HSOC471 syllabus 2010
cross-listed as STSC 471 and PUBH 534
Monday, 2-5 p.m.
203 Cohen Hall
Susan B. Sorenson, Ph.D.
3815 Walnut
Office hours: By appointment - we'll find
a time that works for you
phone: 215.573-1169
e-mail: sorenson@sp2.upenn.edu
You can expect a reply
by the next business day
Survival is the essential basis of health.
In this course, we take a public health perspective on firearms. Firearms are
viewed as another consumer product.
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Everyone is entitled to their own opinion, but they are not entitled to their own facts.
Daniel Patrick Moynihan
Almost everyone seems to have an opinion about almost everything related to
guns. The goal of this course is to step away from ideological wars and take a
look at what we know and, by extension, what we don't know.*
Unanswered questions are far less dangerous than unquestioned answers.
Anonymous
You are expected to question conventional wisdom and to identify and examine
your own assumptions.
* Opinion and fact intersect in the Second Amendment. Many people, despite having no
expertise in history or in law, have strong convictions about whether the Second Amendment
confers an individual right to bear arms. In practice, the only opinion that counts is the one
issued by the U.S. Supreme Court. We will examine the basis for their 2008 ruling on the
individual right to bear arms and take their opinion as the current, operational fact.
The course
The purpose of this course is for students to gain an understanding of the role of guns in
population health. We will approach the topic with a healthy skepticism about the assumptions
and ideologies that dominate formal and informal discourse about the topic. We will view guns
as a consumer product (and examine the life span of the product beginning with design and
manufacture) and review the health outcomes of gun use. In addition, we will address key
aspects of the social context in which firearms exist and within which firearm policy is made.
The course, by design, is inherently interactive. Students are expected to attend all class sessions,
do the readings, and participate in discussions and two field experiences. In addition to my
lectures and student-led discussion about the readings, each class session will include time
during which we will discuss and guide the development of students' papers and capstone
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projects (e.g., how to formulate a testable question, identify data sources). The project and paper
time is structured as a group activity so that students can learn about multiple content areas and
methodologies. In addition, the instructor is available to meet individually with students so as to
be a resource in the planning and execution of their work.
Course objectives
At the conclusion of the course and the completion of all assignments, students are expected to
be able to:
 Critically analyze population-based information about firearm injuries (e.g., interpret data
and identify and assess health risks)
 Describe principles for improving population health (e.g., upstream vs. downstream
approaches, tensions in individual vs. collective approaches)
 Identify policies, regulations, and procedures designed to reduce injuries from firearms
(e.g., assess policy limitations and benefits)
 Refine qualitative and/or quantitative skills and apply them to a research project related
to firearms injury
Week
1.
2.
3.
4.
Date
9.13
9.20
9.27
10.4
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
10.11
10.18
10.25
11.1
11.8
11.15
11.15
11.22
11.29
12.6
Topic
Case study: “Bowling for Columbine"; Introduction to the course
Why firearms?, A few words about homicide; Research projects
Is means restriction an effective prevention approach? - suicide
Introduction to the mechanism of firearms and safe handling
Sgt. Ernest Allmond, lead firearms instructor, UPenn Police
Field trip: Depart 3815 Walnut St. promptly at 2:00 p.m.; will return by 5:00 p.m.
No class - Fall break
Legal & cultural contexts; Economic costs
SDL
Guns and the family
SDL
Prevention approaches
SDL
Final project time
Firearm industry - Manufacturing and design
SDL
Firearm industry - Marketing and sales; Distribution and secondary markets SDL
Firearm owners and users; Training and storage; video
SDL
Policy development, implementation, and evaluation
SDL
Wrap-up; student presentations
Readings and discussion
A list of articles has been compiled for this course. Most of the foundational research in this field
was conducted in the past 25 years. For the past several years, very little funding has gone into
firearm-injury research, thus, we don't have as many very recent articles to draw upon. I have
chosen those that I think are the best in the field and/or present a unique perspective. The articles
are available through Penn’s Blackboard.
