Livingston MD, et al. – In this study, researchers examined the associations of individual-, school-, and gun-level factors with school shooting severity in the United States from April 1999 through May 2018 in order to assess how characteristics related to the school, shooter, and guns used impact school shooting severity (eg, casualty rates, fatality rates, and likelihood of fatality). In the majority of school shootings, handguns were used, but when rifles or shotguns were used, substantially more fatalities were reported. Fatal shootings were more frequently faced by schools: in which the majority of the student and administrative bodies were white, that taught younger students, and that were rural or suburban. Shooters who were older were associated with more severe shootings and, therefore, were unlikely to be students. Furthermore, no reduction in school shooting severity was observed in correlation to the presence of a school resource officer. These findings highlighted the necessity for prevention efforts beyond those commonly used in schools in addition to the need for improved laws.