A Comparative Study of Terrorist Attacks Targeting Healthcare in North America vs Europe

Objective: This study sought to compare terrorist attacks targeting healthcare in two different geographical areas that are economically and culturally similar: North America and Europe. Methods: The Global Terrorism Database is a database that documents 214,666 worldwide terrorist events from 1970 to 2021. It was searched to identify terrorist attacks against healthcare using keywords. We manually excluded incidents that did not specifically relate to attacks on healthcare. This resulted in 311 and 150 entries in North America and Europe respectively. Results: The most common method of attack in Europe was bombing (42%) compared to attacks on infrastructure (66%) in North America. The primary target in North America was abortion related (84%). In Europe, the primary target was businesses (37%). In Europe, 18.7% of attacks were assassinations or attempts vs 3% in North America. The total number of fatalities in Europe is 51 vs 3 in North America. Conclusion: Even though there were significantly more attacks in North America, there were far fewer total fatalities compared to Europe. Attacks in North America appear to be ideological, targeting infrastructure to send a message. Whereas, in Europe, the targets and methods used are more targeted towards the individual and their property.