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Abstract
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Firearm injury has recently become the leading cause of death among American children and adolescents.1 Although the home is the most common place for school-aged children to be injured by firearms,2 firearm injuries are occurring in schools at a rate that exceeds those of other high-income countries.3 What do we know about school shootings and what can pediatricians do to address these tragedies?
In this issue of Pediatrics, Rapa et al4 present trends in kindergarten through 12th grade school shootings from 1997 through 2022. The authors look at 2 categories of events: school shootings and school mass shootings. Data on school shootings were taken from the Center for Homeland Defense and Security's School Shooting Safety Compendium,5 with "school shooting" defined as "every instance a gun is brandished, is fired, or a bullet hits school property for any reason, regardless of the number of victims, time of day or day of week." Rapa et al find that the frequency of school shooting events has increased significantly in the past 5 years compared with the prior 20 years. Data on school mass shootings were taken from the Mother Jones U.S. Mass Shootings database.6 The authors find that the frequency of school mass shootings remained steady throughout this period but that incidents became more deadly.
It is worth noting that the databases used in this study are created and maintained by individuals and organizations using publicly available data with little funding support.7 These are valuable databases for the public and for academic researchers. But the leading cause of childhood death should warrant federal resources commensurate to its burden. Progress has been made in dedicating federal funds to firearm injury research but remains inadequate; medical organizations including the American Academy of Pediatrics continue to advocate for needed federal funding for firearm research and data infrastructure.8
The most common school shooting situation involves a student,9 a handgun,10 and an "escalation of dispute."9 It is no surprise that these events are becoming more prevalent; youth handgun carrying is increasing and occurs in both rural and urban populations.11 Witnessing community violence increases high school students' risk for handgun carrying.12 Community-based prevention systems have shown reduction in youth handgun carrying in some populations13 but little is known about how pediatricians can best address this during clinical encounters. Research is needed to determine effective strategies for pediatricians in direct counseling of youth on handgun carrying.
Most school shooters obtain their firearm from the home of a parent or close relative,14 underscoring the importance of secure home storage. The most secure way to store a firearm is locked up, unloaded, with the ammunition locked and stored separately.15 Pediatricians can play an important role in firearm storage counseling, but many lack training in how to have these conversations with families. In recent years, pediatricians have created educational resources including the online module Safer: Storing Firearms Prevents Harm16 available through the American Academy of Pediatrics at no cost. Pediatricians who have taken the course report improved firearm storage counseling self-efficacy and increased counseling frequency...
Language: en |