Mass Shooting Incidents Research Articles

Acute and Critical Care Nurses' Roles in Mass Shootings: An Integrative Review.

From 2018 to 2022, mass shooting incidents in the United States increased by 67.7%. Health care-associated shootings also increased. The role of acute and critical care nurses during shootings is not well defined in the literature. To identify roles of acute and critical care nurses during mass shooting incidents and provide best-practice recommendations for shooting incidents within a hospital. The methods of Whittemore, Knafl, and Torraco informed this integrative review. Ovid MEDLINE, CINAHL, and Scopus databases were searched for publications related to acute and critical care nurses, mass shooting incidents, and hospital setting. Of 13 589 articles retrieved, 27 were included; 63% were narrative reviews. The highest level of evidence was an expert consensus panel; next highest was a quasi-experimental study that simulated experiences to test mass casualty incident response. Third highest was a qualitative study that analyzed nurses' experiences during a mass casualty experience. The evidence revealed 3 themes: prevention and preparedness, response to incident, and recovery phase. Education and training for acute and critical care nurses about mass shooting incidents are central to defining nurses' roles and best practices for these incidents. Nurses must know Stop the Bleed techniques and run-hide-fight protocols. Additionally, acute and critical care nurses need representation on hospital committees to develop and implement policies and procedures. Hospitals are not immune to mass shooting incidents. Acute and critical care nurses require education including simulations and drills on mass shooting incidents to ensure safety of nurses and patients.

State assault weapons bans are associated with fewer fatalities: analysis of US county mass shooting incidents (2014–2022)

BackgroundThe need for evidence to inform interventions to prevent mass shootings (MS) in the USA has never been greater.MethodsData were abstracted from the Gun Violence Archive, an independent online database...

Entrepreneurial emotional bias from mass shootings: Evidence from Kickstarter

This study examines the impact of emotional bias on entrepreneurial decisions in crowdfunding platforms, specifically considering the impact of mass shootings as exogenous emotional shocks. Using data from a leading crowdfunding platform, Kickstarter, paired with US mass shooting incidents, we apply a difference-in-differences approach. Our analysis shows that entrepreneurs in cities proximate to a mass shooting tend to adjust their fundraising targets downward. This adjustment subsequently increases the likelihood of campaign success, a trend that is even more pronounced for projects tied to the geographic location of the mass shooting incident. Our findings not only attest to the profound influence of emotions in crowdfunding decisions, but also unveil the nuanced, varying effects based on geographic relevance. This research underscores the importance of understanding and addressing such biases to bolster crowdfunding platform efficiency and to support the consistent success of crowdfunded enterprises.

Are Mass Shootings in the U.S. Increasing? Understanding How Differing Definitions of Politically Charged Events Impact People's Perceptions of Expected Trends in Visualizations.

Visualizations of mass shooting incidents in the United States appearing in the media can influence people's beliefs and attitudes. However, different data sources each use their own definition of mass shootings, resulting in varying counts and trends of these incidents across the sources. To investigate the effects of these varying definitions on public perceptions, we conducted a crowdsourced study using data from four sources-Mother Jones, Mass Shooter Database, Everytown for Gun Safety, and The Washington Post. We used one or more line plots, with or without explicitly providing the definition, to see how these variations affect viewers' understanding of a 10-year trend in mass shooting frequency. We found that, depending on the data shown, participants' perceptions of the trend changed in both directions (i.e., more or less increasing) compared to their prestudy perceptions. We discuss how data from a single source can influence people's perceptions, and how visualizing data from multiple sources (e.g., superimposed line graphs) can enable more transparent communication. Our work has implications for other media and public visualizations, highlighting the importance of embracing pluralistic approaches to enquiry, especially when dealing with data of significant importance and consequence.

