Investigating Community-Level Approaches to Prevent Firearm Violence: A Qualitative Approach with Local Experts

Background: In 2020, over 45,000 people in the United States died due to firearm violence, which is an increase over previous years and includes homicides, suicides, accidents, and law enforcement deaths (CDC, 2022). In New York State, 2.79 people per 100,000 die each year as a result of firearm homicide (Institute for Health Metrics and Evaluation, 2022). Erie County, which includes Buffalo, experiences even higher rates of firearm violence, with an age-adjusted firearm mortality rate of 7.6 per 100,000 (EFSG, 2021). The racially motivated May 2022 shooting in Buffalo further demonstrates the pervasiveness of firearm violence in Erie County, including its most populous city.

Local leaders convened a task force to understand the nature of regional responsivity and identify opportunities for collaboration and intervention development to prevent firearm injuries. As part of this effort, a qualitative IRB-approved study with regional experts was undertaken to identify the best strategies to reduce firearm violence.

Methods: Recruitment followed an extensive environmental scan of all county agencies with missions that were inclusive of violence prevention. Agency representatives who were identified as knowledgeable about firearm prevention strategies were identified via snowball sampling and contacted for basic information about their activities and invited to participate in this research (n=34), either in-person or via Zoom. Of those who provided basic information, semi-structured qualitative interviews were conducted (n=23; a 67% participation rate) and were audio-/video-taped per participant agreement. Thematic and content analysis generated emergent themes through two rounds of coding.

Results: Participants were diverse by age, profession, and race/ethnicity and represented agencies in behavioral health, domestic violence, prison/re-entry programming, law enforcement, advocacy groups, and hospital-based violence programs. Summative content analysis identified major themes and subthemes in the data. Participants identified the key causes of firearm violence in the county as poverty, systemic issues, easy access to weapons, lack of education, lack of opportunity, substance abuse, anger issues, racism, and lack of resources. Identified gaps in the community include the need for more programming, addressing systemic issues, repairing the disconnect between police and the community, providing firearm education, and lack of funding for prevention services. Identified gaps with regards to firearm violence responses included the lack of trust between the community and police, the lack of a trauma-informed response, and the need to address systemic issues. Participants shared that funding allocations should be distributed across preventative services, systemic change efforts, firearm education, community policing, and evaluating the impact and outcomes of existing programs.

Conclusions: Many metropolises in the US are grappling with increases in firearm violence, yet little literature exists to guide them in developing coordinated efforts across sectors – efforts that may involve collaboration between non-profits, law enforcement, government officials, and academics. This study represents a first step in coordinating such an endeavor within one county, with particular emphasis on capacity-building among fragmented and underfunded non-profit agencies overwhelmed by clients struggling with individual risks and systemic inequality. These results may be used to facilitate coalition efforts in other communities in the US toward firearm violence prevention.