Research

JAMA Pediatrics | Original Investigation | HEALTH AND THE 2024 US ELECTION

Characteristics and Obtainment Methods of Firearms

Used in Adolescent School Shootings
Brent R. Klein, PhD; Jeff Trowbridge, MA; Cory Schnell, PhD; Kirstin Lewis, MA

Supplemental content
IMPORTANCE Within gun violence research, the types of firearms involved in US school
shootings and the origins of these weapons have not been well explored.

OBJECTIVE To examine the type, make, and power of firearms involved in school-related gun
violence as well as the sources and methods through which adolescents obtained these
weapons.

DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used descriptive statistics and
logistic regression to analyze 253 school shootings executed by 262 adolescents (aged ⱕ19
years) in the US from January 1, 1990, to December 31, 2016, and to calculate adjusted
estimates for missing cases. The data were sourced from The American School Shooting
Study (TASSS), which compiles information about these shooting events from open-source
materials. Data analysis was performed from June 23, 2023, to July 20, 2023.

EXPOSURES Firearm type, make, and power.

MAIN OUTCOMES AND MEASURES The firearm type refers to whether a weapon was a
handgun, rifle, or shotgun. The firearm’s make differentiates semiautomatic or fully automatic
guns from other action mechanisms. The firearm’s power refers to the caliber and velocity,
distinguished as small, moderate, or higher power. The acquisition source captures from
whom the firearm was received. The obtainment method refers to how the shooter obtained
the firearm. Estimates were adjusted by total number of documents and TASSS reliability
score as well as neighborhood demographic, socioeconomic, and land use variables
measured at the census tract level, and were weighted to account for item nonresponse.

RESULTS A total of 262 adolescents (mean [SD] age, 16.2 [1.9] years; 256 [97.8%] male) were
studied. In the adjusted analyses, handguns were the most used weapon in school shootings
(85.5%; 95% CI, 80.6%-89.4%). Firearms were predominantly lower (37.0%; 95% CI,
29.9%-44.7%) or moderate (39.7%; 95% CI, 32.0%-47.8%) in power. Adolescents mainly
obtained their guns from relatives (41.8%; 95% CI, 31.7%-52.6%), friends or acquaintances
(22.0%; 95% CI, 13.2%-34.5%), the illegal market (29.6%; 95% CI, 19.3%-42.5%), strangers
or persons who were shot (4.7%; 95% CI, 1.8%-11.6%), or licensed dealers (1.9%; 95% CI,
0.7%-5.2%). Most firearms were procured via theft from relatives (82.1%; 95% CI,
69.4%-90.3%).

CONCLUSIONS AND RELEVANCE Despite the more frequent use of lower to moderately
powered firearms in school shootings, this study’s results indicated stability in the use of
high-powered weapons in adolescent school shootings throughout the research timeframe.
A majority of the firearms were procured from the perpetrator’s family or relatives or from
friends or acquaintances. These findings may significantly influence discussions around gun
control policy, particularly in advocating for secure firearm storage to reduce adolescents’
access to weapons.
Author Affiliations: Department of
Criminology and Criminal Justice,
University of South Carolina,
Columbia (Klein, Trowbridge,
Schnell); Department of Sociology
and Criminology & Law, University of
Florida, Gainesville (Lewis).
Corresponding Author: Brent R.
Klein, PhD, Department of
Criminology and Criminal Justice,
University of South Carolina, 1305
JAMA Pediatr. doi:10.1001/jamapediatrics.2023.5093 Greene St, Columbia, SC 29208
Published online November 27, 2023. (bk17@mailbox.sc.edu).

