“I had someone say they put it in their bedside table and it is loaded,” said Taylor, a family practitioner with Trinity Health New England. “So, I said, ‘Maybe that’s not a great idea. If you don’t have a safe, at least keep the gun in one place and the bullets in another.’” Her patient promised to consider making a change.

Questions about safe gun storage don’t pop up at every annual physical or well visit. Studies suggest that only a quarter of family physicians regularly discuss gun safety with their patients.

iStock Photo.

Two UConn researchers are studying why doctors don’t routinely ask their patients about safe gun storage in their homes.

Despite having some of the strictest gun control laws in the country, Connecticut is enduring high levels of gun violence, with more than 60 deaths in the first six months of 2022.

Across the nation, with more than 300 mass shootings this year, gun fatalities remain a leading cause of premature death. In 2020, 45,222 people in the U.S. died of gun-related injuries, with suicides accounting for more than half of those deaths, the Centers for Disease Control and Prevention reports.

A new study by two University of Connecticut researchers aims to find out why doctors aren’t routinely addressing this serious public health problem.

“We looked at why they don’t include firearm security or safety conversations as part of what we call anticipatory guidance,” said Jennifer Necci Dineen, an associate professor in residence at the School of Public Policy at the University of Connecticut, referring to when doctors ask about things like cancer screenings and whether a patient uses a seatbelt.

Study Seeks Ways To Reduce Gun Violence

Dineen and co-researcher Kerri Raissian, an associate professor, did a qualitative survey of 18 family physicians in 18 states, including Connecticut. Most physicians surveyed did not ask about gun safety as a primary question but were apt to bring it up if another answer prompted the inquiry.

Jennifer Necci Dineen, Associate Professor in Residence, UConn.

“So, if I screen in for depression, for example, they may ask me if we have guns in our house,” Dineen said. “If I express concern about my partner or, let’s say, one of my children is violent, and I talk to my physician about that, they may ask me if I have guns in the house. But they rarely will bring that up proactively.”

The research is part of UConn’s ARMS Center (Advancing Research, Methods, and Scholarship for Gun Injury Prevention), which connects scholars, advocates, and policymakers in seeking ways to reduce all forms of gun violence.

The researchers selected nine states that have laws regarding gun storage in the home and nine that do not, aiming to determine whether the legal and political framework of the state influenced the physicians’ decisions. In Connecticut, Ethan’s Law on safe gun storage was passed in 2019. The legislation is named for 15-year-old Ethan Song from Guilford, who died from an accidental shooting in a neighbor’s home where there were unsecured firearms.

Doctors’ broaching the topic of guns has been a political minefield in the past. In 2011, Florida passed a law that forbade physicians from asking about firearm ownership. After a series of appeals, a 2017 ruling found that the statute infringed on doctors’ First Amendment rights.

Florida is not the only state to attempt so-called “gag” laws. Similar, though less restrictive, laws have been passed in Minnesota, Montana and Missouri.

But to the researchers’ surprise, the political climate of the physicians’ home state didn’t seem to be the deciding factor. And doctors’ comfort level with the topic was only part of the picture. Instead, the most significant barrier turned out to be time.

“While we had suspected that a lot of it had to do with comfort or political context,” Dineen said, “what we’re hearing is it has more to do with time pressure and the fact that there’s more to talk about now than there ever was before.”

Add to that time pressure the fact that many conversations at wellness appointments are guided by a form provided by the doctor’s electronic medical record system.

“These electronic medical records are prepackaged and purchased,” Dineen said. “They tend to come with a standard set of items. Some of those items are driven by what’s covered by insurance in many cases.”

UConn Photo.

Kerri Raissian, Associate Professor, UConn.

Dineen and Raissian are at the early stages of their research. They are writing a paper on their 18-state survey and hope to get funding to expand their research to include pediatricians and OB-GYNs.

They hope their research will inform how electronic medical records are compiled so that gun safety questions become a routine part of wellness appointments.

