TY - JOUR
T1 - Dissecting the numbers
T2 - A detailed analysis of 23 years of mass shootings across the United States
AU - O'Connor, Devin
AU - Lewis, Richard H.
AU - Jacome, Tomas
AU - Joseph, Bellal
AU - Magnotti, Louis J.
N1 - Publisher Copyright:
© 2025
PY - 2025/12
Y1 - 2025/12
N2 - Introduction: Mass shootings (MS) represent a significant public health problem. The true extent of which remains to be established. Thus, we examined how publicly available, law enforcement and news data might serve to better characterize MS events. Methods: MS (defined as the killing of ≥3 people in a public space excluding the shooter) in the US over 23-years, ending in 2022, were analyzed. Data included number of victims, wounded, and fatalities, firearm type, social media postings, psychiatric history, and demographics. Ratio of fatalities per wounded were stratified by weapon and compared. Rates of MS victims, wounded, and fatalities per 100 million population were stratified by year and compared over time using simple linear regression (LR). Results: 141 MS incidents were identified. Handguns, rifles and shotguns accounted for 80.1 %, 34.8 %, and 19.1 % of incidents, respectively. Rifles accounted for significantly more (p < 0.001) victims (17.5) per incident than multiple weapons (9), handguns (6), and shotguns (6), but had a significantly lower (p = 0.002) fatality to wounded ratio (1) compared to multiple weapons (1.29), handguns (3), and shotguns (2.5). Although LR did not find a significant increase in the rate of MS wounded (0–34.5; β = 1.85, p < 0.084), it did identify a significant increase in the rate of both MS victims (2.49–56.7; β = 2.8, p = 0.029) and fatalities (2.49–22.2; β = 0.95, p < 0.0001) per 100M population from 2000 to 2022. Conclusions: The rate of both MS victims and fatalities has steadily and significantly increased over the past 23-years, despite an unchanging rate of MS wounded. This discrepancy, with fatalities far outpacing wounded, underscores the current reality of MS – those shot during a MS incident are more likely to die than previously. Thus, our study helps to identify where best to focus prevention efforts and firearm policy if we hope to reduce MS-related fatalities.
AB - Introduction: Mass shootings (MS) represent a significant public health problem. The true extent of which remains to be established. Thus, we examined how publicly available, law enforcement and news data might serve to better characterize MS events. Methods: MS (defined as the killing of ≥3 people in a public space excluding the shooter) in the US over 23-years, ending in 2022, were analyzed. Data included number of victims, wounded, and fatalities, firearm type, social media postings, psychiatric history, and demographics. Ratio of fatalities per wounded were stratified by weapon and compared. Rates of MS victims, wounded, and fatalities per 100 million population were stratified by year and compared over time using simple linear regression (LR). Results: 141 MS incidents were identified. Handguns, rifles and shotguns accounted for 80.1 %, 34.8 %, and 19.1 % of incidents, respectively. Rifles accounted for significantly more (p < 0.001) victims (17.5) per incident than multiple weapons (9), handguns (6), and shotguns (6), but had a significantly lower (p = 0.002) fatality to wounded ratio (1) compared to multiple weapons (1.29), handguns (3), and shotguns (2.5). Although LR did not find a significant increase in the rate of MS wounded (0–34.5; β = 1.85, p < 0.084), it did identify a significant increase in the rate of both MS victims (2.49–56.7; β = 2.8, p = 0.029) and fatalities (2.49–22.2; β = 0.95, p < 0.0001) per 100M population from 2000 to 2022. Conclusions: The rate of both MS victims and fatalities has steadily and significantly increased over the past 23-years, despite an unchanging rate of MS wounded. This discrepancy, with fatalities far outpacing wounded, underscores the current reality of MS – those shot during a MS incident are more likely to die than previously. Thus, our study helps to identify where best to focus prevention efforts and firearm policy if we hope to reduce MS-related fatalities.
UR - https://www.scopus.com/pages/publications/105010947886
UR - https://www.scopus.com/pages/publications/105010947886#tab=citedBy
U2 - 10.1016/j.amjsurg.2025.116516
DO - 10.1016/j.amjsurg.2025.116516
M3 - Article
C2 - 40683016
AN - SCOPUS:105010947886
SN - 0002-9610
VL - 250
JO - American journal of surgery
JF - American journal of surgery
M1 - 116516
ER -