Tag Archives: ICD-11 gaming disorder

Public health threats, politics, and taxpayer dollars

Despite the efforts of some of my collaborators, the World Health Organization will be adding Gaming disorder as a new diagnosis to the upcoming International Classification of Disease 11 in 2018. I’m feeling frustrated but resigned.

Video games have been blamed for a lot of societal woes. In the U.S., mass shootings have been linked to video game play several times in the popular press, and even indirectly through scientific papers such as this one (now retracted), that attempt to show how video game play can promote violence. Politics drives some of this. The National Rifle Association is a powerful lobby dedicated to “defending Second Amendment rights”, AKA promoting gun ownership. To this group, anything that can steer the conversation away from the how guns are involved in mass shootings (hint: guns are a prominent factor in shootings) is good for the mission.

Gun ownership is an excellent example of a causal risk factor in public health. It is a necessary, but not sufficient cause of gun deaths, mass shootings, and other firearm-related violence. It is a fact that you can’t have gun violence without guns. Reducing access to guns as a public health intervention, therefore, would be likely to reduce gun violence. Countries that have lower rates of gun ownership just do not have the rate of mass shootings that we have in the US. (Fun fact: Mass shooters in the US brought an average of four weapons with them; the recent Vegas music festival shooter had 23.)

So many possible cartoons to choose from for this

The behind-the-scenes effects of these politics are strong. They’re based in the 1996 Dickey Amendment, which said the Centers for Disease Control and Prevention (CDC) couldn’t use its money “to advocate or promote gun control”.  How did this go down?

  • The NRA accused the CDC of lobbying for gun control when some research came out that—gasp—guns kill people
  • Congress cut the CDC’s budget by $2.6 million, which coincidentally was the amount used to fund gun violence research in the previous year
  • Jay Dickey, a Republican congressman from Arkansas (and big NRA supporter), authored an amendment that prevented CDC research from being used to promote gun control (the logical conclusion of gun violence research)
  • Therefore, the CDC decided to focus its injury prevention efforts elsewhere

Meaning that the way was clear to focus/fund research efforts on potential causal factors that would be wildly insignificant compared to a causal factor that is necessary for mass shootings: access to and use of guns by individuals.

Why is this relevant to public health and video games?  Because between 2005 and 2017, $2.7 million of NIH funding has gone toward studying the effects of violent video games on violence (data compiled from the NIH RePORTER website). Fun Fact #2: That money went to only two researchers! Fun Fact #3: Exposure to violent video games has been associated with a reduction in violent crime!

Population science and gun violence research

Even if we agree with those two researchers that violent video games are a threat to public health (and we don’t), it’s hard to imagine that, at a population level, the effects of violent video games could be as significant as those of having access to guns. So let’s think about this from a population science approach:

  • You need to have guns in order to commit gun violence/mass shootings. The probability of having access to guns, given that gun violence has occurred, is 100%.
  • Therefore, interventions that reduce access to guns should reduce the probability of gun violence.
  • Violent video games do not seem to cause real world violence (and may, in fact, prevent it).
  • Therefore, interventions to reduce violent video game play are unlikely to have strong effects on gun violence, mass shootings, etc.

Yet in the last couple of decades, the US has essentially removed $2.6 million from research funding into gun violence and replaced it with $2.7 million on the effects of violent video games on violence and aggression.

From a public health perspective, this is tragic.

Next up:  The economic costs of public health “threats”