2.2-8.8 |
| Case subject or control lived alone | 3.7 | 2.1-6.6 |
| Gun or guns kept in the home | 2.7 | 1.6-4.4 |
| Any household member arrested | 2.5 | 1.6-4.1 |
- 23.9% of homicides occurred in the victim's home
- 35.8% of the controls (homes where there was not a homicide) kept a firearm in their home
- 45.4% of all victims of homicides in their home kept a firearm in their home
- 62% of victims of firearm homicides in their home kept a firearm in their home (correction to original paper)
- other protective measures, (reinforced doors, deadbolts, burglar alarms, and bars on the windows) were associated with small (about 0.8 times) reductions in risk of homicide in the home
- after adjusting for other factors (such as a police-report history of violence in the home, a convicted felon in the home, drug or alcohol abuse in the home, race, etc.) there remained an independent 2.7 times increase in risk of homicide, specifically associated with a firearm in the home; this risk was not attributable to any particular "high risk" subgroup(s) identifiable by the above factors but was evident to some degree in all subgroups
- this risk was essentially entirely attributable to being shot by a family member or intimate acquaintance with a handgun which was kept loaded and unlocked in the house
- this risk was significantly less than the increased risk due to sociological factors (rental of a home instead of ownership, living alone) but close to that associated with the presence of a convicted felon in the home (see table at right).
These results confirmed the 1986 finding that, in the net, a firearm in the home represents a greater risk overall than the protection it may offer against intruders, either indirectly or by discouraging potential assaults. Kellermann noted that the study demonstrates the pervasiveness of domestic assault, as compared to better publicized crimes such as home invasion, but continued to stress the role of handguns in increasing the lethality of such assaults.
Critics of Kellermann's 1993 paper responded with a large body of statistical analysis, some accurate (i.e. the study population was urban and therefore higher risk in general, compared to suburban or rural areas; that residents of homes where there is a risk of fatal domestic violence typically are more aware of the fact than external researchers), and some inaccurate (i.e. that members of rival gangs were tabulated as "family member or intimate acquaintance"; that the data was "cherry-picked"). Particular attention was paid to the fact that he did not "release his data" immediately upon publication, even though Centers for Disease Control and Prevention's grants do not require the individual investigator to make data public until there are no more publications to be developed from it. SUNY-Buffalo's Lawrence Southwick, among others, went as far as to publicly speculate "that Kellermann's full data set would actually vindicate defensive gun ownership." [2] In 1997, Congress cut funding to the Centers for Disease Control and Prevention’s injury prevention center by $2.6 million, the exact amount the CDC spent on the firearms research the previous year; the point was not lost on the CDC. Congress has also added language to every CDC budget since then prohibiting the agency from funding anything that might "advocate or promote gun control."
Kellermann continues to be a lightning rod for those opposed to gun control, with large numbers of websites and Usenet postings repeating the attacks (both correct and incorrect) on his research, continuing to claim that he is still "hiding" his data, accusing him of fraud, and claiming that the study has been "debunked".
[edit] Other work
Since then, however, Kellermann has gone on to work on other areas of public health, including such as the role of insurance [3] and the situation of the uninsured [4], and our domestic preparedness to respond to different forms of terrorism [5].
[edit] References
- Kellermann AL, Rivara FP, Somes G, et al. Suicide in the Home in Relationship to Gun Ownership. N Engl J Med. 1992; 327: 467-72.
- Kellermann AL and Mercy JA. "Men, Women, and Murder: Gender-specific Differences in Rates of Fatal Violence and Victimization." J Trauma. 1992; 33:1-5.