A Statistical Analysis of the Impact of Gun Ownership on Mass Shootings in the USA Between 2013 and 2022

Mass shootings (incidents with four or more people shot in a single event, not including the shooter) are becoming more frequent in the United States, posing a significant threat to public health and safety in the country. In the current study, we intended to analyze the impact of state-level prevalence of gun ownership on mass shootings—both the frequency and severity of these events. We applied the negative binomial generalized linear mixed model to investigate the association between gun ownership rate, as measured by a proxy (i.e., the proportion of suicides committed with firearms to total suicides), and population-adjusted rates of mass shooting incidents and fatalities at the state level from 2013 to 2022. Gun ownership was found to be significantly associated with the rate of mass shooting fatalities. Specifically, our model indicated that for every 1-SD increase—that is, for every 12.5% increase—in gun ownership, the rate of mass shooting fatalities increased by 34% (p value < 0.001). However, no significant association was found between gun ownership and rate of mass shooting incidents. These findings suggest that restricting gun ownership (and therefore reducing availability to guns) may not decrease the number of mass shooting events, but it may save lives when these events occur.

Assessing the relationship between gun ownership and fear of mass shootings

RationaleGun sales spike after mass shooting incidents. As firearm presence is associated with numerous health and safety risks, it is imperative to understand what catalyzes gun ownership. Despite evidence that Americans’ fear of mass shootings is increasing at a pace that exceeds their likelihood of victimization, the relationship between fear of mass shootings and gun ownership has received minimal attention. ObjectiveThe current study examines group differences in fear of mass shootings and openness to gun ownership. Specifically, it is hypothesized that (1) fear of mass shootings will increase openness to future firearm ownership among non-owners, (2) gun owners will be more afraid of mass shootings than non-owners, and (3) protective owners will be more afraid than non-protective owners. MethodsThis paper uses Wave 26 of Pew Research Center's nationally representative American Trends Panel (n = 1968). ResultsBinary logistic regression analyses indicate that among non-gun-owners, fear of mass shootings decreases openness to ownership. Ordinal logistic regression analyses indicate that while fear of mass shootings does not differ between gun owners and non-owners, protective gun owners are more afraid than non-protective owners. ConclusionsCombined with prior research, these findings suggest that protective gun owners, non-protective gun owners, and non-owners have distinct views of the relationship between guns and mass shootings and are motivated to acquire firearms by different processes. Additional longitudinal work is needed to confirm these findings and clarify the role of causal attributions.

Preparing Public Health Responses to Mass Shooting Incidents

The Pulse| June 2023 Preparing Public Health Responses to Mass Shooting Incidents Amy Gallagher Amy Gallagher Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor June 2023, Vol. 87, 27–28. https://doi.org/10.1097/01.ASM.0000938840.62254.8a Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn Email Cite Icon Cite Get Permissions Search Site Citation Amy Gallagher; Preparing Public Health Responses to Mass Shooting Incidents. ASA Monitor 2023; 87:27–28 doi: https://doi.org/10.1097/01.ASM.0000938840.62254.8a Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: mass shooting, public health medicine, triage, patient tracking Editor's Note: Gun violence, including mass shootings, is increasingly being referred to as a public health crisis. From 2015 onward, the number of mass shooting events and people injured in these events has increased annually, with a peak of 686 incidents in 2021 (asamonitor.pub/41qQhpE). At the time of publication, there have been almost 200 mass shootings so far in 2023 (asamonitor.pub/3UGMBxG). Behind the scenes of mass shooting incidents (MSIs) in the United States stand many dedicated frontline trauma surgeons, anesthesiologists, emergency medicine physicians, nursing teams, and other health care professionals who are advocating for a public health education strategy to reduce firearm-related violence. Brenda Gentz, MD, Chair of the Department of Anesthesiology at Valleywise Health/District Medical Group in Phoenix, and Stephanie Davidson, DO, FASA, of Sunrise Hospital/Sunrise Children's Hospital/U.S. Anesthesia Partners (USAP) in Las Vegas, recently participated in a first-of-its-kind collaboration on mass shooting incidents... You do not currently have access to this content.

