Surviving a school shooting: Impacts on the mental health, education, and earnings of American youth

Key Takeaways

• More than 100,000 American children attended a school at which a shooting took place in 2018 and 2019.

• Research indicates a higher rate of antidepressant use among those exposed to a school shooting in the years following the gun violence.

• School shootings lead to drops in student enrollment and a decline in average test scores.

• School shootings also lead to an increase in student absenteeism and the likelihood of needing to repeat a grade in the two following years.

• Students exposed to shootings at their schools are less likely to graduate high school, go to college, and graduate college, and they are less likely to be employed and have lower earnings in their mid-20s.

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As America reels from yet another school shooting — this one at Robb Elementary School in Uvalde, Texas — much of the public discussion has centered on the lives lost: 19 children and 2 teachers. The Uvalde massacre is the second deadliest on record, following the 2012 shooting at Sandy Hook Elementary School.

These shootings are only two on an already long list of horrific tragedies that have cut short the lives of too many children and their educators over the past decades. According to the Washington Post school shootings database, at least 185 children, educators, and others have been killed by gun violence at American schools since the Columbine massacre in 1999, leaving behind hundreds of grief-stricken family members, friends, and communities.

The costs of school shootings for the direct victims and their loved ones are unimaginable. And an increasing body of research shows that the death toll captures only one part of the broader lasting impact that gun violence at schools permeates throughout our society.

Hundreds of thousands of students exposed

Over the last two decades, the number of shootings at U.S. schools has doubled, and in my research with Marika Cabral, Bokyung Kim, Molly Schnell, and Hannes Schwandt, we estimate that more than 100,000 American children attended a school at which a shooting took place in 2018 and 2019 alone (Cabral et al., 2021). Although mass school shootings such as the one in Uvalde tend to receive significant media attention, the majority of shootings are thankfully much less deadly and also less widely publicized. In fact, about three-quarters of shootings in 2018 and 2019 led to no fatalities at all, and the vast majority had fewer than two deaths.

Researchers have been analyzing the impacts of exposure to shootings on the growing number of students experiencing them in American schools. While many students are physically unharmed, studies have consistently found consequences to their mental health, educational, and economic trajectories that last for years, and potentially decades, to come.

A large interdisciplinary body of research characterizes the neurological and physiological mechanisms through which trauma from exposure to violence can impact young people. In brief, such trauma can affect both the biological stress system as well as young developing brains (see, e.g.: Osofsky, 1999; De Bellis, 2001; Carrion et al., 2002, 2007, 2008, 2012; De Bellis and Zisk, 2014; Heissel et al., 2018; Miller et al., 2018).

Consistent with these mechanisms, large numbers of studies from different countries and contexts have documented negative effects of exposure to local community and domestic violence on children’s educational and behavioral outcomes (see, e.g.:  Cook and Ludwig, 2002; Aizer, 2007; Caudillo and Torche, 2014; Sharkey, 2010, 2018; Sharkey et al., 2012, 2014; Duque, 2017; Monteiro and Rocha, 2017; Gershenson and Tekin, 2018; Koppensteiner and Menezes, 2021).

At the same time, some have argued that children are very resilient and can “bounce back” from trauma, implying that childhood violence exposure — while being damaging in the short run — may not have lasting effects (Agaibi and Wilson, 2005; Goldstein and Brooks, 2005; Garrett et al., 2019).

A matter of location: Why school shootings differ from gun violence elsewhere

There are several reasons why shootings at schools may impact children differently than when they occur elsewhere. Recent studies show that local exposure to police killings of unarmed Black and Hispanic individuals adversely affects the mental health of Black adults (Bor et al., 2018) and educational outcomes of Black and Hispanic students (Ang, 2021).

The mechanisms driving these impacts may include the possibility that Blacks and Hispanics feel a stronger connection to same-race victims of police brutality and that they view these events as breaking their trust in institutions such as law enforcement. Similarly, children exposed to shootings at schools may suffer more acutely than when they are exposed to violence in other settings because of their connection to student and teacher victims and the loss of trust in their schools’ ability to keep them safe.

Further, the intensive media coverage that comes with a school shooting is likely to have put many American students on edge. So much so that exposure to any gunshots in a school setting — even an accidental discharge — may be particularly traumatic if it invokes an intense amount of fear (Lowe and Galea, 2017). Also, compared with violence in other contexts, school shootings are likely to cause a greater amount of disruption to student learning, as they might affect teacher turnover rates, teaching quality, classroom resources, and the continuity of instruction.

Lastly, given that “peer effects” in schools are important — i.e., students’ learning and well-being are highly influenced by what their peers do in the classroom setting — the adverse impacts of a student’s own trauma from experiencing a school shooting may be amplified due to disruptions from other shooting-exposed peers (Carrell et al., 2018).

Early impacts on survivors: Mental health and education

Several studies demonstrate that school shootings have detrimental effects on the mental health and educational outcomes of surviving youth. In my work with Molly Schnell, Hannes Schwandt, Sam Trejo, and Lindsey Uniat (Rossin-Slater et al., 2020), we analyzed the impacts of 44 U.S. school shootings that took place between 2008 and 2013 on youth antidepressant use.

