This quasi-experimental event study examined whether the top 10 deadliest US mass shootings (2008–2023) were associated with short-term increases in nationwide fatal motor vehicle crashes, using the Fatality Analysis Reporting System and Google Trends data for 'shooting' search interest.
On the day after a major mass shooting, traffic fatalities rose by an average of **14.3%**, equating to **19.9 additional deaths** (95% CI, 12.7–27.1) nationwide — roughly **75% of the direct death toll** of the shooting events themselves. Non-fatal active shooter events showed no significant rise in internet search interest or traffic fatalities.
- Analysis is limited to only the **10 deadliest** shootings, restricting generalizability to less severe events. - Causal mechanism (distraction, acute stress) is inferred from correlated search interest data, not directly measured. - Full text was under embargo; some methodological detail could not be verified beyond the abstract.
Clinicians and public health officials should recognize that major mass shootings carry a **hidden secondary mortality burden** via traffic fatalities — a nation-level effect lasting at least the day after the event. Emergency preparedness and trauma systems may need to account for this surge beyond the immediate shooting region.
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