Gun Safety Taught To Medical Students

Dr. Adam Weinstein, associate professor of medical sciences and pediatrics at Quinnipiac’s Netter School of Medicine, says all medical students should be introduced to the idea of asking about safe gun storage as part of their training.

“We introduce this in September of the first year of medical school in a session where we introduce them to health maintenance visits for children and adults,” he said. “Gun safety is introduced as one part of this more comprehensive whole with regards to health promotion and disease prevention.”

Most students will also see the principle in practice as they observe health maintenance visits with a preceptor who is a family medicine practitioner and then again in their third year as they participate on the care team.

“It’s a truly experiential learning,” he said, “though the experience is not specific to gun safety and storage counseling. Rather it’s done in the context of and part of the full comprehensive health maintenance visit.”

Trinity Health Photo.

Dr. Stacy J. Taylor of Trinity Health.

Taylor, who, in addition to being a family physician, is a member of the board of directors of the Connecticut State Medical Society, agrees that the question is also one of training.

“I do have students in my practice, and I teach them how to ask that question before they go in and ask it for the very first time,” she said. “If you just say to someone, ‘Do you own guns?’ that comes across as confrontational.”

Taylor said the better question is: If you own a gun, is it stored safely? “You are implying that you care about the storage, not the gun ownership,” she said.

“It’s a fine line between the patient perceiving you’re challenging them versus helping them.”

“He was my only child and my best friend,” Rice said.

Today Rice is the outreach coordinator for Fairfield-based Connecticut Against Gun Violence, work in which she believes her son shares. This summer has been a particularly difficult time to be working against gun violence in Connecticut. New Haven, Hartford and Bridgeport have experienced a recent spate of shootings and 11 people have been killed in New Haven to date, one shy of the number of homicides for all of last year.

Janet Rice talks with Colleen Shaddox about how the loss of her son Shane shaped her purpose in life.

“I asked myself, in his short time here, 20 years, did he serve his purpose, and I realize now I’m serving his purpose,” Rice says. “I’m speaking his story, working with at-risk youth, doing everything that I can for gun violence prevention. I’m serving his purpose.”

Connecticut has the sixth lowest rate of gun-related deaths in the nation in 2018, according to the most recent data from Centers for Disease Control and Prevention (CDC). The number of gun homicides have fallen since the state passed laws restricting gun ownership in 2013. There were 226 firearm deaths in the state in 2012, compared with 186 in 2018. Most of those gun deaths are suicides. Homicides are concentrated in a few urban centers. More than two-thirds of gun homicides in Connecticut happen in Bridgeport, New Haven and Hartford. As tragic as mass shootings are, low-income neighborhoods and communities of color bear the brunt of gun violence.

For Rice, the toll is never-ending. In early March, she participated in a vigil for a young man who died by gun violence, an all-too-frequent part of her work as an advocate. Several years after she lost her son, a nephew was also fatally shot in Hartford.

Gun violence marred Oliver’s life long before the fatal day in October 2012 when an argument with an acquaintance ended with his death. Luis Rodriguez, also 20 at the time of the shooting, was convicted of murder and sentenced to 40 years. In his short life, Oliver had seen friends and classmates shot and killed.

“The sad thing is … our kids having to walk past the crime scene tape to get from their school, getting off their school bus,” Rice says.

On the day he was shot, Oliver was on his way to collect money for a car he’d refurbished and sold, according to his mother. He’d been buying cars and flipping them for a profit.

Daniela Altimari/Courant Photo.

In December 2019, Janet Rice and State Treasurer Shawn T. Wooden discuss a plan to divest in gun stocks.

Oliver was a born entrepreneur. He was about 7 when he started selling bottled water on the street outside his father’s office. Oliver deduced that he’d do better if he moved to the corner and convinced his dad that it was safe to stray a few yards farther from the office. The new location did boost sales, as did his decision to add juice to his wares.

“He had a head for business,” Rice says. She chuckles and lights up, as she always does when she shares a happy memory of her son.

“He was my guy,” Rice says.