Article

School Firearm Violence Prevention Practices and Policies: Functional or Folly?

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Abstract

Firearm injuries are the third leading cause of death for youths (14% of all deaths of youths 1-19 years of age). In 2016, there were 3,155 firearm deaths of youths less than 19 years of age. Recently, school firearm violence and school shootings have received increasing attention from school personnel, policymakers, and in the mass media. However, little is known about prevention and reduction of school firearm violence. The purpose of this narrative review is to describe the current practices regarding school firearm violence prevention and uses the disease prevention and health promotion framework to describe current practices and policies on school firearm violence prevention measures. A comprehensive review of the literature was conducted from the years 2000 to 2018 to search for school-based practices to reduce firearm violence. Hundreds of millions of dollars have been spent to harden schools. None of the currently employed school firearm violence prevention methods have empirical evidence to show they actually diminish firearm violence in schools. To the extent that schools adopt ineffective firearm violence prevention measures they are creating a false sense of security. School systems need to engage in collaborative research for evidence-based practices and policy advocacy through coalition building to address state firearm laws. Schools also need to expand their mental health services and cost-effective educational interventions for reducing violence (e.g. bullying, peer mediation, conflict resolution, etc.). Hardening of schools seems to be a questionable endeavor for most schools given the dearth of evidence regarding effectiveness.

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... The 24-h, 7-days a week mass media seems to follow the axiom, ''if it bleeds, it leads,'' which creates an inescapable awareness of mass shootings. Also, people pay attention to things that scare them and they tend to overestimate the probability of rare events Price and Khubchandani 2019;Schultz et al. 2014). This disproportionate attention to mass shootings creates the public perception that mass school shootings are far more common than they are. ...
... The result of such misperception in some individuals creates a ''moral panic'' (excessive perception of a threat to social wel-lbeing; Cohen 1972). The result is that often policymakers (e.g., state legislators and college administrators) overreact to the severity of the perceived threat (e.g., permitting firearm carrying on campus and excessively arming campus police; McMahon-Howard et al. 2020;Price and Khubchandani 2019). ...
Article
The impression that college campuses are becoming more dangerous places where firearm violence is common (moral panic) is simply untrue. The result of this erroneous impression is that a contentious debate regarding whether concealed carry of firearms on college campuses makes campuses safer has been occurring on both college campuses and in state legislatures. Frequently, in such debates and policymaking, key stakeholder perceptions are not accounted for by legislators. In this article, we review the perceptions of key college stakeholders (students, faculty, administrators, staff, campus police, parents, mental health counselors, and state legislators) regarding their perceptions of campus safety and their level of support or opposition for concealed carry on college campuses. Also, we assessed the characteristics of those who supported campus carry laws and those who were opposed to such laws. Finally, we explore the effectiveness of campus carry laws. Overwhelmingly, key college stakeholders do not support concealed firearm carrying on college campuses. Those who are white, male, and conservative are more likely to support campus carry laws. Also, there is no evidence-based research to show that concealed carry campuses have less firearm violence when compared to campuses that do not have concealed carry permissions. To date, research has not found evidence that concealed carry makes campuses safer. Additional research is essential to determine the impact of concealed carry on college campuses.
... Safe-storage interventions have shown impacts on youth suicide attempts and unintentional firearm injuries but weaker effects on reducing firearm assaults and homicides among youth (Hepburn, Azrael, Miller, & Hemenway, 2006;Webster, Vernick, Zeoli, & Manganello, 2004;Xuan & Hemenway, 2015). Many school-based programs and technological interventions have also not been adequately evaluated to determine their impact in reducing youth firearm violence (David-Ferdon & Simon, 2014;Price & Khubchandani, 2019). Additionally, behavioral or cognitive based programs that are not implemented as part of a comprehensive strategy show "limited promise for reducing youth gun violence" (Hardy, 2002, p. 101). ...
Article
Firearm homicide and suicide are the leading causes of violence-related injury deaths among U.S. youth. However, evaluations of the effectiveness of firearm violence prevention programs and strategies to reducing youth firearm violence are limited. To help inform and evaluate such efforts, this study aimed to identify risk and protective factors associated with youth firearm access, possession or carrying (for reasons other than hunting or target shooting) among a sample of U.S. urban youth in the Mountain West. Findings show the influence that youth violence risk (e.g., having friends engaged in delinquency; violence; drug sales; gang fights; exposure to violence; screening positive for violence risk) can have on youth firearm access, possession or carrying. Implications for prevention and intervention are discussed.
... measures in reducing school crime and student victimization, with most studies showing ineffective or inconclusive results (Devlin & Gottfredson, 2016;Fisher, Higgins, & Homer, 2019;Gonzalez, Jetelina, & Jennings, 2016;Hankin, Hertz, & Simon, 2010;Jennings, Khey, Maskaly, & Donner, 2011;Monahan & Torres, 2010;Na & Gottfredson, 2013;Price & Khubchandani, 2019;Tanner-Smith, Fisher, Addington, & Gardella, 2018). ...
Article
Important aspects of the school context include the presence of physical security measures, especially those that focus on the monitoring and control of students such as security guards and security cameras, and social school environment factors, such as adult support and perceived fairness. Using data from the 2015 National Crime Victimization Survey – School Crime Supplement, the current study explored the relationships between school security measures in schools, school social environment factors, and student fear of crime and avoidance behavior. The results indicate that the school security measures and school social environment are associated with students’ fear of crime and avoidance, and they suggest that schools need to reconsider the use of security measures and to focus on fair development and implementation of school rules instead.
... An important question to consider at this point is, does "hardening schools" prevent this issue? As outlined by Price and Khubchandani (2019), millions of dollars have been spent on funding the training of SRO's, teachers and staff, and law enforcement on hardening schools against firearm violence. Despite these expenditures, they have little to no impact on firearm homicides and suicides. ...
Article
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In recent years, there has been a growing social, educational, and public policy focus on investigating the correlates associated with youth carrying weapons in their communities and schools. Victimization and other correlates such as drug use and violent risk behaviors among youth have been linked to deviant behavior including weapon carrying. What remains uncertain is how the intersection of sex and race/ethnicity moderate these potential risk factors linked with weapon carrying. Analyses, which draw from the 2015 Youth Risk Behavior Surveillance System (YRBS) data, investigate whether or not sex and race/ethnicity play a role in the relationships between victimization, other risk factors, and weapon carrying (i.e., carrying a gun and bringing a weapon to school). In addition to discussing the findings of this study, this research underscores the importance of understanding the intersection of sex and race/ethnicity when examining youth violence, especially in regards to carrying weapons to school.