The required reading load, in my opinion, is fairly modest. This is intentional. (One or two
supplemental readings also are posted for each session if you are particularly interested in the
topic and have extra time.) The lectures and readings will impart knowledge, but even more so,
as a 400-level course that students can use for their capstone, the course is designed so that you
have an opportunity to think and develop a more complex and nuanced understanding. So it will
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come as no surprise that I expect each student to do all of the readings and think about them
before (as well as in) class.
Before starting any of the readings, it will help to have a reference for unfamiliar terms that you
might encounter. A useful resource can be found under Course Documents on the Blackboard
site for the course.
After the first class session, when the instructor will review characteristics of good discussions
and discussion questions, each session will include a 20-30 minute student-led discussion. (See,
also, "Creating discussion questions" posted online under Course Documents.) Students will pair
off, develop discussion questions, and facilitate discussion about the readings. It is fine - and
sometimes preferable - to integrate information presented in previous sessions. Class session
with student discussion leaders (SDL) are marked with as such on the previous page.
Written work
Each student will complete four written assignments:

Paper 1 is a 5- to 7-page paper and is due October 18th.
The purpose of this written assignment is to spark your intellectual curiosity and to foster
critical analysis as well as to gauge what you have learned from the course. The topic for
the paper will be derived – by the student – from class lectures, discussions, and readings.
The topic must come from material from class session #1 through #6, incorporate outside
references, and demonstrate a clear analysis of the readings and discussions.
The goal of the integrative paper is to give you more practice at identifying overarching
ideas and themes across multiple sources (i.e., to understand the “big picture”) and at
critiquing articles. This is a tall order for a short paper, but core knowledge and concepts
are presented in the first few sessions and it's important that you understand them well
enough to be able to convey them concisely.

Paper 2 is a 3-page field report and is due November 15th.
The report is to be based on a visit to a gun show, gun store, or multiple websites.
Additional information regarding the report will be presented in class. To get started you
might want to review "Pennsylvania Gun Shows, Fall 2010" under Course Documents on
Blackboard.

Paper 3 is a 15-page (13 to 17 pages is fine) final paper about your project. A hardcopy is
to be submitted to the instructor's first-floor mailbox at 3815 Walnut Street no later than
noon on Wednesday, December 22nd.
Each student will conduct an independent project on a topic that interests him or her.
Several ideas for projects (archival research, qualitative research, quantitative research,
literature review & analysis) are posted under "Final papers" on the course website.
Under that same tab, you will find a list of data sources. They include sources of local
Philadelphia data as well as for state, national, and international data. Additional potential
topics and data sets will be discussed throughout the semester. Choose whatever topic
catches your interest and that you believe will best further your learning.
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o A proposal for Paper 3 is due October 25th. It should consist of 1-2 paragraphs
that provide sufficient detail so that the instructor can offer comments and
suggestions so as to make for a successful semester-long paper.
o If a student wants to use this course to meet the HSOC capstone requirement,
Paper 3 can fulfill the requirement if it is a more in-depth, high quality paper of
20-25 pages.
o If a student wants the course to count toward graduate degree requirements via
enrollment in PUBH534, Paper 3 must be a 20-25 page research proposal.
Students will present a synopsis of their work to date on their projects at the end of the
semester. Each presentation will be about 5 minutes long. If you want to use powerpoint
in your presentation, that's fine, but be sure to put 95% of your effort into the paper, not
the slides.
I am generally not all that fussy or rigid of a person, but I've learned that "a paper is not a paper
is not a paper." So...so that all students have the same amount of time and space in which to write
their papers, please note that:
 A hard copy of written work is due at the beginning of class on the due date (at noon on
12.22.10 for the final paper). There are no extensions on written work without the prior
permission of the instructor. “Prior permission” is defined as well before the due date, not
the date the assignment is due. If a paper is turned in late without prior permission of the
instructor, a penalty of one-fourth of the points for that assignment will be applied for
each day it is late.
