A newly released report shows the likelihood of children becoming school shooting victims has quadrupled from 1970 to 2022.

The study, published in the Journal of the American College of Surgeons (JACS) on March 6, analyzed data from the Center for Homeland Defense and Security (CHDS), which included 2,056 school shooting incidents involving 3,083 victims in a period ending in May 2022.

The data shows the number of school shootings each year has increased more than 12 times (20 incidents in 1970 to 251 incidents in 2021). Subsequently, the rate of children being school shooting victims increased from 0.49 to 2.21 per one million population. Deaths also increased more than sixfold from 0.16 to 0.97.

“As trauma surgeons, we’re tasked with caring for these shooting victims, and as such, we hoped, through our study we would be able to reveal and acknowledge an ongoing public health epidemic, not just with firearm violence in general, but school shootings specifically,” said lead study author Louis J. Magnotti, MD, MS, FACS, professor of surgery and a trauma surgeon at the University of Arizona College of Medicine.

Additional key findings include:

• Victims and shooters were predominantly male (77% and 96%)
• Nearly two-thirds of the shooters were under the age of 17
• Handguns were the most commonly used weapon (84%), followed by rifles (7%) and shotguns (4%)
• Rifles were the deadliest weapon with a fatality-to-wounded ratio of 0.45 vs. 0.41 for shooters using multiple weapons, 0.35 for handguns, and 0.30 for shotguns
• California had the most shootings (214), followed by Texas (176), and Florida (120)
• The District of Columbia had the highest rate of school shootings per 100 schools (5.5), followed by Delaware (5.4) and Louisiana (4.6)

A summary of the CHDS’ findings can also be found here.

Report Discusses Safe Firearm Storage

The researchers also highlight the issue of how children gain access to firearms.

“This underscores the necessity of responsible ownership and proper education and training for all firearm owners,” Magnotti said. “Policymakers need to address these issues by focusing on improving knowledge of secure firearm storage amongst parents, educating the school community about potential risks, and engaging in programs and policy discussions concerning strategies to limit youth access to guns.”

In the United States, unintentional injury is the fourth leading cause of death among infants and the top cause of death among children ages 1-18, with firearms being a leading injury method, according to a Dec. 2023 report from the Centers for Disease Control and Prevention (CDC). In 2021, an estimated 30 million children lived in homes with firearms, including 4.6 million in households that reported storing firearms loaded and unlocked.

According to recent data from the K-12 School Shooting Database, most school gun violence is linked to escalated disputes (30%). However, the second-most common are accidental shootings (8.5%), followed by drive-by shootings (7.8%), suicide/attempted suicide (5.7%), and shootings linked to illegal activities (5.6%).

5 Tips for Preventing School Shootings

To “curtail the trend and help prevent future school shootings,” the report authors offer five steps to address the problem “through a public health approach:”

• Defining and monitoring school shootings
• Implementing preventative interventions
• Identifying factors that pose risks or offer protection
• Testing the effectiveness of interventions
• Ensuring widespread adoption of the most successful approaches

Continuing to track gun violence on school property is critical to improving mitigation, response, and recovery from these incidents. However, while much attention is given to school shooting response, prevention must be at the forefront of school safety planning. Measures like behavioral threat assessments, site assessments, anonymous tip lines, and mental health support have proven to decrease school violence.

The researchers also suggest preventative initiatives should incorporate recommendations for safe firearm storage from the American College of Surgeons Committee on Trauma (ACS COT) Firearm Strategy Team (FAST).

“Firearm violence is a public health crisis and it needs to be addressed,” Magnotti said. “By applying this approach, we can focus our efforts on minimizing the impact of firearm violence.”

The findings and recommendations were first presented in Dec. 2023 at the Southern Surgical Association 135th Annual Meeting in Hot Springs, Virginia.

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