Why is it that the U.S. is among the top 30 countries in the world with the highest rates of deaths from gun violence? At a rate of 4.43 deaths per 100,000 people, it is four times higher than the rates in war-torn Syria and Yemen.

In the aftermath of two mass shootings in less than 24 hours in the United States, we posed that question and others to Vin Gupta, a critical-care physician with military experience. And he is a scientist at the Institute for Health Metrics and Evaluation at the University of Washington, which compiles comprehensive data on what it calls the "global burden of disease," including data on deaths from gun violence around the world.

This interview has been edited for length and clarity.

What was your reaction to the two mass shootings this past weekend, in Texas and then Ohio?

There was anger. There was frustration. It was not surprising.

It is a comment on the times to say that two mass shootings in rapid succession, claiming 31 lives and injuring many more, is not surprising.

That sort of fatalism is in part because this particular issue [of gun violence and gun control] is so politicized.

How are we going to get courageous politicians to do the right thing? In my home state of Ohio, [former] Gov. John Kasich was for the strategic overhaul of criminal background checks and support for the "red flag" law that would allow courts to take guns away from someone who poses a threat to themselves or others, for example. [His policy recommendations were released on March 1, 2018.] Sadly, these reforms didn't get a vote in the Ohio House.

Do gun laws always bring down gun fatalities?

Mexico has very restrictive background checks for gun purchases and licenses, but it's had no effect on gun-related homicides because of the heavy organized crime. Our lack of federal regulation [of guns] has contributed to the problem in Mexico — you have that flow [of guns] across the border.

If there were broad-based gun reform legislation in the U.S., would that make a difference?

It's my opinion that the United States would see an outsize impact from a slate of legislative proposals that Mexico has adopted because we lack the organized crime in the way Mexico has. But not only do we have to have legislation [to address gun control]; we need to think about policy positions that allow us to buy back the current supply of firearms, of how we dwindle that number down.

Is there an example of a country that had a high rate of deaths from gun violence, then enacted legislation and saw a change?

South Africa passed its Firearm Control Act in 2000 — banned automatic rifles, instituted background checks, permits and licenses. In the next five years, there was a 13.6% decline on average per year in gun-related firearm deaths. Austria passed a similar law and saw a similar result a few years before that.

What surprises you in the global data for deaths from gun violence?

Some say that the disaffection that leads to gun violence in the U.S. might be rooted in economic reasons, a lack of socioeconomic opportunity. But we have a higher death rate from firearms than countries rated by the Fragile States Index, [which ranks] fragile places in the world from the perspective of governance.

Afghanistan, Central African Republic, Iraq, Somalia, South Sudan, Somalia, Yemen — those are countries that are worse to live in from a conflict standpoint than the United States. You would think they would have outsized numbers of gun-based violence. It's remarkable to me that they don't.

What are the theories about why the rate of death from gun violence isn't higher in countries like Afghanistan and Yemen?

The IHME [Institute for Health Metrics and Evaluation] does not have an explanation, but I like to speculate. Off the top of my head, my gosh, my sense is that the easiest explanation is the most plausible. In countries that are chronically in conflict, you have tons of arms, but my speculation is that the arms are really concentrated in areas that are very militarized, in the hands of militia men and militaries. But in the United States, essentially in every ZIP code you have some exposure to somebody who may own a firearm.

Copyright 2019 NPR. To see more, visit https://www.npr.org.

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