 Papers are to be prepared using 12 pt. New Times Roman font, 1” margins, and doublespaced pages. Number the pages and stick to the page limits. In general, use whatever
reference style you wish, but do not use a footnote style - footnoting references reduces
your writing space. The list of references is not included in the page count.
 Papers should be reviewed prior to submission for correct grammar, punctuation, and
spelling.
 Students are expected to conduct themselves consistent with the University of
Pennsylvania's Code of Academic Integrity, which presents standards regarding
plagiarism, multiple submissions and other actions. If not familiar with the Code, please
refer to http://www.vpul.upenn.edu/osl/acadint.html
Evaluation
Grades will be based on leading class discussion (10%), paper 1 (25%), paper 2 (the field report:
10%), and paper 3 (45%). Points are not given for the presentation of papers during finals week,
but 5 points will be deducted for no-shows. Students who participate substantively in class
discussion throughout the semester will have their grade bumped up a half grade (e.g., a B to B+).
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Course readings
Session #1 – September 13, 2010
No readings
Session #2 – September 20, 2010 – Why firearms?; A few words about homicide
Required
Gladwell M. The tipping point (pp. 32-9). The New Yorker, June 3, 1996.
Zimring FE, Hawkins G. What Americans fear (pp.3-20). From Crime is not the problem: Lethal
violence in America, NY: Oxford University Press, 1997.
Hardin G. The tragedy of the commons. Science, 1968;162:1243-5.
Bingenheimer JB, Brennan RT, Earls FJ. Firearm violence exposure and serious violent
behavior. Science, 2005;308:1323-6.
Supplemental
Fackler ML. Gunshot wound review. Annals of Emergency Medicine, 1996;28:194-203.
Sorenson SB, Berk RA. Young guns: an empirical study of persons who use a firearm in a
suicide or a homicide. Injury Prevention, 1999;5:280-3.
Hu G, Webster DW, Baker SP. Hidden homicide increases in the USA, 1999-2005. Journal of
Urban Health, 2008;85:597-606.
Session #3 – September 27, 2010 – Is means restriction... suicide
Required
Brent DA. Firearms and suicide. Annals of the New York Academy of Sciences, 2001;932:225-40.
Ajdacic-Gross V, et al. Changing times: A longitudinal analysis of international firearm suicide
data. American Journal of Public Health, 2006;96:1752-5.
Varnik A, et al. Suicide methods in Europe: A gender-specific analysis of countries participating
in the European Alliance Against Depression. Journal of Epidemiology and Community Health,
2008;62:545-51.
Elnour AA, Harrison J. Lethality of suicide methods. Injury Prevention, 2008; 14:39-45.
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Wintemute GJ, Parham CA, Beaumont JJ, Wright M, Drake C. Mortality among recent
purchasers of handguns. New England Journal of Medicine, 1999;34:1583-9.
Supplemental
Friend T. Jumpers: The fatal grandeur of the Golden Gate Bridge. The New Yorker, October 13,
2003.
Webster DW, Vernick JS, Zeoli AM, Manganello JA. Association between youth-focused
firearm laws and youth suicides. Journal of the American Medical Association, 2004;292:594601.
Session #4 – October 4, 2010 – Intro to the mechanism of firearms and safe handling
No readings
Session #5 – October 11, 2010 – Legal and cultural contexts; Costs
Required
Read at least one of these - they each emphasize something a bit different Gostin L. The right to bear arms: Constitutional law, politics, and public health. JAMA:
Journal of the American Medical Association. 2008;300:1575-7.
Glantz LH, Annas G. Handguns, health, and the Second Amendment. New England
Journal of Medicine, 2009;360:2360-5.
Teitelbaum J, Spector E. District of Columbia v. Heller: Implications for public health
policy and practice. Public Health Reports, 2009;124:758-60.
Wright JD. Ten essential observations on guns in America. Society, 1995;32:63-68.
Kahan DM, Braman D. More statistics, less persuasion: A cultural theory of gun-risk perception.
University of Pennsylvania Law Review, 2003;151:1291-327.
