The following is a Q & A with Professor Garen Wintemute, Baker-Teret Chair of Violence Prevention, at the University of California at Davis medical school. Wintemute is one of the country’s leading experts on the public health theory of gun control. He has long argued that gun violence is equivalent to a medical epidemic, and that, as such, public health measures ought to be taken to counter its spread.   Sasha Abramsky: What happened in Connecticut last Friday was by some measures an appalling aberration; yet by other measures it was all too predictable. How can we understand this event as something more than an aberration?

Garen Wintemute: We may very much want to understand and to predict. But predicting exactly who and where and when and what the body count will be is simply impossible—because no two of these events are alike. And one of the great mistakes is trying to prevent the last one—because the next one will be different. But will there be another similar event, will there be another body count? That’s an absolute certainty. Firearms are readily available. We have created “global gunning,” much as we have created global warming. We have made a whole series of policy decisions that have made the widest possible array of firearms available to the widest possible array of people for use in the widest in the widest possible array of circumstances. And we are paying the price for those decisions; or, in this case, our children are paying it for us.

What can be done about this? You’ve got the issue of mental illness; the issue of gun control. You read about Syria’s chemical weapons, for example; they’re in a binary state—you need both elements to make them deadly. It’s the same thing here. You’ve got two elements. How do you stop them fusing?

We don’t know how big a role mental illness played here. But let’s step back; we have conversations like this at times when there’s been a mass murder, particularly of children, because we’re wired to see these catastrophes as salient events. But take Sandy Hook, Oak Creek, Aurora, Columbine, Virginia Tech, all of them together come to ninety-one dead. It’s awful. But we lose, on average, eighty-eight people every day to firearm violence in the United States, and we have more than 200 people every day injured seriously enough to go to the emergency department. You ask me what we do? The answer is first what we do not do is try to figure out a way simply to prevent mass shootings. That won’t work. The one option we might have had in the past is closed to us now. That’s the option Australia took; they got rid of high-capacity weapons. But we have nearly as many firearms in this country as we have people; our context is different. We could ban high-capacity magazines. That would be fine. But there are tens of millions of them already in circulation. What do we do about those? We could ban further sales of assault weapons. But we need to understand there are millions of those guns in circulation in the US already. Unless we are willing to recover those weapons, we are going to continue to pay the price for the decisions we have made over the last thirty to fifty years.

We need to have solutions that will make a difference in the presence of 300 million firearms. Our chance to emulate the model set by Britain and Australia and Canada is gone. The guns are here now. We all participated at one level or another in letting that happen. And we will continue to pay a price. But we can make a difference. We can make a dent, and that’s worth shooting for.

So we work to prevent firearm violence. We require a background check for all firearm purchases. Forty percent of gun sales in the US do not involve a background check. Number two, we improve the data on which those background checks are run, so somebody whose mental illness is known in one state, that mental illness is known in all states. Improving the mental health records database would help us identify seriously mentally ill people so that they can’t buy guns. The third thing I’d recommend is we expand the criteria we now use for denying the purchase and possession of firearms. For example, under federal law we do not ban people from purchasing firearms for alcohol abuse; it doesn’t matter how serious the abuse is. We don’t ban people from purchasing firearms who have long records of violent crimes when those crimes are misdemeanors. If I beat my partner, I am prohibited [from gun ownership] for life. If I beat you up, nothing happens; I can buy guns the next day.

After what happened in Connecticut, it’s at least possible that there will be a momentum to a conversation on gun control. If it’s to be done well, what should it involve?

Assault weapons play a disproportionate role in violence generally. If we’re going to go after assault weapons, we’ll need to do so in a more comprehensive way than we did before. The two signature pieces of violence prevention legislation in the last thirty years have been the Brady Act and assault weapons ban. The assault weapons ban was a great idea, it got watered down, and it’s been very difficult to show a beneficial effect. The Brady Act, denying the purchase of firearms to people who are prohibited, that’s been shown to be effective, but at the same time not to prevent firearms homicides; because 40 percent of gun sales are not subject to the Brady Act because they are made by private parties. If you think you’re going to fail a background check, you don’t waste your time with a dealer; you go to private parties.

We know they [universal background checks and expanded denial-of-purchase criteria] are feasible, effective, and at the political level we know they’re supported not just by the general population, but by gun owners and even NRA members. Poll after poll after poll on background checks and broadening denial criteria. Gun policy in the US does not reflect the priorities of gun owners, let alone the general public. It reflects the priorities of a radical fringe of gun owners.