At least 26 people were killed Sunday after a gunman opened fire on a church in a rural Texas community, in the deadliest church shooting in US history. And horrific as this event was, it was, somehow, not the deadliest mass shooting that occurred in recent weeks. On Oct. 1, a gunman killed 59 people, including himself, and injured hundreds more at a Las Vegas concert, in the deadliest overall shooting in US history.

Because such shootings have become routine, we can now divide the aftermath into phases. There is the initial shock-and-outrage phase, the flurry-of-think-pieces phase, the phase where we gradually begin to talk about it less, and, of course, the complete-political-inaction phase. And then the next shooting happens.


With this pattern well-established, is there anything left to say in the wake of these events? Yes, there is. While the cycle of violence has not changed, neither have the potential solutions to this violence. Although there is still much research to be done on guns, the data point to several measures that, if implemented nationally, could mitigate the carnage we now see so regularly. Here are three:

1. Keep guns away from dangerous people.

State-level data have shown that background checks are among the best tools we have to reduce gun deaths in the United States. A 1995 Connecticut law making would-be gun purchasers first apply for permits requiring background checks was linked to a 40 percent drop in firearm homicides in the state. At the Boston University School of Public Health, where I am dean, our research team corroborated earlier findings that linked local background checks with a 22 percent homicide rate reduction. Background checks have also been consistently supported by at least 70 percent of Americans.

We can also save lives through laws crafted specifically to keep guns out of the hands of domestic abusers. Firearm-related intimate partner violence (IPV) rates were 14 percent lower in states with laws requiring people subject to IPV-related restraining orders to turn over any guns they possessed. Such laws could, potentially, have prevented the violence in Texas — the shooter had been court-martialed for assaulting his wife and child.


2. Utilize ballistic imprinting/microstamping. Promote the use of “smart guns.”

Laws requiring firearm identification through the use of ballistic fingerprinting or microstamping could reduce firearm mortality substantially. Smart guns — weapons fused with technology that ensures they can only be fired by an authorized user — could make guns safer, while respecting the right to own and use them.

3. Rethink concealed-carry laws.

Finally, we can reduce mortality by doing away with concealed carry laws. Our team, for example, found “shall-issue” concealed carry laws to be linked with a 6.5 percent higher total homicide rate, an 8.6 percent higher firearm homicide rate, and a 10.6 percent higher handgun-specific homicide rate. (“Shall issue” states are regions where gun permits must be issued if criteria for them are met. In “may issue” states, law enforcement officials have more discretion over whether or not to give people the permits.)

None of these suggestions has anything to do with challenging gun ownership as a constitutional principle. They are simply practical actions we can take to stop people from dying. While we cannot prevent disturbed people from seeking to do evil, we can refuse to make it easy for them and we can do all this without infringing on the right of well-intentioned citizens to use firearms for recreation and self-defense.


Yet as clear as these solutions are, we continue to do nothing. Even the push to ban bump stocks after Las Vegas, a comparatively minor step, has since come to little. In refusing, over and over, to take action, we signal something worse than apathy: We signal our acceptance of the status quo.

In 1958, the pioneering scientist Sir Geoffrey Vickers published a paper on the goals of public health. He argued that public health action is motivated when people begin to consider intolerable something that they had previously accepted as a given. It was, for example, once considered acceptable that people should die in large numbers from regular cholera outbreaks. Yet a better understanding of germ theory and the role of poor sanitation in causing cholera led people to see just how preventable these deaths could be. They realized that by doing nothing, they were, in effect, making an active choice that cholera deaths should remain a fact of life in civilized society. With this understanding, they decided that such mortality is, in fact, unacceptable, and then took the steps they knew would prevent it.

We are in roughly the same place on guns. The data tell us mass shootings are preventable, and suggest ways we can stop them. All that remains is for us to deem this clear and present public health threat unacceptable in our society. Until we do, we must prepare for these shootings to happen again and again and again. Indeed, it is a chilling but likely probability that someone, somewhere in America, is planning a mass shooting at this very moment. His scheme may be well-advanced or just the slightest whisper of an idea. Whether or not he is able to follow through on his designs depends on his access to weapons, and the vigilance of the people around him. We have the power, should we choose to use it, to improve the odds of a peaceful conclusion to his tale. Another Las Vegas or Texas need not be inevitable. But we must choose to make the acceptable unacceptable. Until we do, we are all to blame for mass shootings.


Sandro Galea is a professor and dean of Boston University School of Public Health. His book “Healthier: Fifty Thoughts on the Foundations of Population Health” was published in June. Follow him on Twitter: @sandrogalea.