... Not surprisingly, increasing the number of guns in school is quite controversial [39,48,49]. A literature review of current practices regarding school firearm violence prevention concluded that while hundreds of millions of dollars have been spent to harden schools, "none of the currently employed school firearm prevention methods have empirical evidence to show that they actually diminish firearm violence in schools" [50]. ...
Article
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Purpose of Review To update current understanding of the extent and impact of firearm violence in the USA. Recent Findings In the past decade, rates of firearm injury have increased in the USA, both absolutely and in comparison to other high-income countries. Firearm homicides, firearm suicides, and public mass shootings have all been increasing. Firearm homicide rates remain highest for young non-White males in urban areas, and firearm suicide rates remain highest for older White males in rural areas. The burden of all these shootings falls not only directly on the victims themselves but also can impact their families, friends, and communities. These more indirect costs include medical care, grief, fear, hopelessness, and PTSD. The negative effects of exposure to firearm violence have been highlighted in the literature. Individual and community efforts to prepare for and prevent the shootings entail additional costs and burdens. Summary The scope of the US gun problem in 2019 is far greater than is indicated merely by medical costs and body counts.
... Schools have employed a variety of safety strategies (e.g., SROs and metal detectors) in response to mass shootings that aim to prevent crises (Muschert, Henry, Bracy, & Peguero, 2014). Although the actual impacts that these crisis prevention strategies have had on mass shootings are equivocal (Price & Khubchandani, 2019), these strategies have a collateral effect: When not being used to thwart the uncommon school shooting, they instead serve to increase the capacity of schools to identify and punish students for less serious offenses. These less serious offenses, like disorderly conduct and disruption of an educational environment, have consequently become more common than assault and weapons violations (Advancement Project, 2018;Theriot, 2009). ...
Article
Policy responses to gun violence within K-12 school systems have not stopped the increasing frequency of their occurrence, but have instead increased racial and ethnic disparities in multiple forms of discipline. The crisis prevention policies that follow school shootings tend to exacerbate racial and ethnic discipline disparities (a) within schools as practitioners enact policies with discretion and bias, (b) between schools where policy is complicated by racial segregation, and (c) indirectly where academic consequences accrue to those who are not disciplined but attend schools with elevated school rates of discipline. Among the most promising policy alternatives to punitive disciplinary policy is restorative justice.
... There are urgent concerns associated with suicidal behaviors among Black people. Between 2001 and 2017, the rates of Black suicide has been rising (Price and Khubchandani, 2019). Because rates of suicides among Black people are lower than rates among White people, assessment of preventive factors and examination of suicide etiology among Black adults have been vastly overlooked. ...
Article
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The objective of the study was to examine the association between lifetime arrest and marijuana-related first arrest with past-year suicide ideation among Black and White people. We used data from Wave-IV (2008–2009; N = 5114) of the publicly available National Adolescent Health Study (Add Health) data. A total of 4313 Non-Hispanic Black and White participants were selected for this study. Logistic regression was used to assess whether lifetime arrest and marijuana-related arrests were associated with past year suicide. Overall, 28.8% of the sample reported lifetime arrest, 6.3% reported lifetime suicide ideation, and 3.7% reported marijuana-related arrest. A significantly higher percentage of Black people (32.3%) in comparison to White people (27.4%) reported lifetime arrest (χ ² = 9.91; p < 0.001; df = 1). Among Black people, lifetime arrest (AOR = 2.98; 95% CI, 1.66–5.35; p < 0.001) and marijuana-related arrest (AOR = 4.09; 95% CI, 1.47–11.35; p < 0.001) were both associated with lifetime suicide ideation. Given the rate of death by suicide among Black people has been rising for two decades, further efforts are needed to educate and inform key stakeholders including law enforcement and policymakers regarding racial disparities in arrests, which may contribute to reducing risk for death by suicide among Black people.
... The vast majority of youths who are killed with firearms are from intentional shootings (e.g., homicides and suicides). 2 In contrast, unintentional firearm-related deaths, especially in African-American (AA) youths, have not been adequately explored. Unintentional firearm mortality is commonly called "accidental" deaths, implying nothing could be done to prevent them. ...
Article
Background/ Purpose There is a dearth of studies that have examined unintentional firearm-related mortality in African–American (AA) youths. The purpose of this article is to assess the epidemiology of unintentional firearm mortality in AA youth, examine the risk factors associated with unintentional AA youth firearm mortality, and explore the evidence for preventing unintentional firearm-mortality in AA youths. Methods In this cross-sectional study, the Web-Based Injury Statistics Query and Reporting System (WISQARS) data from the Centers for Disease Control and Prevention (CDC) was used. Data were analyzed from the years 2010–2019 using descriptive statistics. Results Between the years 2010 and 2019, the AA youth unintentional firearm mortality rate increased by 48% while the rate for White youths declined by 29%. The decade from 2010 to 2019 saw almost 400 AA youths lose their lives to unintentional firearm trauma. AA male children averaged 87% of all AA unintentional firearm deaths during this time. The years of potential life lost due to unintentional firearm mortality ranged between 21,200 and 24,300 years. The risk factors for unintentional firearm mortality in AA youths include living in states with high rates of firearm ownership, living in a home with firearms, being an older adolescent, and being of lower socioeconomic status. Of all the strategies to prevent unintentional firearm mortality in youths, the most effective include strong (felony penalty) Child Access Prevention laws, the absence of Stand-Your-Ground laws, and physicians engaging in anticipatory guidance with patients regarding safe storage of firearms. Conclusions Despite the limited scale of unintentional firearm mortality in AA youths, primary prevention dictates that public health professionals intervene to keep this public health problem from becoming an epidemic and a larger contributor to health disparities.
... For example, schools should be able to request funding for implementing counseling programs and mental health screening tools as a means of increasing school safety. Additionally, given that the effectiveness of various school violence prevention strategies have been largely inconclusive 29 , funding agencies should require, as a part of the request for proposals, that schools state how they will empirically evaluate the effectiveness of the school safety approach that will be funded. Collaboration between schools and local research institutions may be one way to efficiently explore the cost-effectiveness of a diverse array of violence prevention strategies. ...
Article
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This article introduces a three-dimensional conceptual framework around approaches to promoting school safety practices in the United States. Our framework suggests school safety is maximized when three hardening dimensions are equally deployed-physical hardening (school's environmental elements), procedural hardening (school's policies and procedures), and psychological hardening (school's strategies used to improve psychological wellbeing). A systematic review of the literature was completed and organized in the context of our three-dimensional framework to identify current hardening practices that have been empirically investigated. Among the 41 studies identified by our search criteria, 28 included physical hardening practices, 12 included procedural hardening practices, and 21 included psychological hardening practices. Few studies (n=8) included all three hardening practices within their efforts to promote school safety. The most commonly studied variables were school resource officers, locker checks, and clear and fair rules. Implications of this three-dimensional conceptual framework for future school safety research and policy directions in the United States are highlighted.