The COVID-19 pandemic and its impacts on mass shootings in six major US cities

BackgroundThe COVID-19 pandemic has significant impacts on the US socioeconomic structure. Gun violence is a major public health issue and the effects on this area have not been well-elucidated. The objective of this study was to determine the impacts of the pandemic on mass shootings in six major United States cities with historically high rates of gun violence. MethodsMass shooting data were extracted from an open-source database, Gun Violence Archive. Mass shooting was defined as four or more people shot at a single event. Data from six cities with the highest incidence of mass shootings were analyzed in 2019 versus 2020 (Baltimore, Chicago, Detroit, New Orleans, Philadelphia, and St. Louis). Geographic data were examined to assess changes in each city's mass shooting geographic distribution over time. Quantitative changes were assessed using the Area Deprivation Index (ADI), and qualitative data were assessed using ArcGIS. ResultsIn 2020, the overall percentage of mass shootings increased by 46.7% though there was no change in the distribution of these events when assessed quantitatively (no change in average ADI) nor qualitatively (using ArcGIS). In the six cities analyzed, the total proportion of mass shooting events was unchanged during the pandemic (21.8% vs 20.6%, p = 0.64). Chicago, the US city with the highest incidence of mass shootings, did not experience a significant change in 2020 (n = 34/91, 37.3% vs. n = 53/126, 42.1%, p = 0.57). Baltimore had a significant decrease in mass shooting events (n = 18/91, 19.8% vs. 10/126, 7.9%, p = 0.01). The other four cities had no significant change in the number of mass shootings (p>0.05). ConclusionThis study is the first to use ArcGIS technology to describe the patterns of mass shooting in six major US cities during the COVID-19 pandemic. The number of mass shootings in six US cities remained largely unchanged which suggests that changes in mass shootings is likely occurring in smaller cities. Future studies should focus on the changing patterns of homicides in at-risk communities and other possible social influences.

An ML-Powered Risk Assessment System for Predicting Prospective Mass Shooting

The United States has had more mass shooting incidents than any other country. It is reported that more than 1800 incidents occurred in the US during the past three years. Mass shooters often display warning signs before committing crimes, such as childhood traumas, domestic violence, firearms access, and aggressive social media posts. With the advancement of machine learning (ML), it is more possible than ever to predict mass shootings before they occur by studying the behavior of prospective mass shooters. This paper presents an ML-based system that uses various unsupervised ML models to warn about a balanced progressive tendency of a person to commit a mass shooting. Our system used two models, namely local outlier factor and K-means clustering, to learn both the psychological factors and social media activities of previous shooters to provide a probabilistic similarity of a new observation to an existing shooter. The developed system can show the similarity between a new record for a prospective shooter and one or more records from our dataset via a GUI-friendly interface. It enables users to select some social and criminal observations about the prospective shooter. Then, the webpage creates a new record, classifies it, and displays the similarity results. Furthermore, we developed a feed-in module, which allows new observations to be added to our dataset and retrains the ML models. Finally, we evaluated our system using various performance metrics.

Analyzing the impact of state gun laws on mass shootings in the United States from 2013 to 2021

ObjectivesMass shooting incidents have drastically increased in the United States in the last 10 years, with a disproportionate number of incidents occurring in some states. Gun laws vary greatly by state, but little research has been conducted to examine the association between the strength of state gun laws and mass shootings. This study aims to explore the aggregate effect of state gun laws on the rate of mass shooting incidents and fatalities. Study designThis was a cross-sectional time series. MethodsThis study applied the negative binomial generalized linear mixed model to assess the impact of state gun laws restrictiveness—as measured by the total number of active gun laws—on the rate of mass shooting incidents and fatalities. ResultsThe restrictiveness of state gun laws was significantly associated with the rate of mass shooting fatalities; specifically, for every 1 standard deviation (SD) increase in the state gun law restrictiveness score (i.e. for every additional 27 gun laws in place), the rate of mass shooting fatalities was decreased by 24% (P-value <0.0001), controlling for other predictor variables in the model. However, no significant association was found between the restrictiveness of state gun laws and rate of mass shooting incidents. ConclusionsState gun laws may not decrease the number of mass shooting events, but they appear to help reduce the number of deaths when these mass shootings occur. Better data collection on mass shootings and further research on the impacts of specific gun laws are needed to help understand the effectiveness of gun laws and inform law-based interventions.

