Public Health Consequences of Mass Shootings

Indiscriminate mass shootings in public spaces cause direct harm through loss of life and severe injuries, but they also inflict psychological harm in affected communities. Relatively little is known, however, about the impacts on those who are not direct victims.

In The Hidden Cost of Firearm Violence on Pregnant Women and Their Infants (NBER Working Paper 31774), Janet Currie, Bahadır Dursun, Michael Hatch, and Erdal Tekin investigate the consequences of these attacks for some of society’s most vulnerable members, pregnant women and their infants.

Pregnant women’s exposure to the Beltway sniper shootings that terrorized metropolitan Washington in 2002 increased the likelihood of very low birth weights and premature births.

The researchers consider the “Beltway sniper” attacks, a series of random shootings that terrorized the Washington, DC, metropolitan area and disrupted daily life over a three-week period in 2002. The data come from restricted administrative birth records with maternal residential addresses in Virginia. The authors compare birth outcomes of children who were in utero during the attack and whose mothers lived near a shooting location with birth outcomes of children who were not exposed. They find that exposure to the Beltway sniper attacks during pregnancy increased the likelihood of very low birth weights and very premature births by 25 percent. The increase in the risk of very low birth weight was most pronounced, 40 percent and 35 percent respectively, for those exposed during the first and second trimesters. No effect was observed for those exposed during the third trimester. Effects on extreme prematurity were also concentrated among those exposed during the first two trimesters. The researchers estimate that the total cost of the harms to children in utero during the Beltway sniper attacks was $15.5 billion in 2023 dollars.

The findings illustrate the importance of considering the impact of firearm violence on vulnerable populations. The researchers study in utero exposure to mass shootings more broadly using restricted-access US Vital Statistics Natality records from the period 2006 to 2019. They exploit variation in the timing of mass shootings in counties where at least one shooting occurred. They conclude that the effects of these shootings on in utero children average more than $7 billion annually. They point out that pregnant women and their infants may need additional support in the form of counseling and access to health care following incidents of mass gun violence.

— Lauri Scherer