Big Head Press

L. Neil Smith's
Number 759, February 23, 2014

It isn't really that surprising: underneath
the skin of every "progressive", there is a
would-be plantation-owner and slave-keeper,
struggling to get out.

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Doctoring Data on Kids and Guns
by C.D. Michel

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Special to L. Neil Smith's The Libertarian Enterprise

That a medical student may have doctored data is both a crime and a terrible pun.

But this is probably what happened when a student formerly from the University of Michigan Medical School presented a paper at the American Academy of Pediatrics convention, and the media apishly copied headlines about the paper's claims concerning the intersection of guns and kids.

Since reporters are generally not well educated [should I end the sentence there] on criminology, statistics, robust data sources and the minutia of gun policy, they accepted the paper without scrutiny. So I'll have to roll-up my sleeves and dig into this one for the reporters who wouldn't.

The paper (United States Childhood Gun-Violence—Disturbing Trends) took child hospitalization discharge data along with survey responses concerning gun ownership, and applied a weighted analysis to determine that more handguns causes more child deaths and hospitalizations.

This came as a surprise to criminologists, and other people with cranial blood supplies, who have watched the number of handguns in circulation rise steadily over the past three decades, while simultaneously watching child firearm deaths decline. Using criminology/epidemiology data gold standards—Center for Disease Control (CDC) mortality databases and Bureau of Alcohol, Tobacco and Firearms Commerce Reports—we can chart these with ease. It shows that while gun availability has risen, fewer kids die.

Surprising then that the aspiring doctor told the world that "Policies designed to reduce the number of household firearms, especially handguns, may reduce childhood [gunshot wounds]."

To be clear, from 1981 through 2009, the number of child firearm fatalities has fallen 48%. But because the population kept growing, the rate of child firearm fatalities has fallen 56%. This reduction occurred in a period where the number of handguns went up 216%.

So how can a young doctor be so wrong, and would you want him removing your appendix? With only his abstract to review (the paper and raw data were not immediately locatable and a request sent to the American Academy of Pediatrics was not answered) we can only illustrate the obvious deficiencies in United States Childhood Gun-Violence—Disturbing Trends.

When is a database debased?

In every field of science, there are several sources of raw data. Some are the standard, some are not, and some simply stink. This paper failed to use the most common data sources available in the fields of criminology and epidemiology, namely the CDC's WISQARS database and the Bureau of Justice Statistics crime databases (both online for everyone to use). Instead the doctor-in-training selected a highly variable database of hospital discharge records and a single-point-in-time government survey of gun ownership.

None of this is pretty.

The Kids' Inpatient Database (KID) lists the discharge status of young patients. However, in terms of mortality and even injury, it is incomplete. Not every dead child enters a hospital, not every injured child needs hospitalization, and the descriptions of the "accidents" have no validation. Data quality is vague, and for such small numbers as those represented by fatal firearm deaths for children, they are statistically suspect.

But this gets much worse. Participation in KID is completely voluntary, and the number of contributing states and hospitals has risen since its inception. This means the number of children being recorded rose as well. Whereas the CDC shows a steady drop in child firearm deaths since 1993, the KID database wasn't even launched until 1997, when it had a mere 22 participating states. Between then and 2009, the number of states adding data to KID rose 200% and the number of hospitals went up 163%. As you can see, the raw numbers used in this intern's study mirrors the rise in KID database participation, not in actual firearm death rates.

Which is why United States Childhood Gun-Violence—Disturbing Trends uses raw numbers from an oddball source. Criminologists and the CDC—people who are ever so comfortable with numbers—always report in terms of rates of deaths. In other words, divide the number of deaths by the number of people. This is an accurate reflection of a situation because a change in numbers may reflect many other causes. For example, in the years immediately after Washington D.C. banned handguns, the number of homicides fell. But the population of D.C. was also dropping because the place had already become a gangster paradise and D.C. workers with cars moved to the suburbs. The number of homicides fell but rate of homicides rose at an alarming pace. Net-net, the odds of being murdered in D.C. skyrocketed.

So the raw numbers presented in United States Childhood Gun-Violence—Disturbing Trends not only conflict with the raw numbers provided by the CDC, they also obfuscate the rapidly falling rate of child firearm deaths. I would claim that the apprentice doctor did this on purpose, but I doubt he is that clever.

This report also leveraged the often rejected Behavioral Risk Factor Surveillance System (BRFSS). Run by the CDC, this periodic survey asks people a lot of embarrassing questions. In 2004 at least, they asked people about firearms they had in their homes, and this single year was used as the basis for firearm ownership rates in United States Childhood Gun-Violence—Disturbing Trends. Yet the study we have under a microscope covered a decade in which firearms in circulation and the number of concealed carry permit holders were rising rapidly, and childhood firearm deaths were simultaneously falling. A serious attempt to find causes and effects would have used more than a single data point, and would have used rates of deaths, not raw numbers.

Some critical criminologists think that the BRFSS sounds like passing gas, and is driven by the same raw material. Responses to government surveys about your firearm ownership are renowned for resulting in inaccurate tallies. Gun owners have been trained through government abuse not to trust the government on this subject. So the BRFSS is not a great source of accurate firearm ownership data. And using a single year of firearm ownership data to evaluate ten years of death is junk science.

Interestingly, the same instance of the BRFSS also asked people if they kept their guns loaded, which was relatively uncommon, and if they kept them locked. These data points might have been a better test variable than mere ownership.

Similar reporting problems may have occurred by our young saw-bones using "percent childhood [gunshot wounds] occurring in the home" as their measurement criteria. One thing we know for certain from the criminological world is that gunplay around inner-city gangland areas is common, and many innocent bystanders are hit by bullets fired during drug and turf wars. This is out-of-home gun mayhem, an odd thing to omit from a study about gun deaths. In the past year I can recall two childhood shooting deaths from rival gang crossfire in public places in Oakland, California alone ... and I don't read the Oakland Tribune every day. Given such connections, the University of Michigan Medical School seems uniquely unconcerned about a primary source of child gun fatalities. Which doctor is a witch doctor?

The Joyce Foundation—the financier of the American gun control movement—loves giving money to medical schools and having their indentured servants cook-up such studies. Google queries show many people at UofM involved neck-deep with the Joyce Foundation, as are Boston Children's Hospital and Harvard Medical School who predigested our young doctor's statistical gruel. It is yet another in a seemingly endless stream of doctors not doing what doctors are trained for, and instead trying their hand at research requiring deep methodological expertise in selected fields of non-medical inquiry.

Let's pray Arin Madenci was better at his medical studies than his criminological research. If not, then pray this careless intern isn't working when you are brought in for treatment.

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