The Centers for Disease Control and Prevention has awarded $30 million in grants to 23 state health departments to tackle pressing injury and violence issues, including traumatic brain injury, motor vehicle crashes, and intimate partner violence. None of the funding went toward programs addressing gun violence, even though gun deaths outnumber traffic deaths in the majority of states — and even though shootings are a chronically understudied major public health issue.

As The Trace reported in April, the CDC claims a decades-old amendment has completely restricted its ability to fund gun violence research. As a result, less than $5 million is spent each year on gun studies by public health agencies and research groups. A single HIV or cancer study can cost twice as much.

Former agency leaders argue that the agency is not, in fact, explicitly prohibited from financing firearm research — but rather is making a conscious choice to avoid a contentious issue altogether, for fear of political backlash.

“There is still a fear of doing something about gun violence,” Linda Degutis, a former director of the Injury Center, tells The Trace. “The history hasn’t changed.”

The CDC department that awarded the new $30 million grant, announced on July 5, is the Injury Center Core State Violence and Injury Prevention Program (Core SVIPP), which funds state-level initiatives to reduce injury and violence. That the grant would not be used to finance gun violence research was all but predetermined.

The CDC requires states to limit their funding proposals when applying for injury prevention grants to specified issues. In the case of Core SVIPP, funding is restricted to four main subjects: automobile crash injuries and deaths, child abuse and neglect, intimate partner violence, and youth sports concussions.

In an emailed statement, CDC Spokeswoman Courtney Lenard said those issues were were chosen because they currently top the Injury Center’s research priority list.

While few would argue that car crashes or brain injuries aren’t a worthy focus for safety prevention programs, Degutis, who resigned from the CDC in 2014 over the agency’s inaction on gun violence prevention, says limiting funding areas sends a clear message to states about which issues the agency is willing to engage with.

“The applications have very specific criteria for what the CDC wants to be covered,” she says. “The states have to say how they’re going to address those issues, and then they’re obligated to follow that plan.”

The CDC’s refusal to list gun violence as a funding priority means that states that struggle the most with gun injuries and deaths are unlikely to request money to address the crisis. Arizona, Kentucky, Oklahoma, and Tennessee — four of the states that received grants from CORE SVIPP — have some of the highest rates of gun suicide in the country, but no CDC funding is available to address the issue. Louisiana, another grant recipient, struggles with gun-related intimate partner homicides, but the CDC will not provide preventative funding under the current program limitations.

Gun violence was once a primary research focus of the CDC. Without any political obstructions, the agency’s Injury Center conducted several gun violence studies in the early 1990s. In one, “Gun Ownership as a Risk Factor for Homicide in the Home,” researchers found that the presence of a firearm in the home increased the risk of a gun-related death by 2.7 percent, and suicide fivefold.

But the agency has refused to fund substantive studies or analyses on gun violence for two decades. The CDC also stopped measuring state-level firearm ownership in 2004, making it difficult for outside researchers to obtain verified data for their studies.

Today, the agency only examines firearms injuries and deaths in indirect ways. The CDC’s general injury surveillance programs — databases that collect information on injury and death — record gun deaths and injuries.

The CDC is facing growing scrutiny over its avoidance of gun violence. Delaware Senator Tom Carper has written two letters to CDC Director Tom Frieden, questioning the agency’s purported inability to conduct firearms research, and urging him to reallocate available funds toward new studies. In April, a coalition of 141 medical groups sent a letter to four senior members of the House and Senate Appropriations Committees, urging them to restore federal funding for gun violence research.

Other researchers, however, say the CDC is right to be cautious. David Satcher, a former CDC director, told The Trace that the Republican-led Congress could punish the agency financially if it decided to study gun violence research.

Historic precedent supports his claim. In 1997, Congress cut $2.6 million from the Injury Center’s budget and reallocated the funds from firearm injury research to traumatic brain injury prevention after Republicans accused the agency of advocating for gun control.

David Hemenway, a researcher at Harvard, says the agency is forced to tread carefully around gun violence due to the threat of congressional retribution.

“It’s like battered women’s syndrome,” he says. “You get beaten up enough and you understand what the rules are.”

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