Death by gunfire is typically thought of as an urban plague, but rural America also has the affliction, says the New York Times. “Americans in small towns and rural areas are just as likely to die from gunfire as Americans in major cities,” said Charles Branas, an epidemiologist at the University of Pennsylvania School of Medicine. “The difference is in who does the shooting.” Suicides occur at a higher rate in rural areas than in cities or suburbs, with the rate rising steadily the more rural the community. With homicides, the trend works in reverse, with higher rates in more urban areas.
New research illuminates the substantial role of firearms in suicide. When Branas examined data from the federal Centers for Disease Control and Prevention, he found that the risk of dying by gunshot was the same in rural and urban areas from 1989 to 1999, findings that were published in The American Journal of Public Health. He concluded that in the most rural counties, the incidence of suicide with guns is greater than the incidence of murder with guns in major cities. People who see themselves as rugged frontiersmen are often reluctant to reach out for mental health treatment. If they do, they may see a physician instead of a psychiatrist or another trained mental health expert. Suicide risk factors like depression, economic worries, and alcohol use are heightened in rural areas by social isolation, lack of mental health care, and the easy availability of guns. “People say, ‘How could people living in such beautiful places commit suicide?’ ” said Nels Sanddal, a psychologist in Bozeman, Mont., and president of the Critical Illness and Trauma Foundation. “We have a culture of suicide.”