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This chapter finds lessons for feminist vigilance in the work of a national gun control organization, Moms Demand Action for Gun Sense in America (Moms). A moral mandate of care undergirds the organization’s work—the protection of children. Sotirin examines two signature Moms campaigns: the Be SMART campaign focused on parental responsibility for gun accessibility; and a coalition effort with other gun safety and education organizations to eliminate gun violence in schools that includes a protest against active shooter drills. She characterizes these campaigns as civic action based in vigilant care. The lessons they offer frame a feminist vigilance of anger, care, and hope alert to the possibilities for nonviolent futures.
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Shootings in schools remain common in the United States, and incite particular outrage as the lives of students, many of whom are minors, are put at risk. The reasons for school shootings may be related to exposure to violence, firearm access, or lack of support for mental health or depression issues. Creating safer schools will require consistent, widespread national legislation to respect school environments and to support those with underlying mental health conditions or socially limited communities.
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Purpose This study aims to examine parent perceptions of school active shooter preparedness and prevention efforts, as well as parent perceptions of the risk of an active shooter event. Design/methodology/approach Data were obtained in 2019 through an online survey of 182 Pennsylvania residents who were the parents or step-parents of children enrolled in pre-Kindergarten, Kindergarten-12th or college/ university. Respondents were a subset of a state-representative sample of 668 individuals. Findings Actions taken by schools were largely unrelated to parent perceptions. Parents who reported that their child’s school had provided information about active shooters to students had better attitudes toward preventive efforts overall. Parents who reported that their child’s school had changed firearms policy perceived a higher level of risk. Parents were also asked to share what they felt their child’s school could do that would help them feel more prepared for an active shooter event. The most common response was for schools to install metal detectors or perform random metal detector checks. Originality/value While there is extensive research on the views of students about school safety and security and, to a lesser degree, the views of school administrators and teachers, parents have largely been neglected in school safety research.
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Despite data indicating that schools are safe, and safer today than they were 20 years ago, it is not uncommon for both the general public and school policymakers to exaggerate safety threats following high-fatality school shootings such as the attack on Marjory Stoneman Douglas High School in Parkland, Florida. Often this leads to reactionary policies not supported by science. This paper reviews current school safety policy making efforts, with special attention directed to a policy analysis conducted by the Education Commission of the States, reviews the literature surrounding school safety approaches, and draws contrasts between the two. Implications for school psychology practice and for school safety advocacy are discussed.
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A serious information gap exists between current practices to address threats of violence in pre-K-12 school settings in the USA and research on school climate and best practices in violence prevention. This article explores the nature and extent of gun violence on American school campuses and examines responses by school administrators and policymakers to address these threats. Further, it explores research that suggests that many efforts to prevent or prepare for gun violence in schools, such as zero-tolerance policies, profiling, physical security measures, lockdowns, and active shooter drills, may not only be misguided but may also cause significant unintended harm to children. Finally, it examines current research that points to policies and practices that are more likely to foster safe and humane school settings.
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Background: Although less than 2% of all homicides among young people are school-associated, since 1970 1373 K-12 school gun violence incidents have injured 1403 people and killed another 728. These incidents have changed the education landscape. Informed stakeholders must work together to prevent school gun violence. Methods: We reviewed the nature of school gun violence in the United States and efforts to prevent it. Results: We briefly outline a public health approach to prevent school gun violence, major actions the nation has taken, current school gun violence surveillance systems, the effects of school gun violence nationwide, the extent to which our schools are implementing various interventions to prevent it, and a national strategy to move forward. Conclusions: Our young people and our schools deserve a more organized national effort.
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What approaches and methods can be employed that will effectively reduce the risk of antisocial behaviour and of other criminal offending in schools? We report an evidence review involving a search of eight electronic databases from 2010 to 2020. This produced 6331 unique items and a final set of 49 review articles and 116 research studies. Only a small amount of evidence supported direct placement of police personnel in schools risked opening a “school-to-prison pipeline”. It is possible to reduce levels of several types of problems amongst school students, of kinds that are associated with participation in delinquency and adult crime including reduction of bullying, other forms of conflict and aggression, dating and relational violence and risk of involvement in alcohol and drug abuse. School-wide interventions that emphasize social norms emerged more positively than selectively targeted interventions. Disciplinary responses to violations worked best in a positive and supportive school climate rather than responses that emphasized security or punishment. Police services can advise and engage in multi-agency initiatives through liaison roles, highlighting potential links between problems exhibited in schools and the appearance of more serious delinquent activity.
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Background: This study evaluated trends and risk factors over time for self-reported gun carrying among freshman and sophomore public school students in Chicago, New York City and Los Angeles, chosen as high profile cities with different levels of firearm violence. Methods: The study used four biennial waves (2007-2013) of the Youth Risk Behavior Survey (YRBS), an anonymous, voluntary survey of public high school students. Analyses were restricted to freshman and sophomores given significant high school dropout rates among older students. School population weighted results are presented based on the YRBS complex survey design, including comparisons of reported gun carrying across survey waves and cities. A violence index was created from eight survey items that capture students' perceived threat level. Chi square tests and multivariable Poisson regression analyses were used to test the significance of differences across cities and over time in the likelihood of gun carrying controlling for sociodemographic characteristics, mental health risk factors and behavioral risk factors. Results: The study included a total weighted population estimate of 1,137,449 students across the three cities and four survey waves. Mean self-reported gun carrying across all survey waves was 8.89% in Chicago, 4.09% in New York City, and 6.03% in Los Angeles (p < 0.001). There were no significant changes in gun carrying prevalence within each individual city over the survey waves. Multivariable Poisson regression estimates showed increased likelihood for gun carrying among males (IRR 1.41, CI 1.27-1.58), among non-Hispanic Blacks (IRR 1.26, CI 1.07-1.48), and among those who reported a higher violence index. Each additional violence index count increase was associated with a 1.74 times (CI 1.70-1.78) increased likelihood for gun carrying. Conclusions: There was a much higher self-reported rate of gun carrying and a higher burden of violence exposure in Chicago as compared to New York City and Los Angeles. Students' exposure to violence extended to other stressors illuminated by the YRBS including fighting, perceptions of safety, and other high-risk behaviors. Through the violence index we created, we are better able to categorize the most high-risk individuals and describe the magnitude of their increased likelihood to carry a gun.
