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View Diary: The NRA's solution to gun violence is... (250 comments)

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  •  Well (1+ / 0-)
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    oldpunk

    ORs can overstate the relative risk in the case of rare events. But they don't "tend to be large." More often than not, they are under 2.0. Most epidemiologic analyses are dealing with risks of events that are not a lot more common than homicide. If you want to express the odds of a risk factor for a given mortality cause (say, lymphoma) it is going to look similar to the Kellermann results if you expressed it as an absolute percentage of the population. But epidemologists don't typically minimize an excess risk by saying, "Well, that only affects 0.001 percent of the population in a given year anyway."

    •  Compared to the rate of rare events? (2+ / 0-)
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      oldpunk, PavePusher

      ORs are often two or more orders of magnitude larger.

      Most epidemiologists don't obsess over subset of events that occur orders of magnitude less frequently than the general problem.  Otherwise, we wouldn't have vaccination.

      •  ? (1+ / 0-)
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        oldpunk

        I'm in this field and don't agree.

        Vaccination is a great example actually of a large 'reaction' over a relatively rare event (look at HiB for example).

        •  Isn't that a good example? (2+ / 0-)
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          oldpunk, PavePusher

          Would you end vaccination that admits incidence in one thousandth of a percent of children?

          •  Not based on (3+ / 0-)
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            Pete Cortez, tytalus, oldpunk

            our current practice. (I assume you mean end a vaccine where the incidence is less than 0.001%.) For example kids are still getting polio vaccines in the US and there hasn't been a case here in decades. The reason they haven't stopped it is that if someone from a place where it still exists flew in it could cause a terrible outbreak if there still isn't residual immunity.

            Chickenpox is another example. Everybody used to get chickenpox before the vaccine, and it caused about 50 deaths a year in children in the US IIRC. There are 4 million births a year so that means 0.00125% of children died from it. The percent hospitalized was higher obviously but the same is true with gunshots. In any case, they thought that was worth a vaccine even with a similar percentage mortality.

            •  No, I mean end it when incidence is greater. (2+ / 0-)
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              oldpunk, PavePusher
              •  ...you mean (1+ / 0-)
                Recommended by:
                oldpunk

                end it because the vaccine caused the disease?

                Sorry, I am not following.

                •  Precisely. (2+ / 0-)
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                  oldpunk, PavePusher

                  But you've already made my point.  You accept the mortality rate for applying...say...the HiB vaccine, because incidence is one to two three orders of magnitude greater.  You do not obsess over the marginal cost.

                  I imagine this is less obvious to epidemiologists when they get into areas outside of their expertise--particularly crime--where treatments can be fanciful as you can imagine.

                  •  Not really (1+ / 0-)
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                    oldpunk

                    I meant the mortality from HiB was relatively low as a percentage of all infants, but even though it was low, we made a vaccine anyway. The fact that it was a small percentage of infants who died didn't stop us from acting, and really on a grand scale relative to the number of deaths.

                    The mortality from the vaccine (if any) is lower than the mortality from the disease. They do worry about the marginal cost actually. Costs and benefits are assessed as part of the vaccine approval process.

                    I don't really see firearms death as being different from that. I do approach it from a public health perspective. Like HiB, it's an unnecessary set of deaths (much larger than the number of HiB deaths) that may be preventable. HiB didn't have the NRA behind it though.

                    •  HiB had a vaccine (2+ / 0-)
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                      oldpunk, PavePusher

                      And your approach suffers some extraordinary defects.  One, a disease by definition is undesirable; the only way you get to that point with guns is from a position of personal disgust, a dismissal of excess deaths prevented from defensive use, or an unjustified conflation of firearm injury with the implements themselves.  Two, intentional homicide and suicide are not pathogenic and directionless; they are purposeful.  You have additional burden to show that your proposed treatment actually defeats intelligent efforts to surmount it; not one study by the epidemiologists bears out any such conclusion about any sort of proposed policy impacting any subset of firearm death and injury.

                      Otherwise, you leave well enough alone.

                      •  It's not that guns (2+ / 0-)
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                        tytalus, oldpunk

                        per se are undesirable. Firearm deaths are (in my view). It is not the object itself, it is the killing people part that I have a problem with. It's all costs and benefits; personally I do not value the enjoyment of guns as highly as the lives that would be saved without them. The value of defensive use would be irrelevant if nobody had them (eg: the UK).

                        However, I agree that the "treatment" of this problem isn't straightforward given how awash in guns our country is. The gun lobby has been very smart in creating a situation where there would be no other practical option other than going their way. I would love to see more restriction, but I realize it is not going to happen any time soon.

                        •  "...the lives that would be saved without them." (2+ / 0-)
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                          PavePusher, Robobagpiper

                          That's the issue.  If it's not the "guns per se," but firearms mortality and injury that concerns you (or, in my view, violent crime in general), why focus on the tool?  The same reasoning has been applied to recreational drug use with similar (lack of) success.  

                          Your epidemiology is also immature.  The UK and Colombia have effectively the same rates of gun ownership, yet vastly different outcomes in intentional homicide overall and firearms homicide in particular.  South Korea and Japan have extraordinarily low rates of gun ownership, yet lead the world in suicide rates.  With a small enough sample and set of covariates, you can conclude just about anything; and this is before you even cover the question of excess deaths due to inhibiting laws against self-defense.

                          So that's where we stand today.  Gun rights activists have no reason to accept your point of view because there's little to no evidence for it, and none whatsoever favoring any specific prescriptions the Brady bunch has devised.  On the other hand, there is a powerful argument for self defense, and it only requires counting to make.  What does that leave your side with?

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