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Firearm Safety—Where Politics and Public Health Collide: An Interview with Dr. Megan Ranney

Illustration by Rosie Dinsmore ‘24

Dr. Megan Ranney is a practicing emergency physician, researcher, and advocate for innovative approaches to health. She currently serves as Deputy Dean of the Brown School of Public Health and founding Director of the Brown-Lifespan Center for Digital Health. In addition, she is the co-founder of the American Foundation for Firearm Injury Reduction in Medicine at the Aspen Institute. Dr. Ranney has been a leading voice in public health, integrating social media into her health campaigns, such as through #GetUsPPE and #ThisIsOurLane. 

Yuliya Velhan: How do you think the pandemic affected firearm safety in the United States and globally? 

Megan Ranney: The pandemic worsened firearm safety in three ways. First, we saw an unprecedented number of folks buying firearms, many of them for the first time, meaning there are more firearms in circulation. Second, most of those buyers did not get safety training or any basic training in how to handle their gun. Many of those lessons that are passed on through the community about how to handle a gun safely, how to store it safely, and how to minimize risk of injury were completely missed. Oftentimes, those messages can be missing in general, but they were completely absent during the pandemic. Third, there have been increases in the general level of hopelessness and the lack of community. We all serve as safeguards for each other. We watch out for each other. We reach out to our friends when they’re feeling down, and we provide a sense of community and norms around what’s okay to do and not okay to do. It all disappeared when we were separated and had only social media to turn to. 

YV: While firearms are a very political issue, firearm safety is also a big public health issue. How do you think we could get individuals to shift their perspectives to see this as a public health issue?

MR: The biggest thing that’s been getting people to shift their perspectives to seeing firearm injury as a public health issue is consistent messaging. It is human nature to want to go to absolutes or extremes, and that’s not productive. We haven’t passed policies over the last 15 years that have successfully reduced firearm injury rates, improved safe storage rates, or reduced the risk of firearm suicide or homicide. To me, it signals that we need to have a different approach. In order to be convincing, we would have to share the stories that would help people see it as a public health issue. It’s one thing to say, “Oh, it’s a public health problem.” But what does that mean? What is it that we’re actually asking people to do? Do we have proof that it makes a difference? That’s what many of us are trying to accumulate right now: proof that this approach does reduce injury and death.

YV: How do you think the #ThisIsOurLane movement has changed the way people look at firearm safety? 

MR: The #ThisIsOurLane movement was instrumental in finally releasing federal funds to allow the study of the prevention of firearm injury for the first time in 23 years. It also made a difference in terms of raising the awareness of representatives in Congress and the public about the fact that firearms do cause health problems. It’s not just a criminal justice or policy issue. It’s not just about self-defense or gangs. It’s also about the health effects. With every controversial issue, like this one, there’s a lot of pushback when trying to pass new legislation. 

YV: How do you think the issue of government funding can be minimized for future gun safety studies? 

MR: It requires a tireless commitment to the issue. There need to be individuals who are going to keep showing up day after day, talking about policies that take into account the lived experiences of those affected by firearms injury. We also need to pay attention to some of the structural determinants that precede firearm suicide and homicide. These don’t occur in a vacuum. It’s a terminal event in a long series of problems. I think some of the most innovative and promising work around firearm injury prevention takes a step back long before someone has their finger on a trigger. It’s about changing the preceding conditions that lead someone to choose to pick up a firearm to hurt themselves or others and making sure that, in that moment of impulsivity, that person is separated from the thing that can cause lethal effects.

YV: Who is at the highest risk for firearm injury? Is it a result of structural disparities? 

MR: There are three groups: Older white men are at the highest risk of firearm suicide, young Black and Hispanic men are at a disproportionate risk of firearm homicide, and women are at a disproportionate risk of intimate partner homicide. There are absolutely structural determinants for each of those. Older white men are at highest risk of firearm suicide due to a mistaken sense of masculinity, stigma around mental health treatment, and easy access to a firearm at a moment of desperation. Structural racism, the built environment, the lack of job opportunities, and easy access to illegal guns are all major drivers of firearm homicide. For women, it’s about lacking financial independence, lacking easy ways to get out of an abusive relationship, and then the easy access of firearms to abusers. We find that domestic violence goes up in societies where there’s greater misogyny and less equality between women and men.

YV: What is one way in which firearm safety could be addressed on a federal level? 

MR: There are huge issues around the flow of illegal firearms from states with looser firearm laws to states with more restrictive firearm laws. If we had more universal laws around background checks, permits, and the ability to identify “bad apple” dealers, it would make a big impact on firearm homicide in the country.

YV: From where we are now, what do you think are the best steps to promoting firearm safety on a large scale? 

MR: I think there are a few things. The first and most important is deeply engaging firearm owners and firearm owner organizations themselves. Second is taking a harm reduction approach rather than an absolutist approach. Maybe we’re not going to get to zero firearm deaths, but we can greatly decrease the numbers we are seeing today. Third is addressing structural drivers of firearm injury. I think policy is critically important, but it is not going to happen in the short term, and there are policies that can actually be harmful. If we can take those first three steps, we will make forward progress with or without policy change.

*This interview has been edited for length and clarity.