Children are more likely to be killed in mass shootings by their parents or family members rather than by strangers or peers at school, according to findings from a new study.

Researchers analyzed 121 pediatric mass shootings involving 308 child fatalities from 2009 to 2020 using data from two comprehensive sources: the Mass Killing Database and the Everytown for Gun Safety Mass Shooting in America database. The team independently verified each incident using three or more corroborating sources, including news reports and police records. The study defined pediatric mass shootings as incidents in which four or more victims were killed, excluding the perpetrator, with at least one victim aged younger than 18 years. The mean age of child victims was 9.7 years.

Parental figures were the most common perpetrators, responsible for 40.9% of all child victims (126 deaths), while family members as a whole accounted for 59.1% of mass shooting casualties (182 deaths). Acquaintances were the next most frequent perpetrators (14.6%), followed by strangers (12%), and classmates (6.8%). Other perpetrators included aunts or uncles (5.5%), siblings (4.9%), former relatives/in-laws (2.6%), grandparents (1.9%), and neighbors (2.6%).

"While school shootings dominate media coverage, our work suggests that domestic violence plays a larger role in child mass shootings," wrote first study author Pamela Emengo, MD, of the Division of Pediatric Surgery in the Department of Surgery at Stanford University School of Medicine, and colleagues in JAMA Pediatrics.

White children represented the largest racial group of victims (51.9%), followed by Black (19.2%), Hispanic or Latino (15.6%), Asian or Pacific Islander (4.5%), and American Indian or Alaska Native (1.9%) children. An additional 4.2% of victims were categorized as "other," while race or ethnicity was unknown for 2.6%.

"Our work is among the first to highlight parents as the predominant perpetrators of mass shootings involving children," noted the authors, suggesting the findings may support firearm injury prevention initiatives focused on decreasing gun access in the home rather than policy proposals such as arming teachers with weapons.

The research was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health.

The authors declared having no competing interests.