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African American youths have the highest risk for firearm and other weapon related homicides. This study utilized the national Youth Risk Behavior Surveys from 2001 to 2015 to assess trends in violence related behaviors and weapon carrying of African American adolescents. Our analyses found statistically significant reductions in physical fighting and weapon carrying among African American male adolescents from 2007 to 2015. Planning suicide increased in both male and female African American adolescents since 2007. In addition, the number of firearm homicides increased in African American males. African American females and males had groups of items highly predictive of weapon carrying behaviors: alcohol, tobacco, and other drug use and violent risk behaviors. Both female and male students who made mostly A’s or B’s in school were significantly less likely to carry weapons in and out of school. Our findings indicate that firearm homicides have increased in African American adolescents, but weapon carrying in school going adolescents has significantly declined. School engagement and satisfactory school performance seems to have a significant protective effect on firearm homicides and violent behavior risks in African American adolescents.
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I analyze attitudes towards gun control from a recent survey of American high school students. For students who most closely identify as Republicans, cueing them to think about prior school shootings increases their agreement that armed staff in schools will improve safety and arming citizens will reduce risk of mass shootings. For those identifying as Democrats and Independents, providing them with selective information that certain states have loose gun control laws and low rates of gun violence makes them more supportive of gun rights. For Republicans, providing selective information that certain states have loose gun control laws and high rates of gun violence makes them less supportive of gun rights. These results suggest that emotional cues may exacerbate a priori biases, while informational cues may be more likely to change people's minds about firearm policies.
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Hispanic youths are disproportionately represented in gangs in the United States, are more likely to drink alcohol at younger ages, and to live in poverty; all are risks for violence and weapon carrying. No studies to date have assessed violence related behaviors and weapon carrying in Hispanic youth over an extended period. This study utilized the national Youth Risk Behavior Surveys from 2001 to 2015 to assess trends in violence related behaviors and weapon carrying of Hispanic adolescents. Our analyses found both physical fighting and fighting on school property had statistically significant reductions from 2001 to 2015 for Hispanic females and their suicide attempts increased from 2009 to 2015. Hispanic males had statistically significant decreasing trends for: being in a physical fight in the past year, being bullied on school property, being in a physical fight on school property within the past year; threatened or injured with a weapon on school property in the past year; and having attempted suicide in the past year. Hispanic females and males had two groups of items highly predictive of weapon carrying behaviors: alcohol, tobacco, and other drug use and violent risk behaviors. Both female and male students who made mostly A’s or B’s in school were significantly less likely (about half as likely) to carry weapons. This data could be used to identify Hispanic adolescents at higher risk for weapon carrying and used as a basis for enriching programs to improve academic success of Hispanic adolescents.
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Public school systems in America have come under scrutiny due to the harsh treatment of students by School Resource Officers (SROs). Incidents of armed, uniformed police in schools affecting physical arrests in American classrooms seem to be ever more frequent in news cycles, likely due to the ease of capturing these events on video via cell phones of bystanders. Of particular note, visceral reports of “heavy-handed” SROs reinforce a consistent narrative from some media outlets suggesting that the simple presence of these officers inside schools leads to student arrests for behaviors that can arguably be dealt with by the school administration in a reintegrative manner. The apparent lack of school discretion and the presence of strict zero tolerance policies are at the root of an issue that has been termed the “School to Prison Pipeline” by mass media. SROs are often the exclusive focus of this issue, typically as a symbol of a school’s dedication to strict enforcement of rigid rules.
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Purpose Gun access and bullying are risk factors for sustaining or perpetrating violence among adolescents. Our knowledge of gun access among bullied students is limited. Methods We used data on students, aged 12–18 years, from the 2011 and 2013 School Crime Supplement to the National Crime Victimization Survey to assess the association between self-reported bullying victimization (traditional and cyber) and access to a loaded gun without adult permission. Prevalence ratios (PRs) and confidence intervals (CIs) were obtained from multivariable Poisson regression using the Taylor series after controlling for student age, sex, family income, public/private school, and race. Results Of 10,704 participants, 4.2% (95% CI: 3.8%–4.6%) reported gun access. Compared with nonbullied students, those who reported traditional bullying (PR = 2.2; 95% CI: 1.7–2.4), cyberbullying (PR = 2.8; 95% CI: 1.6–4.9), and both (PR = 5.9; 95% CI: 4.6–7.7) were more likely to also report gun access. Conclusions Adolescents who experience bullying, particularly those who report both traditional bullying and cyberbullying, are more likely to report access to a loaded gun without adult permission. These findings highlight the importance of developing interventions focused on these modifiable risk factors for preventing self-directed or interpersonal violence among youth.
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Firearm violence remains a significant problem in the US (with 2787 adolescents killed in 2015). However, the research on school firearm violence prevention practices and policies is scant. Parents are major stakeholders in relation to firearm violence by youths and school safety in general. The purpose of this study was to examine what parents thought schools should be doing to reduce the risk of firearm violence in schools. A valid and reliable questionnaire was mailed to a national random sample of 600 parents who had at least one child enrolled in a public secondary school (response rate = 47%). Parents perceived inadequate parental monitoring/rearing practices (73%), peer harassment and/or bullying (58%), inadequate mental health care services for youth (54%), and easy access to guns (51%) as major causes of firearm violence in schools. The school policies perceived to be most effective in reducing firearm violence were installing an alert system in schools (70%), working with law enforcement to design an emergency response plan (70%), creating a comprehensive security plan (68%), requiring criminal background checks for all school personnel prior to hiring (67%), and implementing an anonymous system for students to report peer concerns regarding potential violence (67%). Parents seem to have a limited grasp of potentially effective interventions to reduce firearm violence.
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Suicidal ideation and suicide attempts are more common in Latina adolescents than White or African– American adolescents. Several health risk behaviors have been identified as being associated with Latina adolescent suicides. However, to date, no study has identified the consistency and stability of these risk behaviors over time. This study utilized the national Youth Risk Behaviors Survey from 2001 to 2013 to estimate the prevalence of suicidal ideation, suicide attempts, and health risk behaviors associated with suicidal behaviors in Latina adolescents. Our analysis found the prevalence of suicidal ideation and suicide attempts varied significantly over the 13-year study span, decreasing from 2001 to 2009 and increased from 2011 to 2013. The analyses found 11 health risk behaviors that were significantly associated with both suicidal ideation and suicide attempts that did not vary ove time. The stability of these 11 health risk behaviors associated with suicidal behaviors could be useful to school personnel to identify early at risk Latina adolescents who may benefit from school and community mental health resources.