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 Research Original Investigation
F
atal and nonfatal gun violence at K-12 schools in the
US is a significant social issue that has substantial
policy and public health implications. 1-3 The US
Department of Education’s Institute of Education Sciences
has tracked school shootings since the turn of the millen-
nium. Its latest findings, documenting 93 incidents between
2020 and 2021, are particularly alarming, as numbers are
almost 4 times higher than the yearly averages reported in
prior research.4,5 One pivotal aspect of this mounting prob-
lem revolves around the age of the individuals responsible
for these acts. Empirical research has consistently shown
that more than 70% of school shooters in the US are adoles-
cents aged 19 years or younger.5 In light of escalating gun
violence among US youth and the daunting reality that gun-
related injuries are now a leading cause of adolescent
deaths, carefully examining the firearms deployed in these
school shootings remains crucial for improving knowledge
of this urgent public health concern.6
Contrary to the widespread perceptions fueled by media
narratives, most adolescent school shootings do not fit the ste-
reotype of mass casualty rampages involving assault-style
weapons.7 Rather, a detailed analysis8 of school violence
from 1990 to 2016 revealed that adolescents were respon-
sible for only 7 mass casualty shootings, defined as causing 4
or more gunshot fatalities. Most incidents, approximately
98%, resulted in 1 or 2 fatalities. These shootings often in-
volved handguns rather than assault rifles and were typically
rooted in interpersonal disputes, largely reflecting broader
patterns of gun violence within our society.5,8,9
As with studies of gun violence in schools, the existing
literature suggests that small- or medium-caliber semiauto-
matic handguns, with their concealability and simple
design, feature prominently in firearm assaults and murders
across US communities, where youth frequently acquire
them illegally through trusted channels, such as family
members, friends, or underground markets.10-12 Unfortu-
nately, despite growing research on the characteristics and
patterns of school-related gun violence, it remains unclear
whether these findings are specifically true for school shoot-
ers. Few empirical studies have systematically investigated
the firearms used in adolescent school shootings, including
their characteristics, acquisition sources, and obtainment
methods, underscoring the critical need for further research
to address this complex issue.
The primary goal of this study was to bridge this gap by
leveraging innovative data from The American School Shoot-
ing Study (TASSS). In particular, we analyzed the type, make,
and potency of firearms involved in school-related gun vio-
lence, as well as the sources (eg, family, friends, or illegal mar-
ket) and methods (eg, theft and illegal purchase) through which
adolescents obtained firearms. By studying these critical as-
pects, we provide essential insights that can inform evidence-
based policies and preventive measures to reduce school shoot-
ings and safeguard the well-being of students and educators
alike. At a time marked by increasing concerns over the safety
of educational environments, our research seeks to advance
our understanding and inform strategies to address this press-
ing issue comprehensively.
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Firearms Used in Adolescent School Shootings
Key Points
Question What types of firearms are used in school shootings,
and how are the firearms obtained?
Findings In this cross-sectional study of data from 262
adolescents who discharged firearms in 253 school shootings
spanning 26 years from The American School Shooting Study,
school shooting incidents in the US were typically executed
using low- and moderate-powered firearms. These weapons
were most frequently stolen from family members or relatives
of the perpetrators.
Meaning These findings inform the debate on how school
shooters obtain their firearms and indicate that secure storage
of firearms could benefit public health.
Methods
This cross-sectional study used data from the TASSS data-
base. TASSS relies on public records (eTables 1 and 2 in Supple-
ment 1) to document every known instance of firearm dis-
charges on K-12 school property resulting in at least 1 gunshot
injury or death in the US from January 1, 1990, to December
31, 2016, the most current period the data are available. Being
one of the longest-running projects on US school shootings,
TASSS has gathered data from various open sources, includ-
ing news media (online and print), court records, police files,
and academic reports (eFigure 2 in Supplement 1). With its
