Drawing on the theory of policy diffusion, I analyze 129 regulatory firearm law provisions from 1991 to 2019 across the United States and examine the innovation and development of restrictive firearm policies. I control for the demographics, politics, and institutional characteristics of the states and hypothesize that public health concerns lead to the adoption of firearm regulations. I find support for my hypothesis: most novel, state firearm policy diffusion is dependent on state firearm suicide and homicide rates. Furthermore, I find that states are more likely to adopt policy if they are characterized by a large population, a large white population, high firearm ownership, a liberal government, or if their geographical neighbors are actively adopting firearm regulations. Firearm-related fatalities have risen dramatically, but a majority of states have adopted few policies to address this public health concern. My article highlights the state-level factors that produce a public policy response to this phenomenon.