In January 2013, a diverse group of researchers from institutions across the country sent a letter to Vice President Joe Biden’s Gun Violence Commission. The message was straightforward: The previous month’s massacre at Sandy Hook Elementary School in Newtown, Connecticut, was the latest evidence that gun violence was a public health threat that the country could no longer afford to ignore.

One of the primary barriers to gun violence prevention, the authors argued, was the extraordinarily low level of basic research on firearms. There were over 4 million gun injuries from 1973 to 2012, but the National Institutes of Health awarded just three major grants to study gun violence over that time. (Rabies, with 65 total cases, received 89 NIH research awards. Cholera, with 400 total cases, received 212.)

“A blue-ribbon commission appointed by the National Academy of Sciences concluded that very little is currently known about effective ways to reduce gun violence,” the researchers wrote. “One consequence is that our current approach of ‘muddling through’ has led to little long-term progress in addressing this problem: While mortality rates from almost every major cause of death declined dramatically over the past half-century, the homicide rate in America today is almost exactly the same as it was in 1950.”

Public health researchers widely agree that more research on gun violence is needed, but federal health agencies have largely avoided conducting even basic research, for fear of violating a statutory prohibition on using tax dollars to “advocate or promote gun control.” In 1997, Congress approved an appropriations rider for the Centers for Disease Control that included that language. In 2012, the NIH became subject to the same prohibition. “This language has been in all subsequent appropriations bills, so the restriction still applies today,” said Emma Wojtowicz, a spokesperson for the NIH, in an emailed statement to The Trace.

While the CDC has interpreted Congress’s restriction as self-imposed ban, the NIH has cautiously supported some new studies on firearms — the key word being some.

In September 2013, a few months after the researchers released their letter, the NIH announced a call for research projects examining gun violence. The funding opportunity, which would support research projects over the next three years, was driven largely by a memorandum from President Obama that ordered federal science agencies to support research into the causes and prevention of firearm injuries.

Three years after the NIH announced its new funding opportunity, The Trace found that the agency has made little progress in expanding gun violence studies, based on an analysis of research grants made by the agency. Our analysis* was inspired by previous studies by researchers from the University of Pennsylvania and University of Chicago, who compared the number of gun violence research grants awarded by the NIH to the number of grants that funded studies on four rare diseases in the U.S.

Our results show that while the NIH has publicly called for more gun violence studies, the agency still isn’t awarding very many grants. From 2013 to 2016, the number of major NIH-funded studies on gun violence prevention doubled — from three to six. Some of the grants funded direct gun violence research, such as an ongoing study from the University of California, Davis, that analyzes the relationship between alcohol abuse and handgun purchases. Others funded more indirect research, such as a study on a juvenile treatment center in Madison, Wisconsin that aimed to reduce recidivism for all violent crime, including firearm offenses.

“NIH has and will continue to support research that develops more effective interventions to prevent the injuries and mortality associated with violence,” Wojtowicz, the NIH spokeswoman, said in the email. “This research may be conducted within the context of multiple types of violence, of which firearms violence is only one example.”

In total, the NIH devoted $3,218,432 to major gun research grants from 2013 to 2016. As The Trace noted in April, a single cancer or HIV study can cost almost twice as much. A nicotine-dependence study funded by the NIH in 2016, for example, received $1,020,517, more than double the amount of some firearms studies.

While the increase in NIH research grants is ultimately a positive sign, it remains to be seen when research funding will better reflect the human toll of gun violence. From 2013 to 2014, the most recent years available in CDC datasets, firearms claimed 67,235 lives and resulted in 165,292 injuries.

*We obtained our data on research awards from NIH RePORTER, an online database of NIH-funded projects. To replicate the methodology of researchers who have conducted similar analyses in the past, we tallied only R01 grants, which are the major research awards given out by the NIH.

[Photo: AP /Charles Rex Arbogast, File]