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This study assessed the perceptions and practices of a national sample of secondary school principals regarding reducing firearm violence in high schools. Data were collected via three-wave postal mailings. A 59-item valid and reliable questionnaire was mailed to a national random sample of 800 secondary school principals. Of the 349 principals (46 %) that responded, 17 % reported a firearm incident at their school in the past 5 years. Principals perceived inadequate parental monitoring (70 %), inadequate mental health services (64 %), peer harassment/bullying (59 %), and easy access to firearms (50 %) as the main causes of firearm violence in schools. The three barriers to implementing firearm violence prevention practices were: lack of expertise as to which practices to implement (33 %), lack of time (30 %), and lack of research as to which practices are most effective (30 %). Less than half of schools trained school personnel regarding firearm violence issues. The findings indicate that firearm incidents at schools may be more common than previously thought. A significant portion of principals are at a loss as to what to implement because of a lack of empirical evidence on what is effective. More research is needed to find the most effective school interventions for reducing firearm violence.
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Purpose The goal of the current study is to assess the perspectives of law enforcement executives and public school principals regarding SROs, armed teachers, and armed school administrators in order to inform the policy discussion surrounding school safety issues. Design/methodology/approach This study utilizes data collected from two surveys that were sent to law enforcement executives and public school principals in South Carolina. Respondents were asked about their experience with SROs and their perspectives on these officers’ ability to maintain school safety. Both groups of respondents were also asked about their attitudes regarding arming school employees. Findings There is a large amount of support for SROs from both law enforcement executives and principals. However, in general, both groups of respondents do not believe armed administrators or armed teachers to be an effective school safety strategy. Originality/value SROs have been the primary strategy adopted by schools to maintain safety, but in the wake of the shooting at Sandy Hook Elementary School, public outcry and political debate has spawned a number of proposed alternatives. Among these alternative security measures has been the idea of arming school teachers and/or administrators. However, there appears to have been little effort to empirically consider the perspectives of those directly impacted by school safety policy decisions. In particular, a gap in the literature remains regarding the perceptions of police executives and school principals concerning school safety policies and how the attitudes of these key actors compare. Thus, the current study addresses this gap by exploring the perspectives of key school safety stakeholders.
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Risky behaviors contribute to a host of teenage misfortunes, including high rates of sexually transmitted diseases, teen pregnancies, and accidental deaths. This state-level study examines whether these behaviors also contribute to unintentional firearms fatalities in juvenile populations. Controlling for indicators of socioeconomic status, social disorganization, and the firearms density, the authors found that these unintentional deaths are consistently associated with state-level indicators of risky behavior. Accidental firearms deaths were also associated with rural populations as well as reductions in socioeconomic status. Also examined were the influences of child access prevention (safe storage), overall firearms laws, and background checks on firearms fatalities. Contrary to initial expectations, child access prevention laws were significantly associated with lower rates of unintentional firearms fatalities in the general population but were not associated with reductions in accidental firearms deaths in juvenile populations.
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Objectives: We investigated how state-level firearms legislation is associated with firearm ownership and storage among families with preschool-aged children. Methods: Using 2005 nationally representative data from the Early Childhood Longitudinal Study-Birth Cohort (n = 8100), we conducted multinomial regression models to examine the associations between state-level firearms legislation generally, child access prevention (CAP) firearms legislation specifically, and parental firearm ownership and storage safety practices. Results: Overall, 8% of families with children aged 4 years living in states with stronger firearm laws and CAP laws owned firearms compared with 24% of families in states with weaker firearm laws and no CAP laws. Storage behaviors of firearm owners differed minimally across legislative contexts. When we controlled for family- and state-level characteristics, we found that firearm legislation and CAP laws interacted to predict ownership and storage behaviors, with unsafe storage least likely among families in states with both CAP laws and stronger firearm legislation. Conclusions: Broader firearm legislation is linked with the efficacy of child-specific legislation in promoting responsible firearm ownership.
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Adding to the body of research that describes students who will bring weapons to school, the current research examined middle-school students' willingness to report when they know someone has a weapon at school. The sample included 1,957 sixth, seventh, and eighth graders from 27 schools in five states. Overall, a majority of students indicated that they would be willing to report; however, there were significant effects for the conditions of reporting (such as anonymity) and effects for some demographic characteristics. Furthermore, students who perceived adult or parental involvement in their lives were more willing to report. In contrast, students with delinquent involvement (self or peers) were significantly less likely to report the presence of weapons.
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: media-1vid110.1542/5789654953001PEDS-VA_2017-3318Video Abstract OBJECTIVES: Firearms are a leading cause of injury and death for children and adolescents in the United States. We examined how hospitalization rates for firearm injuries differ for rural and urban populations. Methods: The Kids' Inpatient Database was used to identify hospitalizations for firearm injuries in patients <20 years of age by using International Classification of Diseases, Ninth Revision external-cause-of-injury codes. Data from 2006, 2009, and 2012 were analyzed to compare demographics and intent (assault, self-inflicted, unintentional, and undetermined). Urban-rural classification was based on patients' county of residence. Rates were calculated by using weighted cases and US Census data. Results: There were 21 581 hospitalizations for firearm injuries. The overall hospitalization rate was higher in urban versus rural areas (risk ratio [RR] = 1.95; 95% confidence interval [CI]: 1.81-2.10). Rates were highest for assaults in urban 15- to 19-year-olds (RR = 7.82; 95% CI: 6.48-9.44). Unintentional injuries were the leading cause of hospitalizations in younger age groups in all urban and rural locations. Rates for unintentional injuries were lower among urban versus rural 5- to 9-year-olds (RR = 0.47; 95% CI: 0.36-0.63) and 10- to 14-year-olds (RR = 0.44; 95% CI: 0.37-0.52). Conclusions: Hospitalizations for firearm assaults among urban 15- to 19-year-olds represent the highest injury rate. Notably, hospitalizations are lower for urban versus rural 5- to 9-year-olds and 10- to 14-year-olds, and unintentional firearm injuries are most common among these groups. Preventative public health approaches should address these differences in injury epidemiology.