broad scope, TASSS encompasses more than 30 000 docu-
ments and 90 000 pages of information chronicling inci-
dents of gun violence at US schools. Researchers have used
these resources to extract variables into a quantitative
database. 5,13 The University of South Carolina, Michigan
State University, John Jay College of Criminal Justice, and The
University of Texas at Dallas institutional review boards ap-
proved this study as non–human participant research; thus,
there was no need for informed consent from participants.14
This study followed the Strengthening the Reporting of Ob-
servational Studies in Epidemiology (STROBE) reporting
guideline.
Due to the public and media attention that school gun vio-
lence attracts, TASSS likely captures the known population of
school shooting incidents and offenders.15 The database has
information on 354 school shootings involving 373 publicly
known individuals (adults and adolescents) who committed
firearm-related assaults, as some incidents involved multiple
shooters (eFigure 1 in Supplement 1). Given the importance of
studying youth gun-carrying and acquisition behaviors, we ex-
tracted all 262 named adolescent perpetrators (aged ≤19 years)
who discharged firearms in 253 school shootings for our analy-
sis. We then examined all open-source documents housed in
TASSS related to these school shootings to code variables about
firearm attributes and adolescents’ methods to obtain them.
We included item nonresponse and results from intercoder re-
liability using the Cohen κ coefficient for all variables ana-
lyzed. Missing data ranged from 4% to more than 50%.
The Cohen κ results indicated substantial reliability for every
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 Firearms Used in Adolescent School Shootings
variable, with scores between 0.789 and 0.988 (eTable 3 in
Supplement 1).16,17 All demographic information used in this
study was reported in the TASSS database.
Three indicators captured the make and configuration of
the guns discharged during school shootings. Firearm type in-
cluded handguns, shotguns, and rifles. The firearm’s action
mechanism coded the operational apparatus that loads, fires,
and ejects ammunition as semiautomatic or fully automatic
and otherwise (eg, revolvers, lever/bolt action, derringers, and
pump action). The firearm’s power encompassed its caliber size
and velocity as lower, moderate, and higher power. Lower
power included the 0.22, 0.25, and 0.32 calibers and textual
indicators from the open sources that a small-caliber gun was
used. Moderate power included 0.38 caliber, 0.380 caliber, 9
mm, 0.410 gauge, and 20 gauge. Higher power included the
0.357 magnum, 10 mm, 0.40 caliber, 0.45 caliber, and 0.44
magnum or high-velocity rifles and shotguns, such as the
7.62 × 39-mm NATO, 5.56 × 45-mm NATO, 0.223 caliber, 0.270
caliber, 0.30 to 0.06 caliber, 0.30 to 30 caliber, 16 gauge, and
12 gauge (eMethods in Supplement 1).18
Two additional variables detailed the firearm’s obtain-
ment sources and methods. Acquisition source captured the
immediate individual (source) who supplied the firearm to the
school shooter (knowingly or unknowingly), coded as a li-
censed dealer, family or relative (eg, parents or guardians, sib-
lings, or grandparents), friends or acquaintances, street or il-
legal market, and strangers or from the person who was shot
during the incident. The obtainment method examined how
the school shooter procured the firearm from the acquisition
source as a legal purchase, borrowed, taken or stolen, illegal
purchase, or found randomly (eMethods in Supplement 1).10,11
Importantly, because the obtainment method captures how the
gun was procured from the acquisition source, there neces-
sarily is an overlap between these 2 variables, limiting poten-
tial combinations. For example, the variable licensed dealer
indicates that the firearm was procured legally or taken or sto-
len, whereas other gun sources offer diverse obtainment meth-
ods. The findings should thus be interpreted with this limita-
tion in mind.
Statistical Analysis
Our analysis uses descriptive statistics to report the vari-
able’s distributions within the school shooting population and
across time. We present unadjusted and adjusted estimates to
address item nonresponse (ie, missingness). To adjust the data,
we fit a logistic regression model, linking indicators of open-
source quantity (eg, total number of documents) and reliabil-
ity (TASSS reliability score) and neighborhood factors with
the likelihood of missing values on each of the gun variables
(with 1 indicating missing and 0 not missing). Using data from
the US Census Bureau’s decennial surveys (1990, 2000, and
2010) that correlate with violence and neighborhood charac-
teristics, we incorporated several contextual indicators asso-