Mass Outcome or Mass Intent? A Proposal for an Intent-Focused, No-Minimum Casualty Count Definition of Public Mass Shooting Incidents

In this commentary, we propose a unifying public mass shooting definition that captures the generally conceptualized phenomenon but also expands the inclusion to all incidents regardless of casualty count. We suggest that public mass shootings be broken down into four outcome categories – completed, attempted, failed, and foiled – which have unique incident outcomes but share a common thread of mass intent. We argue for the importance of a no-minimum casualty count definition (thus including zero casualties) that emphasizes mass intent rather than the completion of the shooting. We highlight the value of and rationale for this definition by discussing the limitations of current victim criteria, and we conclude with a proposed strategy that emphasizes objective indicators of mass intent.

Mass Shootings in America: Consensus Recommendations for Healthcare Response.

In 2021, 702 people died in mass shooting incidents (MSIs) in the US. To define the best healthcare response to MSIs, the Uniformed Services University's National Center for Disaster Medicine and Public Health hosted a consensus conference of emergency medical services (EMS) clinicians, emergency medicine (EM) physicians, and surgeons who provided medical response to six of the nation's largest recent mass shootings. The study consisted of a 3-round modified Delphi process. A planning committee selected 6 MSI sites with the following criteria: the MSI occurred in 2016 or later, and must have resulted in at least 15 people killed and injured. The MSI sites were Orlando, FL, Las Vegas, NV, Sutherland Springs, TX, Parkland, FL, El Paso, TX, and Dayton, OH. Fifteen clinicians participated in the conference. All participants had EMS, EM, or surgery expertise and responded to 1 of the 6 MSIs. The first round consisted of a 2-part survey. The second and third rounds consisted of site-specific presentations followed by specialty-specific discussion groups to generate consensus recommendations. The 3 specialty-specific groups created 8 consensus recommendations in common. These 8 recommendations addressed readiness training, public education, triage, communication, patient tracking, medical records, family reunification, and mental health services for responders. There were an additional 11 recommendations created in common between 2 subgroups, either EMS and EM (2), EM and surgery (7), or EMS and surgery (2). There are multiple common recommendations identified by EMS, EM, and surgery clinicians who responded to recent MSIs. Clinicians, emergency planners, and others involved in preparing and executing a response to a future mass shooting event may benefit from considering these consensus lessons learned.

Mass shootings and peer-to-peer lending

This paper analyzes the effect of mass shootings on peer-to-peer lending behavior. Using U.S. data from 2014–2018, we implement an event study methodology to exploit the quasi-experimental nature of mass-shooting incidents on local credit markets. Our findings indicate a short-term tightening of local credit conditions (higher interest rates and lower loan amounts) immediately after a mass shooting in affected communities relative to those in non-affected communities. These findings highlight that online credit marketplaces are reactive to random local shocks of violence at the community level and their corresponding public and media attention.

