How local prevention efforts and state regulations intersect to reduce fatal shootings: a configurational analysis of firearm policies in the United States.

Firearm violence arises from a complex interplay of local conditions and state regulations. Using coincidence analysis (CNA), we examined how combinations of city-level prevention efforts and state-level firearm policies correspond to fatal shooting rates across 100 US cities. Drawing on data from the Community Justice Violence Prevention Index, Everytown's gun-law rankings, the US Census Bureau, and the Gun Violence Archive, we identified configurations of state policies and local efforts associated with relatively low rates of firearm-related fatalities. Five distinct pathways characterized cities with lower shooting rates, involving combinations of regional location, restraining order prohibitors, authority to deny firearm purchases, police use-of-force data collection, microstamping for new handguns, city population, ban-the-box initiatives, city-wide reporting for hate crimes, school-based violence prevention programs, and local emergency response improvements. Findings underscore how multilevel policy environments jointly shape firearm violence outcomes and demonstrate the value of configurational methods for public health and policy research.