Lemaire J. The cost of firearm deaths in the United States: reduced life expectancies and
increased insurance costs. Journal of Risk and Insurance, 2005;72:359-74.
Small Arms Survey Geneva. Obstructing development: The effects of small arms on human
development (pp. 142-9). Small arms survey 2003: Development denied. NY: Oxford University
Press.
Supplemental
Jiobu RM, Curry TJ. Lack of confidence in the federal government and the ownership of
firearms. Social Science Quarterly, 2001;82:77-88.
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Session #6 – October 18, 2010
No readings - Fall break
Session #7 – October 25, 2010 – Guns and the family
Required
Sorenson SB, Wiebe DJ. Weapons in the lives of battered women. American Journal of Public
Health, 2004; 94:1412-1417.
Sorenson SB. Firearms use in intimate partner violence: A brief overview. Evaluation Review,
2006;30:229-236.
Campbell JC, et al. Risk factors for femicide in abusive relationships: Results from a multisite
case control study. American Journal of Public Health, 2003;93:1089-97.
Casiano H, Mota N, Afifi TO, Enns MW, Sareen J. Childhood maltreatment and threats with
weapons. Journal of Nervous and Mental Disease, 2009;197:856-61.
Supplemental
Kellermann AL, et al. Gun ownership as a risk factor for homicide in the home. New England
Journal of Medicine, 1993;329:1084-91.
Zeoli AM, Webster DW. Effects of domestic violence policies, alcohol taxes and police staffing
levels on intimate partner homicide in large U.S. cities. Injury Prevention, 2010;16:09-5.
Session #8 – November 1, 2010 – Prevention approaches
Required
Teret SP, Wintemute GJ. Policies to prevent firearm injuries. Health Affairs, 1993;12:96-108.
Hemenway D. The public health approach to motor vehicles, tobacco, and alcohol, with
applications to firearms policy. Journal of Public Health Policy, 2001;22:381-402.
Lewin NL, Vernick JS, Beilenson PL, Mair JS, Lindamood MM, Teret SP, Webster DW. The
Baltimore Youth Ammunition Initiative: A model application of local public health authority in
preventing gun violence. American Journal of Public Health, 2005;95:762-5.
Batmanghelidjh C. Conversations in a taxi: firearms and forks. A systemic analysis of youth
crime. Clinical Medicine, 2007:7:453-5.
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Supplemental
Casiano H, Belik SL, Cox BJ, Waldman JC, Sareen J. Mental disorder and threats made by
noninstitutionalized people with weapons in the national comorbidity survey replication. Journal
of Nervous and Mental Disorders, 2008;196:437-45.
Rivara FP, Kellermann AL. Reducing the misuse of firearms (pp. 311-331). LS Doll, SE Bonzo,
JA Mercy, DA Sleet (Eds.). Handbook of injury and violence prevention. NY, NY: Springer
Science + Business Media, 2007.
Session #9 – November 8, 2010 – Final project time
No readings
Session #10 – November 15, 2010 – Manufacturing and design
Required
Sorenson SB. Policy forum: public health. Regulating firearms as a consumer product. Science,
1999; 286:1481-82.
Vernick JS, O'Brien M, Hepburn LM, Johnson SB, Webster DW, Hargarten SW. Unintentional
and undetermined firearm-related deaths: A preventable death analysis for three safety devices.
Injury Prevention, 2003;9:307-11.
Wintemute GJ. The relationship between firearm design and firearm violence. Handguns in the
1990s. JAMA: Journal of the American Medical Association, 1996; 275:1749-53.
Vernick JS, Teret SP. A public health approach to regulating firearms as consumer products.
University of Pennsylvania Law Review, 2000;148:1193-1211.
Supplemental
Vernick JS, Meisel ZF, Teret SP, Milne JS, Hargarten SW. "I didn't know the gun was loaded":
An examination of two safety devices that can reduce the risk of unintentional firearm injuries.
Journal of Public Health Policy, 1999;20:427-40.
