A new study led by Stanford Medicine has revealed a remarkable trend in mass shootings involving children: the majority of pediatric victims are killed by family members rather than strangers. The research, published in JAMA Pediatrics on February 10, provides crucial insights into the underlying causes of gun-related deaths among children in the United States.
The study, which analyzed mass shootings resulting in at least four fatalities between 2009 and 2020, found that 59% of child victims were killed by a relative. Parents were the perpetrators in more than 40% of cases. Other relatives, including aunts, uncles, siblings, grandparents, and cousins, accounted for the remaining familial-related deaths.
“It was surprising that domestic violence was so pervasive,” said Dr. Stephanie Chao, the study’s senior author. “When American parents are surveyed about their concerns, everyone is worried about school shootings. The message from our data is really simple: Our fears are incorrectly placed. Our homes may, in fact, be more dangerous than schools.”
Researchers found that after relatives, the most common perpetrators were acquaintances (14.6%), strangers (12%), classmates (6.8%), neighbors (2.6%), and criminal associates (0.6%). In about 4% of cases, the relationship between the shooter and the victim could not be determined.
Chao emphasized that mass shootings in public spaces such as schools and concerts receive extensive media attention, creating a skewed perception of where the greatest dangers lie. “People tend to think that gun violence occurs mostly at random events that they cannot protect their child against,” she said. “But domestic violence doesn’t make headlines because it happens with more frequency. That is precisely why it is more dangerous.”
With more than 22 million children living in U.S. homes with firearms, the study underscores the importance of preventive measures. Chao suggests that removing guns from households experiencing domestic disturbances or mental health crises could help reduce child fatalities.
As part of their commitment to tackling the issue, Chao’s team is developing an educational curriculum called PLEDGE, designed to teach K-12 students about firearm safety and injury prevention. The program follows a structured, multi-phase approach to ensure its effectiveness.
The first phase, Community Input and Research, gathers feedback from key stakeholders—including educators, parents, and students—to tailor the curriculum to real-world needs. Next, the Curriculum Development phase involves creating educational materials with contributions from experts in law enforcement, pediatrics, behavioral science, and education. Finally, the Implementation and Expansion phase integrates the finalized curriculum into existing school safety and health programs, with the long-term goal of nationwide adoption.
The study highlights the urgent need to address domestic gun violence, as the majority of child victims in mass shootings are killed by family members rather than strangers. By shifting focus from public mass shootings to dangers within the home, researchers advocate for preventive measures such as firearm removal in high-risk households. Through initiatives like the PLEDGE curriculum, efforts are underway to educate children and reduce gun-related fatalities.
