University of Wisconsin–Madison ⋅ Medical College of Wisconsin
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Do We Really Care About Our Children’s School Safety? The Proof Is in the Pudding

Steven Lippmann, MD

WMJ. 2026;125(2):237-238. Published June 2, 2026.

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Gunshots are a major, tragic cause of death among American children,1 and school shootings involving children have increased.2-4 Too many are also dying by firearm-induced suicide, homicide, or accidents, often with associated emotional turmoil. Is our society sufficiently concerned to do something about it?

Firearm-related incidents have occurred for decades. However, gun-related events and shootings at US schools now occur much more often than in the past.1-4 Indeed, our country is experiencing an epidemic of dangerous school shootings,1-5 with the number of such incidents increasing by more than 700% in the last two decades.2

During 2023 and 2024, an average of 341 gun-related incidents were reported in schools each year.2 Such events also included nonshooting circumstances. However, gunfire in each of those years resulted in approximately 260 firearm-related casualties. About 20% of cases resulted in death, and approximately 80% resulted in nonfatal injuries, either from gunshot wounds or injuries sustained while attempting to avoid a shooting.

A 2025 report on the sequelae of gunfire on school grounds documented 141 shootings, with 44 fatalities and 129 injuries.4 However, these statistics also illustrate the difficulty of comparing data across incidents, locations, and years. The cited numbers vary considerably.1-4 There is substantial variation in how such events are defined and counted, contributing to inconsistencies in news reports.5

For example, definitions may differ regarding whether deaths occurred immediately or later, and whether injuries resulted directly from gunshot wounds or from attempts to evade harm. Reported incident numbers also differ because some definitions include only the discovery of a gun or a shooting threat in or near a school – even when no one is shot or no one is present in the building (eg, a drive-by shooting at a school). Additional complexity arises when reports include events occurring away from school grounds, such as at games, field trips, or similar occasions, as well as on school buses or at distant school bus stops.6 Other data inconsistencies arise when reports do or do not include threats of gun violence or the mere discovery of a firearm in a school. Regardless, all of these circumstances have a negative impact on kids.

Gun violence also has significant negative psychological effects, including fear of being shot, exposure to possible firearm threats or presence, and anxiety associated with news reports, metal detectors, increased police presence, and similar measures intended to prevent such events. Beyond the many tragic deaths, this is physically and emotionally harmful to society especially our children.

People voice concern about school safety, but is there sufficient evidence that our society is trying to address this trend? A large number of children have witnessed these events; they are the ones who must cope with the associated risk and/or trauma, especially during school hours. The general public rarely enters school buildings; thus, most adults do not experience these dangers firsthand. They are insulated, yet they are responsible for –  and influential in – government policy and planning.

What people do matters more than what they say. Given awareness of this crisis, Americans should work to address the well-being of school-age children. Physicians can play a productive role in such leadership.7-11

Efforts to reduce the risk of kids being shot at school and elsewhere may begin by talking to others about improving safety. This should include advocating for action from members of Congress, state legislators, governors, mayors, and local or school officials. Engaging with col-leagues and presenting at medical meetings are additional strategies. Become an activist, write letters to newspapers or journals, and participate in community meetings to help shape the desired change. A serious, focused national dialogue may help reduce this problem. Reducing firearm violence in this country would benefit us all – especially our children.

REFERENCES
  1. Whiteman PJ, Macias-Konstantopoulos WL, Relan P, Knopov A, Ranney ML, Riviello RJ. Violence and abuse: a pandemic within a pandemic. West J Emerg Med. 2023;24(4):743-750. doi:10.5811/westjem.58405
  2. Arundel K. School shootings in 2024 fell just below prior year’s record high. K-12 Dive. January 8, 2025. Accessed November 15, 2025. https://www.k12dive.com/news/school-shootings-2024-near-record-high-2025-predictions/736590/
  3. Active Shooter Incidents in the United States: 2024. Federal Bureau of Investigation, Advanced Law Enforcement Rapid Response Training Center; 2025. Accessed November 15, 2025. https://www.fbi.gov/file-repository/reports-and-publications/2024-active-shooter-report/view
  4. Gunfire on school grounds in the United States. Everytown for Gun Safety Support Fund. Accessed November 15, 2025. https://everytownresearch.org/maps/gunfire-on-school-grounds
  5. Betz ME, Harkavy-Friedman J, Dreier FL, Pincus R, Ranney ML. Talking about “firearm injury” and “gun violence”: words matter. Am J Public Health. 2021;111(12):2105-2110. doi:10.2105/AJPH.2021.306525
  6. Foster M, Shapiro E. Young woman shot dead while walking child to bus stop in Louisville. ABC News. August 13, 2025. Accessed November 15, 2025. http://abcnews.go.com/US/young-woman-shot-dead-walking-child-bus-stop/story?id=124622543
  7. Wintemute GJ, Betz ME, Ranney ML. Yes, you can: physicians, patients, and firearms. Ann Intern Med. 2016;165(3):205-213. doi:10.7326/M15-2905
  8. Lippmann S. Doctors teaching gun safety. J Ky Med Assoc. 2015;113(4):112.
  9. Lippmann S. Can we stop gun shooting of kids in school? Internet and Psychiatry. February 2, 2025. Accessed November 14, 2025. https://www.internetandpsychiatry.com/wp/editorials/can-we-stop-gun-shooting-of-kids-in-school/
  10. Enja M, Srinivasan K, Lippmann S. Offer these interventions to help prevent suicide by firearm. Curr Psychiatr. 2016;15(5):e1-e3. Accessed November 13, 2025
  11. Miller ZM, Cooper BP, Lew D, et al. Factors associated with recurrent pediatric firearm injury: a 10-year retrospective cohort analysis. Ann Intern Med. 2024;177(10):1381-1388. doi:10.7326/M24-0430
Author affiliations: Emeritus professor, School of Medicine, University of Louisville, Louisville, Kentucky.
Corresponding author: Steven Lippmann, MD, email steven.lippmann@louisville.edu; ORCID ID 0000-0003-0601-6866
Financial disclosures: None declared.
Funding/support: None declared.
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