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Data from a nationally representative probability-based online survey sample of US adults conducted in 2015 (n = 3949, response rate 55%) were used to assess self-reported gun storage practices among gun owners with children. The presence of firearms and children in the home, along with other household and individual level characteristics, was ascertained from all respondents. Questions pertaining to household firearms (how guns are stored, number, type, etc.) were asked only of those respondents who reported that they personally owned a gun. We found that approximately one in three US households contains at least one firearm, regardless of whether children lived in the home (0.34 [0.29–0.39]) or not (0.35 [0.32–0.38]). Among gun-owning households with children, approximately two in ten gun owners store at least one gun in the least safe manner, i.e., loaded and unlocked (0.21 [0.17–0.26]); three in ten store all guns in the safest manner, i.e., unloaded and locked (0.29, [0.24–0.34]; and the remaining half (0.50 [0.45–0.55]) store firearms in some other way. Although firearm storage practices do not appear to vary across some demographic characteristics, including age, sex, and race, gun owners are more likely to store at least one gun loaded and unlocked if they are female (0.31 [0.23–0.41]) vs. male (0.17 [0.13–0.22]); own at least one handgun (0.27 [0.22–0.32] vs. no handguns (0.05 [0.02–0.15]); or own firearms for protection (0.29 [0.24–0.35]) vs. do not own for protection (0.03 [0.01–0.08]). Approximately 7% of US children (4.6 million) live in homes in which at least one firearm is stored loaded and unlocked, an estimate that is more than twice as high as estimates reported in 2002, the last time a nationally representative survey assessed this outcome. To the extent that the high prevalence of children exposed to unsafe storage that we observe reflects a secular change in public opinion towards the belief that having a gun in the home makes the home safer, rather than less safe, interventions that aim to make homes safer for children should address this misconception. Guidance alone, such as that offered by the American Academy of Pediatrics, has fallen short. Our findings underscore the need for more active and creative efforts to reduce children’s exposure to unsafely stored firearms.
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This article provides a brief history of the development of the federal model of school threat assessment, which was created by the U.S. Secret Service and U.S. Department of Education based upon findings from their empirical research on school shootings across the USA. The article reviews the major findings from that behavioral research, which demonstrates how it is possible to prevent school shootings and other targeted violence in school. The article also describes the components of this evidenced-based federal model and implementation guidance for schools and districts within the USA as well as other countries. The article concludes with the lessons learned by the authors and their colleagues in using the federal school threat assessment model to handle individual school threat cases and in training tens of thousands of other school, law enforcement, and mental health professionals how to use threat assessment to prevent school violence.
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Background: State-level Child Access Prevention (CAP) laws impose criminal liability on adults who negligently allow children access to firearms. CAP laws can be further divided into strong CAP laws which impose criminal liability for negligently stored firearms and weak CAP laws that prohibit adults from intentionally, knowingly, and/or recklessly providing firearms to a minor.We hypothesized that strong CAP laws would be associated with a greater reduction in pediatric firearm injuries than weak CAP laws. Methods: We constructed a cross-sectional national study using the HCUP-Kids Inpatient Database from 2006 and 2009 using weighted counts of firearm related admissions among children <18 years. Poisson regression was used to estimate the association of CAP laws with pediatric firearm injuries. Results: After adjusting for race, sex, age, and socioeconomic income quartile, strong CAP laws were associated with a significant reduction in all (incidence rate ratio 0.70; 95% confidence interval 0.52 to 0.93), self-inflicted (incidence rate ratio 0.46; 95% confidence interval 0.26 to 0.79), and unintentional (incidence rate ratio 0.56; 95% confidence interval 0.43 to 0.74) pediatric firearm injuries. Weak CAP laws, which only impose liability for reckless endangerment, were associated with an increased risk of all pediatric firearm injuries. Conclusions: The association of CAP laws on hospitalizations for pediatric firearm injuries differed greatly depending on whether a state had adopted a strong CAP law or a weak CAP law. Implementation of strong CAP laws, which require safe storage of firearms, by each state has the potential to significantly reduce pediatric firearm injuries. Level of evidence: Level III, prognostic and epidemiology study.
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Prior research has suggested that the use of police in schools has resulted in negative outcomes for students; however, this line of research has failed to consider other factors that may influence an officer’s response outside of their mere presence. Over time, the roles and duties of police in a school setting have continued to expand as a result of social and political shifts in criminal justice and education policy. Paralleling this expansion has been the development of a more punitive school discipline environment where students are more likely to be suspended, expelled, a ticketed, and/or arrested. As these two separate bodies of research have been tangentially related, in this study, we use role theory as a guiding framework to connect these two bodies of research and examine how officers’ roles may influence their responses to student misconduct. Data was collected via an online survey distributed to a sample of commissioned law enforcement officers working in Texas schools. The survey included measures of officer roles as well as vignettes to assess how officers would respond to specific situations involving students. Results of this study suggest that an officer’s role may influence how they respond to student misconduct, and therefore, may be an important piece of information for both researchers and practitioners when looking to minimize the potential negative impacts of using police in schools. These findings related to officer roles are discussed in terms of both practice and future research, while considering the larger discipline environment of schools.
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In response to continued concerns over crime and violence, schools are increasingly employing visible security measures such as cameras, metal detectors, and security personnel. These security measures are not mutually exclusive, but few studies have considered the relationship between the use of multiple forms of security and youth’s exposure to drugs, fighting, property crime, and firearms at school. To address this issue, we analyzed nationally representative school administrator-reported data from the School Survey on Crime & Safety, using a quasi-experimental design with propensity scores to adjust for potential confounding factors. The results indicated that utilization of multiple security measures reduced the likelihood of exposure to property crime in high schools, but most other security utilization patterns were associated with poorer school safety outcomes. Our findings provide guidance to policymakers in considering whether to use – or expand – visible school security measures in schools.
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Objectives: Examine fatal and nonfatal firearm injuries among children aged 0 to 17 in the United States, including intent, demographic characteristics, trends, state-level patterns, and circumstances. Methods: Fatal injuries were examined by using data from the National Vital Statistics System and nonfatal injuries by using data from the National Electronic Injury Surveillance System. Trends from 2002 to 2014 were tested using joinpoint regression analyses. Incident characteristics and circumstances were examined by using data from the National Violent Death Reporting System. Results: Nearly 1300 children die and 5790 are treated for gunshot wounds each year. Boys, older children, and minorities are disproportionately affected. Although unintentional firearm deaths among children declined from 2002 to 2014 and firearm homicides declined from 2007 to 2014, firearm suicides decreased between 2002 and 2007 and then showed a significant upward trend from 2007 to 2014. Rates of firearm homicide among children are higher in many Southern states and parts of the Midwest relative to other parts of the country. Firearm suicides are more dispersed across the United States with some of the highest rates occurring in Western states. Firearm homicides of younger children often occurred in multivictim events and involved intimate partner or family conflict; older children more often died in the context of crime and violence. Firearm suicides were often precipitated by situational and relationship problems. The shooter playing with a gun was the most common circumstance surrounding unintentional firearm deaths of both younger and older children. Conclusions: Firearm injuries are an important public health problem, contributing substantially to premature death and disability of children. Understanding their nature and impact is a first step toward prevention.