ciated with the school at the census tract level.19,20 These rep-
resented 3 general categories.
First, variables capturing sociodemographic characteris-
tics included the percentages of residents who were Black, La-
tino/a/x, White, and of other racial or ethnic groups (includ-
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Original Investigation Research
ing Asian or Pacific Islander and Indigenous peoples of the
Americas); non–US-born residents; and residents younger than
18 years. Second, economic indicators included the percent-
age of residents living below the poverty line, unemploy-
ment, public assistance dependency, households headed by
women, and residents without a high school diploma. Third,
we included variables that display land use characteristics of
neighborhoods as the proportion of vacant total land, percent-
age of owner-occupied homes, residents who lived in the same
house 5 years earlier, and urbanicity. We selected these socio-
demographic and economic variables because they captured
the most comprehensive set of measures available across all
3 US Census surveys and provided a picture of the groups of
people living in the neighborhoods where school shootings oc-
curred. These characteristics are inextricably connected to the
underlying population of those who attend certain schools be-
cause most locations are composed of students who live nearby.
As noted, we assessed the probability of missingness for
each variable to weigh the cases and compute the propor-
tions shown. Hence, the adjusted data incorporated sam-
pling weights (ie, the reciprocal of the adjusted probability).
Because missing values were unavoidable yet vital to con-
sider, this statistical adjustment is a significant contribution,
allowing the data to accurately represent the recognized US
school shooting population. Data analysis was performed from
June 23, 2023, to July 20, 2023, with Stata BE, version 17.0
(StataCorp LLC).
Results
A total of 119 of 253 adolescent school shooting incidents
(47.0%) involved at least 1 fatality, and 7 (2.8%) were mass
killings that caused 4 or more deaths. Among the 262 ado-
lescent shooters, the overwhelming majority (256 [97.8%])
were male and 6 (2.3%) were female, with a mean (SD) age of
16.2 (1.9) years. As reported in TASSS, 141 (57.8%) of these
individuals were Black, 21 (8.6%) were of Latino/a/x ethnic-
ity, 68 (27.9%) were White, and 14 (5.7%) represented other
racial or ethnic groups, including Asian or Pacific Islander
and Indigenous peoples of the Americas. At the time of the
incident, 144 (55.0%) of these adolescent shooters were
enrolled as students at the school they targeted (eTable 4 in
Supplement 1).
Regarding the census tracts associated with the school, a
mean (SD) of 36.9% (36.8%) of residents were Black, 10.4%
(15.7%) were Latino/a/x, and 46.3% (35.2%) were of races other
than White. In these census tracts, a mean (SD) of 7.9% (10.7%)
of residents were born outside the US, and 27.3% (6.2%) were
younger than 18 years. Regarding economic characteristics,
12.3% (7.6%) of households were characterized as headed by
women. Moreover, 26.1% (14.1%) of residents did not have a
high school diploma, and 10.1% (6.5%) were unemployed. Ad-
ditionally, 8.1% (7.5%) of the population depended on public
assistance, whereas 19.7% (13.6%) lived below the poverty line.
A mean (SD) of 58.9% (20.8%) of the residents were home-
owners, and 54.7% (13.6%) had resided in the same house for
5 years or more. The census tracts were predominantly urban
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 Research Original Investigation
Table 1. Characteristics of Firearms Used in US School Shootings Involving Adolescents, 1990-2016a
% (95% CI)
Characteristic Valid No. Unadjusted
Firearm type
Handgun 213 85.2 (80.2-89.1)
Shotgun 15 6.0 (03.6-09.7)
Rifle 22 8.8 (05.9-13.0)
Firearm’s action mechanism
Semiautomatic or automatic 92 56.4 (48.7-63.9)
Nonautomatic 71 43.6 (36.1-51.3)
Size and power
Lower 76 40.9 (34.0-48.1)
Moderate 67 36.0 (29.4-43.2)
Higher 43 23.1 (17.6-29.8)
(81.6% [37.4%]), and 10.5% (8.3%) of the total land in these areas
was vacant (eTable 5 in Supplement 1).
Table 1 reports the unadjusted and adjusted proportions
describing the characteristics of the firearms used in US school
shootings involving adolescent perpetrators. Focusing on the
adjusted proportions, the firearms discharged were primarily
handguns (85.5%; 95% CI, 80.6%-89.4%), followed by rifles
(9.6%; 95% CI, 5.7%-12.7%) and shotguns (5.9%; 95% CI, 3.6%-
9.6%). Most of these guns were semiautomatic or fully auto-
matic (58.5%; 95% CI, 49.8%-66.8%). Regarding the firearm’s
inherent size and power, 37.0% (95% CI, 29.9%-44.7%) were
lower powered, and 39.7% (95% CI, 32.0%-47.8%) were mod-
erately powered. The 0.22-caliber (50 of 186 [26.9%]) and
