The CDC Downplays Guns' Role In Suicide-Prevention Messages : Shots - Health News Congress has told the Centers for Disease Control and Prevention not to "advocate or promote gun control." That directive complicates the public health agency's efforts to prevent suicide.
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How The CDC's Reluctance To Use The 'F-Word' — Firearms — Hinders Suicide Prevention

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How The CDC's Reluctance To Use The 'F-Word' — Firearms — Hinders Suicide Prevention

How The CDC's Reluctance To Use The 'F-Word' — Firearms — Hinders Suicide Prevention

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AUDIE CORNISH, HOST:

In this next story, we're going to look at how the politics around gun control affects public health work to prevent suicide. The nation's top public health agency, the Centers for Disease Control and Prevention, is concerned about rising suicide rates. But as NPR's Nell Greenfieldboyce reports, the CDC has been trying to tackle this problem while shying away from the clear link between suicide and access to guns.

NELL GREENFIELDBOYCE, BYLINE: Guns in the United States kill more people through suicide than homicide. Almost 40,000 people died from guns in 2017 alone, and more than half of those were suicides. Last year, the Centers for Disease Control and Prevention released a report showing that the problem is growing. The report got a lot of media attention, including here at NPR.

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MARY LOUISE KELLY: A new study shows that suicide rates have increased in nearly every state. And in half of them, the rise is dramatic.

GREENFIELDBOYCE: I was the NPR reporter on the story, and what struck me was the way that the CDC barely mentioned guns. I knew that guns are both the most commonly used method for suicide and the most lethal. I also knew guns were a sensitive issue at the agency because of some unusual legislation. Ever since 1996, Congress has forbidden the CDC from using any of its funding to, quote, "advocate or promote gun control." So when I interviewed the report's main author, a CDC researcher named Deborah Stone, I asked whether that had affected her work.

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GREENFIELDBOYCE: Were you told or did you deliberately not put in things like gun control legislation or specific references to reducing access to firearms because of the political concerns about that sort of thing in the CDC?

DEBORAH STONE: We are concerned with all aspects of suicide prevention, including access to lethal means. And so we do include that in a comprehensive approach to suicide prevention.

GREENFIELDBOYCE: Her answer made me wonder, what goes on at the CDC when they try to talk about suicide, given how wrapped up it is with guns? So I filed a Freedom of Information Act request. And about nine months later, I got a bunch of documents. In them, I did find clues that folks at the CDC do speak carefully about guns in the context of suicide. The first thing that struck me was how often officials avoid the word gun altogether. Here's a video about suicide on the agency's website.

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UNIDENTIFIED PERSON: People may be at risk for suicide if they have a family history of suicide, previous suicide attempts, social isolation, economic hardship or a history of mental health problems or alcohol and substance abuse.

GREENFIELDBOYCE: It doesn't mention guns. Instead, the CDC seems to rely on generic terms like, quote, "lethal methods or lethal means." Take a CDC fact sheet on preventing suicide - again, the word gun does not appear. People are advised to, quote, "reduce access to lethal means."

And the internal documents I got seem to reveal why. In one text message, a co-worker told report author Deborah Stone that the phrase, quote, "access to guns" would raise red flags; going on to say that, quote, "lethal means is probably less likely to create issues compared to using the F-word" - the F-word being firearms. Stone replied, very true.

LINDA DEGUTIS: I think when you say lethal means to the general public, they don't know what you're saying. They don't know that you might mean guns.

GREENFIELDBOYCE: Linda Degutis used to serve as director of the CDC's National Center for Injury Prevention and Control. She says, of course the workers there censor themselves.

DEGUTIS: Being there at CDC, there were staff who would say you couldn't even say the word gun. And they would tell other people or even new people sometimes, you can't say the word gun here.

GREENFIELDBOYCE: She says this puts dedicated public health workers in a tough spot.

DEGUTIS: Having a sense of almost being, to some extent, censored in what we could say about some very specific kinds of injury events was just not that comfortable.

GREENFIELDBOYCE: I reached out to the CDC to ask them about all this, but a spokesperson declined to make anyone available for an interview. She said the CDC does publish statistics about gun suicides and that workers do their best to provide the very latest science and evidence-based data to the public so they can protect their health.

Still, another thing really struck me. When it comes to guns and suicide, CDC officials focus on the politically safe message of safe storage. Safe storage means owners locking guns up to keep them away from suicidal people. Here's the CDC's Principal Deputy Director Anne Schuchat talking to reporters when the CDC's suicide report came out last year.

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ANNE SCHUCHAT: One of our recommendations is assuring safe storage of medications and firearms as one of the approaches to prevention - very important to have safe storage.

GREENFIELDBOYCE: Research does suggest that locking up guns and ammunition can help by, say, keeping teenagers from using their parents' guns. The problem is that most gun suicides happen when a gun's owner uses it to die. Daniel Webster is director of the Johns Hopkins Center for Gun Policy and Research. He says the owner of a gun can just unlock it.

DANIEL WEBSTER: I'm a little bit dubious that safe storage will be relevant to the vast majority of suicides with firearms.

GREENFIELDBOYCE: Webster is disappointed that the CDC's main guide to suicide prevention for states and communities doesn't discuss any studies of legislative options that have been linked to lower suicide rates, like licensing requirements or mandatory waiting periods before purchase.

WEBSTER: There is no law in place now that says that CDC can't talk about the research and what's been learned about the connection between firearms and suicide risk.

GREENFIELDBOYCE: Now, some people argue that suicide is a mental health problem not a gun problem. Research suggests, actually, guns really matter in the United States. If people are not able to use a preferred method, they typically will not turn to other alternatives. David Gunnell studies suicide at the University of Bristol in the United Kingdom.

DAVID GUNNELL: The research evidence clearly shows this; that if you restrict access to commonly used, highly lethal methods of suicide, that leads to a fall not only in method-specific rates but also a fall in overall rates of suicide.

GREENFIELDBOYCE: As much as a 30 to 50% drop in other countries after, say, the United Kingdom detoxified the gas used in home ovens and Sri Lanka banned certain poisonous pesticides.

GUNNELL: Look at the States, half of all suicide deaths in the States are from firearms. And so if you like - you know, as a policymaker, my first step would be to say, well, what can we do to restrict access to firearms?

GREENFIELDBOYCE: Remember. Congress has ordered the CDC not to advocate or promote gun control. What that means has never been exactly clear. But it's lawmakers who control the CDC's funding, and CDC officials seem to be playing it safe.

Nell Greenfieldboyce, NPR News.

(SOUNDBITE OF ALBERT HAMMOND JR.'S "SPOOKY COUCH")

CORNISH: We want to pause here to note and say that suicide is preventable. If you're in crisis or know someone who is, please call the National Suicide Prevention Lifeline at 1-800-273-8255 or text 8255 to 741-741.

(SOUNDBITE OF ALBERT HAMMOND JR.'S "SPOOKY COUCH")

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