Distribution of wounding patterns in casualties from mass shooting events

Introduction The incidence and severity of public mass shootings, and mass casualty incidents (MCI), continues to rise. Understanding the wounding pattern and incidence of potentially preventable death after these incidents is key not only to Health System and Trauma Center emergency response planning but also to community outreach and initial emergency interventions. Methods A retrospective study of autopsy reports after events with at least 10 fatalities exclusive of the assailants identified via the Federal Bureau of Investigation database from 1 January 1999 to 31 December 2020 was performed. Sites of injury, identification of weaponry, and identification of potentially survivable wounds were compiled. Results Nine events including 203 victims were reviewed. Overall, 56% of gunshots were to the head/neck/face; 37% were to the chest; 43% were to the abdomen/torso/back; 31% were to the lower extremity; and 36% were to the upper extremity. On average, there were 29 fatalities per event. Conclusion Emergency response disaster care strategy should focus on immediate point of care at the site of wounding by both the civilian population and medical personnel, as well as rapid extrication of victims for definitive medical care. Review of these autopsy results indicates exsanguination, often treatable, is the primary cause of death—supporting community education efforts in hemorrhage control. The location of the wounding patterns seen in this study warrants primary integration of craniomaxillofacial, orthopedic trauma, neurotrauma, and surgical critical care/trauma surgical specialists into the initial response team for MCI.

Won’t You be My Neighbor? Neighborhood Characteristics Associated with Mass Shootings in the USA

We measure the association between neighborhood characteristics and mass shootings building on existing research on neighborhoods and social and economic composition and crime. Using publicly available national data from the Gun Violence Archive (2014–2019), we geocoded and merged mass shooting incidents with US Census American Community Survey data. Our bivariate results suggest that census tracts with a mass shooting are more economically disadvantaged and have greater concentrations of black and Hispanic residents. In multivariate models, the association with concentrated disadvantage is no longer significant and the likelihood of a mass shooting increases until the proportion of black residents reaches 80%, at which point the likelihood decreases, controlling for other community characteristics. Further, as the proportion of black residents and the level of disadvantage increase together, the odds of a mass shooting incident in that tract are reduced. To address and prevent mass shootings, an expanded theory of neighborhood crime that incorporates the unique nature of mass shootings needs to consider structural racism, racial dynamics, and protective factors in relationship to economic conditions.

The Code Silver Exercise: a low-cost simulation alternative to prepare hospitals for an active shooter event

Mass-shooting incidents have been increasing in recent years and Code Silver—the hospital response to a person with a weapon such as an active shooter in many Provinces or States in North America—is quickly shifting from a theoretical safety measure to a realistic scenario for which hospitals must prepare their staff. A Code Silver Exercise (CSE) involving an independent mental practice exercise with written responses to scenarios and questions, followed by a facilitated debrief with all participants, was conceptualized and trialled for feasibility and efficacy. The CSE was piloted as a quality improvement and emergency preparedness initiative in three different settings including in situ within a hospital Emergency Department or Intensive Care Unit, offsite in a large conference room workshop, and online via virtual platform. These sessions took place in 4 different cities in Canada and included 3 academic teaching hospitals. Participants of the in situ and virtual CSE completed pre- and post-simulation surveys which showed improved understanding of Code Silver protocols following participation.The CSE is a reproducible simulation alternative, designed to operationalize a Code Silver policy at a large healthcare institution in a sustainable way. This training model can be administered in multiple settings in-person (in situ or offsite), and virtually, making it versatile and easily accessible for participants. This exercise enables participants to mentally rehearse practical responses to an active shooter in their unique work environments and to discuss ethical and medical-legal implications of their responses during a facilitated debrief with fellow healthcare providers. Implementation of a CSE for training in hospitals may help staff to create a mental schema prior to an active shooter event, and thus indirectly improve the chances of survivability in the event of a real active shooter situation.

