On October 2, 2006, shootings at the West Nickel Mines Amish School resulted in the homicides of 5 female students and the suicide of the adult male perpetrator. This was the 19th violent death incident in Pennsylvania schools since 1992 and the 9th such incident of the 21st century in the state, based on data collected by the National School Safety Center (NSSC). (1)
Since 1992, both the NSSC and the Centers for Disease Control and Prevention (CDC) have tracked school-associated violent deaths occurring each school year throughout the country. NSSC identifies cases through a newspaper clipping service and voluntary reports from state and local education agencies and maintains a report based on this data collection process. The CDC bases its case finding on both the NSSC report plus the additional data sources. (2) The 2 registries are not expected to be the same because the CDC and NSSC use slightly different criteria for case finding and case definition.
School-associated violent deaths represent less than 1% of all homicides and suicides that occur among school-aged children. (3) Nevertheless, these types of events pose special problems for students, parents, schools, and communities. (4) This commentary reviews the continuing pattern of this public health problem into the 21st century, known risk factors, and actions that can be taken by medical and public health professionals to address this issue.
DESCRIPTIVE EPIDEMIOLOGY OF THE PROBLEM
In 1996, the CDC and its partners published the first comprehensive review of school-associated violent deaths during 1992-1993 and 1993-1994, confirming 105 deaths (76 student deaths) in 25 states. (2) In 2001, the CDC and its partners updated this review by focusing on the subsequent 5-year period, confirming 253 deaths (172 student deaths). (3) The US Departments of Education and Justice recently reported the total number of student deaths, by year, through 2004-2005, using CDC data on school-associated violent deaths. (5) The total number of school-associated homicides occurring each school year during the 1990s varied between 28 and 34. The number dropped to 13 and 11 during 1999-2000 and 2000-2001, respectively, and has steadily increased to 21 deaths during 2004-2005. No consistent pattern was observed, however, for school-associated suicides. The total number of suicides occurring each year over this 13-year period varied between 1 and 9. The current NSSC report identified more than 400 deaths in 43 states since 1992. (1)
The 2 CDC papers, the current NSSC report, and other investigations provide valuable information on patterns and potential risk factors. Most cases happened in high schools and in suburban or urban settings and involved non-white youths, males, and firearms. A primary motive for these events was an interpersonal dispute. Evaluations of homicide and suicide events in American schools in the 1990s by the CDC and other partners revealed significant temporal variations in these events over the school year. (6) Student homicide rates were highest near the start of each semester, while suicide rates showed no special variation, although the trend was generally higher in the spring semester.