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Pediatric firearm-related deaths and injuries are a national public health crisis. In this Special Review Article, we characterize the epidemiology of firearm-related injuries in the United States and discuss public health programs, the role of pediatricians, and legislative efforts to address this health crisis. Firearm-related injuries are leading causes of unintentional injury deaths in children and adolescents. Children are more likely to be victims of unintentional injuries, the majority of which occur in the home, and adolescents are more likely to suffer from intentional injuries due to either assault or suicide attempts. Guns are present in 18% to 64% of US households, with significant variability by geographic region. Almost 40% of parents erroneously believe their children are unaware of the storage location of household guns, and 22% of parents wrongly believe that their children have never handled household guns. Public health interventions to increase firearm safety have demonstrated varying results, but the most effective programs have provided free gun safety devices to families. Pediatricians should continue working to reduce gun violence by asking patients and their families about firearm access, encouraging safe storage, and supporting firearm-related injury prevention research. Pediatricians should also play a role in educating trainees about gun violence. From a legislative perspective, universal background checks have been shown to decrease firearm homicides across all ages, and child safety laws have been shown to decrease unintentional firearm deaths and suicide deaths in youth. A collective, data-driven public health approach is crucial to halt the epidemic of pediatric firearm-related injury.
Article
Background: The United States has more than 90% of all youth firearm deaths that occur in high-income countries. Purpose: We summarize the epidemiological literature on the prevalence, risk factors, and protective factors associated with adolescent homicides and suicides and the role of firearms in the loss of these lives. Methods: A systematic process was used to locate literature on adolescent homicide, adolescent suicide, and adolescent firearm deaths. The literature on these topics was summarized to provide an overview of the issues. Results: Approximately 10% of all arrests in a year for murder and nonnegligent manslaughter are by youth younger than 18 years of age; 92% of these are males. African American male teens are 20 times more likely than white male teens to be victims of homicides. Suicides are attempted more often by adolescent females than males, but males are more likely to die from suicides because they usually use a very lethal method—firearms. Firearms are the implements of choice for adolescent homicides and suicides. Discussion: Too many youth grow up in unhealthy circumstances, faced with a multitude of challenges that contribute to adolescents killing others or killing themselves. Translation to Health Education Practice: Community agencies, parents, and schools need to be proactive in enhancing youth resiliency. This literature review will assist Health Educators in community and school settings to assist communities, families, and youth with creating protective factors to minimize adolescent homicides and suicides.
Article
Background: Because the presence and improper storage of household firearms are risk factors for injury, it is important to understand the prevalence of ownership and storage practices within households to help guide intervention development. This systematic review of published articles (1992 to 2002) provides prevalence estimates of firearm ownership and storage practices in U.S. households. Methods: A search of bibliographic databases (MedLine, CINAHL, PsycInfo, Sociological Abstracts) was completed in January 2003. Results: Although all were cross-sectional, the 42 articles included in this review varied in type; there were seven national and five state prevalence studies, as well as studies using clinic-based convenience samples (n = 14) and samples of professionals (n = 10). Published studies indicate that firearms are present in about one third of U.S. households. Handguns in particular are present in more than half of U.S. households with firearms, or about 19% of all U.S. households. The prevalence of firearms and handguns in households with voting people was similar to the prevalence overall. Firearm ownership was highest in the South. Conclusions: Although the methodologic rigor of published articles varies Substantially, the literature clearly establishes that firearms are common in U.S. households, even in the homes of medical professionals and those with children. (C) 2004 American Journal of Preventive Medicine.
Article
Firearm violence is a significant cause of morbidity and premature mortality in the United States. The majority of suicides and homicides are committed with firearms. Considerable debate has occurred regarding firearm violence and mentally ill people. Mental health professionals can play a central role in research, practice, and advocacy regarding firearm violence prevention through a number of avenues. However, little is known about mental health professionals' perceptions and practices regarding firearm safety counseling in the mentally ill. Thus, the purposes of this investigation are to summarize the literature on firearm violence by the mentally ill and to conduct a rigorous review of the available scientific literature on mental health professionals' views and practices on firearm violence prevention. A total of nine studies were found that dealt with mental health professionals' attitudes and practices on firearm violence prevention. Findings have been summarized in the following categories: mental health professionals training, screening for the presence of firearms, engagement in firearm safety counseling, and perceptions regarding firearm violence in the United States. Mental health professionals need more training regarding firearm issues if they are going to play a role in reducing firearm trauma by the mentally ill. Their impact will be primarily on firearm suicides.
Article
The study in this article identifies three major risk categories of high school dropouts and evaluates the impact of possible prevention strategies. As students accumulate these risks, they became more likely to drop out and prevention programs become less effective. Additionally, it was found that factors influencing the decision to drop out vary for different sources of risk, and thus there should be a range of prevention strategies offered to accommodate for this variance.
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Data from the 2013 survey reprinted from Barry CL, McGinty EE, Vernick JS, Webster DW (2013). After Newton—public opinion on gun policy and mental illness. New England Journal of Medicine 368(12): 1077–81.
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The aim of the present study is to quantify the association between child access prevention (CAP) and minimum age laws and state-level youth firearm-related suicide and unintentional death rates. This paper differs from prior research in several ways. First, this is one of the few studies to focus exclusively on youth death rates. Second, this study looks at those laws with the most impact on youth suicides and unintentional deaths. Finally, this study uses one of the largest and most recent data sets of any study on this topic. In order to estimate the determinants of youth firearm deaths, a fixed effects regression model, controlling for both state-level and year-specific effects, is used. Results indicate that state-level minimum age laws have no significant effects on either youth suicides or unintentional deaths and that state-level CAP laws have no significant effects on unintentional deaths. States with CAP laws, however, have lower rates of youth suicide, and, after the enactment of the Federal minimum age requirement, both youth suicide and unintentional death rates fell. Given the mixed results regarding state-level juvenile firearm laws, national restrictions on juvenile handgun possession may be more effective in reducing both youth suicides and unintentional deaths than state-level regulations.
Article
In the past three decades, approximately 1 million Americans have been killed with firearms and over 2 million have been injured with firearms. Firearm violence is one of the top 10 causes of premature mortality for racial/ethnic minorities and youths 1 to 19 years of age. However, firearm violence issues are virtually absent in the past 15 years in health education-related journals. We provide several examples of areas of health education where firearm violence is congruent with the professional responsibilities of health educators. Finally, we encourage health educators to become involved in firearm violence research and health education-related journal leaders to become more proactive in soliciting manuscripts that address firearm violence-related issues. © 2015 Society for Public Health Education.