9-mm (29 of 186 [5.6%]) were the most common lower to mod-
erately powered weapons. It was rare for adolescents to de-
ploy higher-powered firearms in school shootings between
1990 and 2016 (23.3%; 95% CI, 16.6%-31.7%). When they did,
most used the 12-gauge shotgun (9 of 186 [4.8%]), or a 0.40-
caliber (8 of 186 [4.3%]), 0.357-caliber (6 of 183 [3.2%]), or 0.45-
caliber (5 of 186 [2.7%]) handgun. Among rifles, typical recre-
ational firearm calibers, such as the 0.223, 0.30 to 0.30, 0.30
to 0.06, 0.30, and 0.270, were used most often; 4 of the 186
shootings (2.1%) involved 7.62 × 39-mm NATO rifle rounds.
Extending this discussion, the Figure reports changes in
firearm size and power across time. The use of lower to mod-
erately powered firearms in school shootings involving ado-
lescents in the US has decreased. The early 1990s marked the
height of such firearm use, with the lowest point in the 2010s.
The frequency of adolescents using higher-powered firearms
has been stable over time, with a modest increase since the
mid-1990s. Furthermore, the number of incidents in which the
firearm’s power was undisclosed in open sources has notably
increased between 1990 and 2016.
Table 2 reports the sources of firearm acquisition and meth-
ods of obtaining guns for both the unadjusted and adjusted
data. Considering the adjusted data, 51.8% (95% CI, 31.7%-
52.6%) of the adolescents involved in US school shootings pro-
cured firearms from family members or relatives, primarily par-
ents. A total of 22.0% (95% CI, 13.2%-34.5%) obtained weapons
from friends or acquaintances, whereas 29.6% (95% CI, 19.3%
42.5%) secured them from the illegal market. Fewer adoles-
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Firearms Used in Adolescent School Shootings
a
The 14 variables used to calculate
Adjusted adjusted estimates include the
following: the percentage of Black
residents, Latino/a/x residents, and
85.5 (80.6-89.4)
residents other than White;
5.9 (03.6-09.6) residents born outside the US;
8.6 (05.7-12.7) residents younger than 18 years; the
percentage of residents living below
the poverty line; unemployment;
58.6 (49.8-66.8) public assistance dependency;
41.4 (33.2-50.2) households headed by women;
residents without a high school
diploma; the proportion of total
37.0 (29.9-44.7) land that is vacant; the percentage
39.7 (32.0-47.8) of owner-occupied homes;
residents who lived in the same
23.3 (16.6-31.7)
house 5 years earlier; and urbanicity.
cents sourced guns directly from strangers or the persons who
were shot (4.7%; 95% CI, 1.8%-11.6%) or used personally owned
weapons bought legally (1.9%; 95% CI, 0.7%-5.2%).
Most firearms were procured via theft (78 of 128), pre-
dominantly from family or relatives (82.1%; 95% CI, 69.4%-
90.3%), followed by strangers or the persons who were shot
(9.5%; 95% CI, 3.7%-22.0%) and friends or acquaintances
(8.4%; 95% CI, 3.5%-18.7%). When firearms were loaned or
gifted to the shooter, the majority came from friends or ac-
quaintances (93.5%; 95% CI, 79.2%-98.2%). All illegally pur-
chased or randomly discovered firearms were traced to the
street or illegal market.
Discussion
This study addresses existing gaps in knowledge by present-
ing key trends relating to the firearms used in US school shoot-
ings perpetrated by adolescents from 1990 to 2016 and the
methods of obtaining these weapons. Although today’s me-
dia coverage primarily focuses on high-profile school shoot-
ings in which assault-style rifles are used, our findings sug-
gest these cases do not historically represent the broader issue,
despite the emergence of this new trend in recent years, which
falls beyond the scope of TASSS (ie, 2017 to 2023). We found
that handguns, likely due to their higher accessibility and con-
cealability, accounted for most of the firearms used, and many
of these weapons were semiautomatic or fully automatic and
lower to moderately powered. Our findings thus align with prior
research on adolescent gun-carrying behaviors, showing that
small-caliber (eg, 0.22, 0.25, and 0.32) and medium-caliber
(eg, 0.38 and 0.380) handguns constitute most firearms ac-
quired by criminally involved youths in US communities.10
Overall, these results indicate that the firearms involved in
community violence are similarly deployed in school shoot-
ings, suggesting a potential overlap in the factors driving these
violent incidents collectively.
Throughout our study period, we also observed a notable
decrease in the use of lower- to moderate-power firearms, such
as 0.22-caliber and 9-mm firearms, whereas the prevalence of
higher-powered weapons remained consistent. This trend mir-
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 Firearms Used in Adolescent School Shootings Original Investigation Research