Session #11 – November 22, 2010 – Marketing and sales; Distribution & secondary markets
Required
Vernick JS, Teret SP, Webster DW. Regulating firearm advertisements that promise home
protection. A public health intervention. JAMA: Journal of the American Medical Association,
1997;277:1391-97.
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Cook PJ, Ludwig J, Venkatesh S, Braga AA. Underground gun markets. The Economic Journal,
2007;117:F588-F618.
Wintemute GJ, Cook PJ, Wright MA. Risk factors among handgun retailers for frequent and
disproportionate sales of guns used in violent and firearm related crimes. Injury Prevention,
2005;11:357-63.
Small Arms Survey comic strip 2008.
Supplemental
Saylor EA, Vittes KA, Sorenson SB. Firearm advertising: Product depiction in consumer gun
magazines. Evaluation Review, 2004;28:420-433.
Webster DW, Vernick JS, Hepburn LM. Relationship between licensing, registration, and other
gun sales laws and the source state of crime guns. Injury Prevention, 2001;7:184-89.
Wintemute GJ. Gun shows: Gun shows across a multistate American gun market: observational
evidence of the effects of regulatory policies. Injury Prevention, 2007;13:150-5.
Kairys D. The cities take the initiative: Public nuisance lawsuits against handgun manufacturers
(pp. 363-383). In BE Harcourt (ed.), Guns, crime, and punishment in America. New York: New
York University Press, 2003.
Session #12 – November 29, 2010 – Owners and users; training and storage
Required
Kopel D, Volokh E. Loaded guns can be good for kids. Cato Institute. 1999.
Wellford DF, Pepper JV, Petrie CV (eds.). Right-to-carry laws (pp. 120-151). From Firearms
and violence: A critical review. Washington, D.C.: National Academies Press, 2005.
Hardy MS. Teaching firearm safety to children: failure of a program. Journal of Developmental
and Behavioral Pediatrics, 2002;23:71-6.
Okoro CA,et al. Prevalence of household firearms and firearm-storage practices in the 50 states
and the District of Columbia: Findings from the Behavioral Risk Factor Surveillance System,
2002. Pediatrics, 2005;116:370-6.
Supplemental
Hepburn L, Miller M, Azrael D, Hemenway D. The U.S. gun stock: Results from the 2004
national survey. Injury Prevention, 2007;13:15-19.
Hemenway D, Solnick SJ, Azrael DR. Firearm training and storage. Journal of the American
Medical Association, 1995;273:46-50.
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Session #13 – December 6, 2010 – Policy development, implementation, and evaluation
Required
Cook PJ, Ludwig J. Aiming for evidence-based gun policy. Journal of Policy and Management,
2006:25:691-735.
Hemenway D. Chapter 10 and Conclusion (pp. 209-226). From Private guns, public health.
University of Michigan Press, 2004.
Goss K. The participation paradox (pp. 23-30) and Mobilizing around modest measures: Three
cases (pp. 176-89). From Disarmed: The missing movement for gun control in America.
Princeton, NJ: Princeton University Press, 2005.
Hemenway D. How to find nothing. Journal of Public Health Policy, 2009; 30: 260-268.
Freudenberg N, Bradley SP, Serrano M. Public health campaigns to change industry practices
that damage health: An analysis of 12 case studies. Health Education and Behavior,
2009;36:230-49.
Supplemental
Suss R. Do Lego guns cause crime? A light-hearted review of case-control, cohort, and RCT
study designs. Canadian Family Physician, 2008;54:1634-5.
Vizzard WJ. Gun control and the policy process (pp. 172-180). From Shots in the dark: The
policy, politics, and symbolism of gun control. Oxford: Rowman & Littlefield Publishers, Inc,
2000.
Price JH, Dake JA, Thompson AJ. Congressional voting behavior on firearm control legislation:
1993-2000. Journal of Community Health, 2002;27:419-32.
Vernick JS, Mair JS. How the law affects gun policy in the United States: Law as intervention or
obstacle to prevention. Journal of Law, Medicine, & Ethics, 2002;30;692-704.
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