Prevalence of anger, engaged in sadness: engagement in misinformation, correction, and emotional tweets during mass shootings

PurposeThe goal of this study is to examine how tweets containing distinct emotions (i.e., emotional tweets) and different information types (i.e., misinformation, corrective information, and others) are prevalent during the initial phase of mass shootings and furthermore, how users engage in those tweets.Design/methodology/approachThe researchers manually coded 1,478 tweets posted between August 3–11, 2019, in the immediate aftermath of the El Paso and Dayton mass shootings. This manual coding approach systematically examined the distinct emotions and information types of each tweet.FindingsThe authors found that, on Twitter, misinformation was more prevalent than correction during crises and a large portion of misinformation had negative emotions (i.e., anger, sadness, and anxiety), while correction featured anger. Notably, sadness-exhibiting tweets were more likely to be retweeted and liked by users, but tweets containing other emotions (i.e., anger, anxiety, and joy) were less likely to be retweeted and liked.Research limitations/implicationsOnly a portion of the larger conversation was manually coded. However, the current study provides an overall picture of how tweets are circulated during crises in terms of misinformation and correction, and moreover, how emotions and information types alike influence engagement behaviors.Originality/valueThe pervasive anger-laden tweets about mass shooting incidents might contribute to hostile narratives and eventually reignite political polarization. The notable presence of anger in correction tweets further suggests that those who are trying to provide correction to misinformation also rely on emotion. Moreover, our study suggests that displays of sadness could function in a way that leads individuals to rely on false claims as a coping strategy to counteract uncertainty.Peer reviewThe peer review history for this article is available at: https://publons.com/publon/10.1108/OIR-03-2021-0121/

Mass Shootings and Peer-to-Peer Lending: How Do Local Shocks Affect Platform Lending Behavior?

This paper analyzes the effect of mass shootings on peer-to-peer lending behavior and credit access. The study uses data from a national gun violence tracker and a major peer-to-peer online lending platform for 2014-2018. We use a difference-in-differences methodology to exploit the quasi-experimental nature of mass-shooting incidents. The results show that relative to the control group (zip codes with no mass-shooting incidents), individuals from treatment zip codes (those with mass-shooting incidents) are approved for lower loan amounts, with higher interest rates, and shorter loan terms. Both principal and interest rates' repayment decreases immediately after a mass shooting relative to the control group, resulting in increases of charge offs for the lenders. Additionally, the interest rate spread increases, while volatility seems to decrease. These results are further amplified, the higher the severity level of the mass-shooting incidents. These results highlight that online credit marketplaces are reactive to random local shocks at the community level.

Mass-Shootings and Peer-to-Peer Lending

This paper analyzes the effect of mass-shootings on peer-to-peer lending behavior. Using US data from 2014-2018, we implement both an event study and a difference-in-differences methodology to exploit the quasi-experimental nature of mass-shooting incidents on local credit markets. Our findings indicate that immediately after a mass-shooting event, borrowing costs increase (higher interest rates and lower loan amounts) for individuals in affected communities relative to those in non-affected communities. These findings highlight that online credit marketplaces are reactive to random local shocks of violence at the community level.

Mass shooting incidents: evolution of preventive procedures, preparation, treatment, and medical care supply

"Abstract: Mass shootings incidents occur with increasing frequency over time. Studying these cases proved that, despite their diversity, several common features could be taken into account in the early detection and possible prevention of certain future cases. Accepting that such incidents may occur anywhere and anytime, societies need to be prepared for their more effective response. Informing citizens about the best way to react to a mass shooting event is considered crucial and essential. The ""Run-Hide-Fight"" guideline/directive seems to be the most appropriate guideline given to the public. Proper training, of both the Suppression Forces and the emergency medical care providers, is considered of utmost importance. The role of the Incident Commander, regarding the incident management, as well as the external bleeding control of the injured people, are factors of paramount importance in trying to mitigate the casualties from such an incident. The alertness of both citizens and organizations/structures may lead to early detection of potential perpetrators and thereby averting a mass shooting incident. To achieve increased survival and a reduced number of casualties from a mass shooting event it is vital proper education be present at all levels. The response to a mass shooting event should be imprinted in an Emergency plan. Such a plan should have been decided and made, by the Security and Suppression Forces, the Healthcare Institutions, and the Public Safety Answering Point. Keywords: mass shooting incident, first responder, active bleeding, tourniquet, Incident Commander"