Figure. Changes in Firearm Size and Power Across Time in US School Shootings Involving Adolescents, 1990-2016

A Lower-power firearms B Moderate-power firearms

10 10

8 8
No. of incidents

No. of incidents
6 6

4 4

2 2

0 0
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Year Year

C Higher-power firearms D Firearms with unknown power

10 10

8 8
No. of incidents

No. of incidents

6 6

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2 2

0 0
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Year Year

Data are unadjusted.

rors earlier research detailing the evolution of handgun de-
signs, especially the change from revolvers to semiautomat-
ics and the increased prominence of calibers like the 9 mm.21
Several factors could account for these findings: alterations in
firearm manufacturing and availability, increasing adoles-
cent interest in and familiarity with more potent weapons, or
changes in documentation methods. Moreover, we discov-
ered a sharp increase in unreported firearm size and calibers
in the open sources in recent years. Although school shoot-
ings typically receive extensive media coverage,22 this find-
ing indicates that the content and nature of reporting prac-
tices may have changed over time.
Therefore, despite more extensive media coverage, the in-
crease of online publications and social media in the 21st cen-
tury has not necessarily deepened our understanding of fire-
arms used in shootings. This situation underscores the need
for a standardized national reporting system for these inci-
dents instead of solely depending on media sources. The 2014
death of Michael Brown in Ferguson, Missouri, for instance,
highlighted this gap: without a national data registry at the
time, it was challenging to discern nationwide patterns in po-
lice use of deadly force. Such barriers can impede our ability
to study vital societal issues. Consequently, future efforts must
prioritize consistent reporting procedures, especially for in-
frequent but significant events, such as school shootings and
other notable violent acts.
Another crucial discovery from this study is the predomi-
nant sources of firearms deployed in adolescent school shoot-
ings: many were procured from family members (primarily par-
ents), friends, or street markets and usually through illegal
means, such as theft. Previous studies corroborate that crimi-
nally engaged youths younger than 18 years typically acquire
guns from these same sources.11 This finding again suggests a
parallel between school gun violence and broader commu-
nity violence. School shootings may not be isolated occur-
rences but could share underlying factors with off-campus vio-
lence. Hence, policy solutions should be comprehensive,
intertwining with strategies to address gun violence more
broadly, especially those targeting weapon accessibility.
Overall, these findings stress the critical public health mes-
sage concerning the secure storage of firearms, especially in
households with adolescents. Our study suggests that initia-

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 Research Original Investigation Firearms Used in Adolescent School Shootings

Table 2. Firearm Acquisition Sources and Method of Obtainment in US School Shootings Involving Adolescents, 1990-2016a
Proportion of Legal purchase Borrowed or gifted Taken or stolen Illegal purchase Found randomly
Acquisition source acquisition source (n = 4) (n = 22) (n = 78) (n = 22) (n = 2)
Obtainment method (unadjusted data), No. (%; 95% CI)
Licensed dealer 4 (3.1; 1.2-8.1) 4 (100.0) NA NA NA NA
Family or relative 69 (53.9; 45.2-62.4) NA 3 (13.6; 4.4-35.1) 66 (84.6; 74.7-91.1) NA NA
Friend or acquaintance 25 (19.5; 13.5-27.4) NA 19 (86.4; 64.9-95.6) 6 (7.7; 3.5-16.2) NA NA
Stranger or person 6 (4.8; 2.1-10.1) NA NA 6 (7.7; 3.5-16.2) NA NA
who was shot
Street or illegal market 24 (18.9; 12.8-26.5) NA NA NA 22 (100.0) 2 (100.0)
Obtainment method (adjusted data), % (95% CI)b
Licensed dealer 1.9 (0.7-5.2) 100.0 NA NA NA NA
Family or relative 41.8 (31.7-52.6) NA 6.5 (1.8-20.8) 82.1 (69.4-90.3) NA NA
Friend or acquaintance 22.0 (13.2-34.5) NA 93.5 (79.2-98.2) 8.4 (3.5-18.7) NA NA
Stranger or person 4.7 (1.8-11.6) NA NA 9.5 (3.7-22.0) NA NA
who was shot
Street or illegal market 29.6 (19.3-42.5) NA NA NA 100.0 100.0
Abbreviation: NA, not applicable. the percentage of Black residents, Latino/a/x residents, and residents other
a
Obtainment method captures how the gun was procured from the acquisition than White; residents born outside the US; residents younger than 18 years;
source. Hence, there is an overlap between these 2 variables. Specifically, the percentage of residents living below the poverty line; unemployment;
licensed dealer had only 2 possible combinations: legal purchase or taken or public assistance dependency; households headed by women; residents
stolen; however, all cases in the data were obtained via the former method. without a high school diploma; the proportion of total land that is vacant;
All other gun sources offered diverse obtainment methods. Percentages may the percentage of owner-occupied homes; residents who lived in the same
not add to 100 due to rounding. house 5 years earlier; and urbanicity.
b
The 14 variables used to calculate adjusted estimates include the following:

tives limiting adolescent access to firearms, such as child ac-
cess prevention laws or efforts to decrease illegal gun traffick-
ing, might effectively prevent school shooting incidents.23,24
Furthermore, hospital-based initiatives centered on screen-
ing for firearm accessibility and exposure for inpatients could
be fruitful in preventing gun violence, both inside and out-
side schools.25
Limitations
This study has some limitations. We used publicly sourced
data, presenting benefits and challenges when evaluating
firearm characteristics and acquisition methods. Despite
TASSS’s rigor and this study’s strong intercoder reliability,
open sources can include vague, imprecise, and conflicting
information, leading to human and other measurement
errors. Therefore, we advise readers to approach the results
with caution. Moreover, although we adjusted for missing
values, which had minimal impact on the estimates, signifi-
cant data were missing for some variables, which may dis-
tort this study’s findings if these missing values could ever
be captured. In addition, TASSS data are current only up to
2016. Analyzing more recent data in future research could
reveal new and evolving trends.
Conclusions
The results of this study provide valuable insights that can in-
form both public health interventions and policy measures.
The study highlights the need for comprehensive strategies,
including better firearm safety practices at home, legal mea-
sures, and community education, to address the multifac-
eted issue of school shootings. Ultimately, this study sup-
ports policies encouraging secure firearm storage in households
and limiting adolescents’ access to firearms through legisla-
tive measures, educational campaigns, or public health ini-
tiatives. The study further underlines the role played by the
illegal market and informal networks (such as friends and
acquaintances) in firearm acquisition, implying the need to
bolster efforts to curtail illegal firearm trafficking.

ARTICLE INFORMATION
Accepted for Publication: September 20, 2023.
Published Online: November 27, 2023.
doi:10.1001/jamapediatrics.2023.5093
Author Contributions: Dr Klein had full access to
all of the data in the study and takes responsibility
for the integrity of the data and the accuracy of the
data analysis.
Concept and design: Klein, Schnell.
Acquisition, analysis, or interpretation of data:
All authors.
Drafting of the manuscript: Klein, Schnell, Lewis.
Critical review of the manuscript for important
intellectual content: Klein, Trowbridge, Schnell.
Statistical analysis: Klein, Trowbridge, Schnell.
Obtained funding: Klein.
Administrative, technical, or material support: Klein.
Supervision: Klein, Schnell.
Conflict of Interest Disclosures: Dr Klein reported
grants receiving from the National Institute of
Justice during the conduct of the study. No other
disclosures were reported.
Funding/Support: The data used for this
manuscript were collected as part of 3 National
Institute of Justice awards: 2016-CK-BX-0013;
2018-R2-CX-0002; 2020-CK-BX-0003.
Role of the Funder/Sponsor: The National
Institute of Justice had no role in the design and
conduct of the study; collection, management,
analysis, and interpretation of the data;
preparation, review, or approval of the manuscript;
and decision to submit the manuscript for
publication.
Disclaimer: The views and statements contained
herein are those of the authors and do not
necessarily reflect the National Institute of Justice.
Data Sharing Statement: See Supplement 2.

E6 JAMA Pediatrics Published online November 27, 2023 (Reprinted) jamapediatrics.com

© 2023 American Medical Association. All rights reserved.

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 Firearms Used in Adolescent School Shootings
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