Article
Many states have passed child access prevention (CAP) laws, which hold the gun owner responsible if a child gains access to a gun that is not securely stored. Previous research on CAP laws has focused exclusively on gun-related deaths even though most gun injuries are not fatal. We use annual hospital discharge data to investigate whether CAP laws are associated with decreased nonfatal gun injuries. Results from Poisson regressions that control for various hospital, county, and state characteristics, including state-specific fixed effects and time trends, indicate that CAP laws are associated with reductions in nonfatal gun injuries among children under age 18. Our results are bolstered by the absence of effects on other outcomes such as self-inflicted gun injuries among adults and nongun self-inflicted injuries.
Article
Firearm morbidity and mortality place an enormous burden on the health care enterprise and society at large. Recent research has shown strong public support for strategies to regulate firearms yet effective federal legislation to control the types of firearms sold, conditions of sale and purchase, limitation in transportation and storage, and responsibility for use of personally owned firearms has been limited. Thus the purpose of this study was to evaluate the relationship between Congressional voting on firearm control legislation and the following: political affiliation, military service, geographic location of representation, education level, sex, and gun rights and gun control contributions. This was accomplished using a retrospective assessment of Congressional voting records from the 103rd–106th Congresses (1993–2000) regarding firearm control legislation. The study found that $6,270,553 was donated to members of Congress, $5,394,049 to members of the House and $876,504 to members of the Senate by groups concerned with firearm legislation. In the House, males (Odds Ratio [OR], 3.87), Republicans (OR, 13), those from the South (OR, 5), and those who received gun rights funds (OR, 13 to 203, depending on level of donations) were more likely to vote pro gun rights. In the Senate, support for gun rights occurred more often for those from the West (OR, 3.56), Republicans (OR, 130.50), or those who had received gun rights donations (OR, 28.00). This study has found a strong and consistent relationship between a Congressional member's position on firearm legislation and the amount of money received, political affiliation, and geographic location of representation.
Article
Firearm control laws vary across the United States and remain state specific. The aim of this study was to determine the relationship between variation in states' firearm control laws and the risk of firearm-related injuries in pediatric population. We hypothesized that strict firearm control laws impact the incidence of pediatric firearm injury. All patients with trauma Ecodes and those 18 years or younger were identified from the 2009 Nationwide Inpatient Sample. Individual states' firearm control laws were evaluated and scored based on background checks on firearm sales, permit requirements, assault weapon and large-capacity magazine ban, mandatory child safety lock requirements, and regulations regarding firearms in college and workplaces. States were then dichotomized into strict firearm laws (SFLs) and non-strict firearm laws (non-SFLs) state based on median total score. The primary outcome measure was incidence of firearm injury. Data were compared between the two groups using simple linear regression analysis. A total of 60,224 pediatric patients with trauma-related injuries across 44 states were included. Thirty-three states were categorized as non-SFL and 11 as SFL. Two hundred eighty-six (0.5%) had firearm injuries, of which 31 were self-inflicted. Mean firearm injury rates per 1,000 trauma patients was higher in the non-SFL states (mean [SD]: SFL, 2.2 [1.6]; non-SFL, 5.9 [5.6]; p = 0. 001). Being in a non-SFL state increased the mean firearm injury rate by 3.75 (β coefficient, 3.75; 95% confidence interval, 0.25-7.25; p = 0.036). Children living in states with strict firearm legislation are safer. Efforts to improve and standardize national firearm control laws are warranted. Prognostic study, level III.
Article
After the shootings at Columbine High School, many public schools increased their visible security measures, such as use of security cameras and guards. This study assesses this policy response. Particular attention is given to the fear that prompted changes in school security, the types of visible security measures adopted by schools after Columbine, and the positive and negative consequences of these measures. Synthesizing the relevant literature highlights the lack of evaluative work regarding the effectiveness of school security and how little is known about the impact of security measures on students' civil liberty and privacy interests. Gaining a better understanding of school security can help officials make more informed decisions in response to rare, but highly publicized, violent crimes such as Columbine.
Article
School superintendents in 60 public school systems in Georgia were surveyed to describe strategies being pursued to prevent school violence and promote a safe learning environment. Results from the present study were compared with results from a survey of superintendents conducted by one of the authors in 1995 to determine the extent of change in school violence prevention strategies. The primacy of safe schools is well recognized today following the shocking multiple student murders of Columbine and Red Lake. Descriptive data analysis suggests that violence prevention policies and procedures implemented in most public school systems in Georgia are deterring students from bringing weapons to school. Whereas superintendents surveyed in 1995 were split on whether school safety concerns were growing or staying at the same level, similar question in 2005 produced a modal response that safety concerns are staying the same. A comparative analysis reveals shifts in the use of technology and human resources, which documents change in superintendents' perceptions over the past decade.
Article
A recent report indicates that firearm-related injuries are responsible for 30% of pediatric trauma fatality. The literature is however limited in examining pediatric firearm injuries and variations in state gun control laws. Therefore, we sought to examine the association between pediatric firearm injuries and the Stand-Your-Ground (SYG) and Child Access Protection (CAP) laws. All pediatric (age, 0-20 years) hospitalizations with firearm injuries were identified from the Kids' Inpatient Database from 2006 and 2009. States were compared for SYG and CAP laws. A total of 19,233 firearm injury hospitalizations were identified, with 64.7% assault, 27.2% accidental, and 3.1% suicide injury. Demographics for assault injury were as follows: mean age of 17.6 years, 88.4% male, 44.4% black, 18.2% Hispanic, 70.5% from metropolitan areas, and 50.1% from the poorest median income neighborhoods. Suicide injury cases were more likely to be white (57.8% vs. 16.6%, p < 0.001) and female (15.1% vs. 9.8%, p < 0.001). States with the SYG law were associated with increased accidental injury (odds ratio [OR], 1.282; p < 0.001). There was no statistical association between CAP law and the incidence of accidental injury or suicide. Multivariate logistic regression analysis found other predictive demographic factors for firearm injury: black (OR, 6.164), urban areas (OR, 1.557), poorest median income neighborhoods (OR, 2.785), male (OR, 28.602), and 16 years or older (OR, 37.308). Total economic burden was estimated at more than $1 billion dollars, with a median length of stay of 3 days, 8.4% discharge to rehabilitation, and 6.2% in-hospital mortality. Pediatric firearm injuries continue to be a significant source of morbidity, mortality, and economic burden. A significant increase in accidental firearm injuries in states with the SYG law may highlight inadvertent effects of the law. Race, sex, and median income are additional contributing factors. Advocacy and focused educational efforts for specific socioeconomic and racial groups may potentially reduce firearm injuries. Prognostic study, level II.