We compared the number of antidepressant prescriptions written by providers practicing within five miles of a school that experienced a shooting with those written by providers 10 to 15 miles away, both before and after the shooting. Our results indicated that the average monthly number of antidepressant prescriptions written to youth under age 20 by providers located near schools that experienced a fatal shooting was 21.3 percent higher relative to providers located farther away in the two to three years following a shooting than in the two years before.

Consistent with this evidence suggesting a deterioration in shooting-exposed children’s mental health, Levine and McKnight (2020) document an increase in deaths (including suicides and accidents) among residents of Jefferson County, Colorado, who were between 14 and 18 at the time of the 1999 shooting at Columbine High School (which is located in that county).

When it comes to educational outcomes, studies have found that school shootings lead to drops in student enrollment and a decline in average test scores (Abouk and Adams, 2013; Poutvaara and Ropponen, 2018; Beland and Kim, 2016; Levine and McKnight, 2020).

In my research with Marika Cabral, Bokyung Kim, Molly Schnell, and Hannes Schwandt, we examined the effects of the 33 shootings that took place during school hours at public schools in Texas between 1995 and 2016 (Cabral et al., 2021). We used detailed administrative student-level data on all children in Texas public schools and analyzed changes in educational outcomes within the same students in the years before and after a shooting.

In order to control for general time trends, we compared these within-student changes to changes in students from control schools that were chosen to be similar based on their institutional and student demographic characteristics. We found that, in the two years following a shooting, exposed students experienced a 12.1 percent increase in the share of school days that they were absent, a 27.8 percent increase in the likelihood of being chronically absent, and a more than doubling of the likelihood of needing to repeat a grade.

The long haul: Educational and economic outcomes for shooting survivors

Our team also studied longer-term consequences of exposure to gun violence at schools. In this analysis, we studied the impacts of the eight shootings that took place at Texas public high schools between 1998 and 2006 on individual outcomes through age 26.

We compared cohorts of shooting-exposed students with cohorts that attended the same schools in the years before the shooting occurred. As in the short-run analysis, we compared these differences in cohort outcomes with the analogous cohort differences in matched control schools.

We found that students who were exposed to a shooting at their school in grades 10 and 11 were 3.7 percent at the mean less likely to graduate from high school; 9.5 percent less likely to enroll in any college; 17.2 percent less likely to enroll in a four-year college; and 15.3 percent less likely to obtain a bachelor's degree by age 26.

We also found that students exposed to shootings in grades 9 through 11 were 6.3 percent less likely to be employed and had $2,779.84 (13.5 percent) lower average annual earnings between the ages of 24 and 26. Our estimates imply a reduction of $115,550 (in 2018 dollars) in the present discounted value of lifetime earnings per shooting-exposed student. Given that approximately 50,000 children per year have been experiencing shootings at their schools in recent times, this amounts to an aggregate cost of $5.8 billion per year in terms of lost lifetime earnings among survivors.

Importantly — and thankfully — the shootings that we studied in Texas were not as deadly as the one in Uvalde. In fact, 18 of the 33 shootings had no fatalities, and no shootings had more than one death. And yet, our research indicates that these less deadly and mostly unpublicized acts of gun violence at schools have major and long-lasting consequences for many children who were on school grounds when they occurred.

Lessons learned and policy considerations

It is impossible to overstate the devastation caused by the lives lost to school shootings. But research indicates that even those who escape these events without any visible physical harm carry scars that could impair their lives for many years to come.

While it is undeniably clear that the United States urgently needs to take action to prevent school shootings from occurring in the first place, it is also important to remember the hundreds of thousands of children who have already experienced them.

Indeed, our team’s estimates of the impacts of exposure to school shootings in Texas on children’s long-run outcomes are comparable in magnitudes to those found by researchers who studied the survivors of the 2011 massacre in Utøya, Norway (Bharadwaj et al., 2021). The Utøya shooting was the deadliest event in recent Norwegian history, killing 69 people. It is therefore in some ways remarkable that we find similarly large negative impacts of exposure to shootings in Texas public schools in which at most one person was killed.

While Norway and Texas differ in a variety of ways, it is important to note that the Norwegian government provided substantial resources and support to the survivors of the Utøya attack, which likely buffered against some of the detrimental long-term effects. In comparison, we are not aware of governmental responses to the school shootings that we studied, and we did not find any changes in observable mental health resources to support students (e.g., as measured by the number of social support staff) at the school level.

Thus, as we mourn the 21 lives tragically cut short on May 24, 2022, in Uvalde, we must not forget about the hundreds of students who were also at school on that day. This loss of life underscores the devastating cost of America’s continued inaction on gun control. And as policymakers debate what can be done to prevent school shootings, they must also act to help the hundreds of thousands of children who have already survived them.

Taking steps similar to those in Norway, Congress and statehouses throughout the U.S. can ensure that schools, families, and communities have access to mental health resources and financial support. This is of paramount importance if our society wants to give these children a chance at prevailing as happy, successful, and productive adults.

Maya Rossin-Slater is a SIEPR Senior Fellow and an Associate Professor of Health Policy in the Department of Health Policy at the Stanford University School of Medicine. Her research includes work in health, public, and labor economics. She focuses on issues in maternal and child well-being, family structure and behavior, and policies targeting disadvantaged populations in the United States and other developed countries.

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