Violent death in American schools in the 21st century: reflections following the 2006 Amish School shootings.

JAMES N. LOGUE, DrPH, MPH 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). 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. 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. Nevertheless, these types of events pose special problems for students, parents, schools, and communities. 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.