A higher prevalence of gun ownership in rural America has contributed to increased suicides, raising the overall gun-death rate in rural areas above that of urban communities.

Experts say some legal interventions that have broad public support could help lower the risk of people harming themselves or others with guns.

Suicide Rates in Rural America

In 2020, the rural gun death rate was 28% higher than the urban rate. Nonmetropolitan counties reported 17.01 deaths per 100,000 residents, compared to a rate of 13.19 in urban America, according to CDC reports.   

Although urban areas have higher rates of gun homicide, rural places have higher firearm deaths overall because suicides make up about two thirds of gun deaths nationwide, says researcher Michael Siegel, PhD, of Tufts University School of Medicine. Siegel says it is important to categorize gun deaths into three groups. 

“There’s firearm homicide, there’s firearm suicide, and then there’s unintentional injuries,” Siegel said in a phone interview. 

Siegel said that the high rates of suicide in rural America can be explained in part by the prevalence of gun ownership. While 46% of rural residents say they own guns, only 19% of urban residents say they own guns, according to PEW Center studies. 

“Because we know that guns are the most lethal means for suicide, if a gun is available, a suicide attempt is likely to result in a death,” said Siegel. “Whereas, if there aren’t guns around, other methods that people might use to attempt suicide are not as lethal.”

Mandatory Waiting Periods

Siegel said that prevention measures such as mandatory waiting periods and red flag laws can lower gun death rates. 

“Suicide is an impulsive behavior, so people who are maybe feeling suicidal, if they can just run to the store and get a gun that day, they can use it,” Siegel said. “But if there’s a mandatory waiting period before they’re allowed to deliver the gun, then once that waiting period goes by, they may have come out of their crisis.”

Waiting periods could help rural communities in the American West that have some of the highest suicide rates in the country. The suicide rate in Montana was 27 suicides per 100,000 residents in 2019, twice the national rate. Sixty percent of the suicides were completed using firearms. 

From 2019 to 2021, Flathead County, Montana, witnessed a suicide rate of 39.3 suicides per 100,000 residents. The total gun death rate in 2021 was 22.67 deaths per 100,000 residents, 65% higher than the national rate of 13.73. 

Waiting periods wouldn’t stop those who already own guns from committing suicide. Given the prevalence of gun ownership in rural America, red flag laws may be more effective at removing firearms for individuals who are a threat. 

Red Flag Laws

The specifics of red flag laws vary from state to state and may go by a variety of different names. They allow law enforcement or concerned family members to petition a court to remove firearms from individuals deemed to be a threat to themselves or others. 

In Illinois, for instance, family and household members may file a petition to remove firearms from an individual for up to six months. Some states, on the other hand, only allow law enforcement to petition a court for firearm confiscation, with confiscation periods ranging from six months to a year. 

The proof needed to confiscate firearms also varies. Some requirements are stricter than others, but experts and citizens alike support these laws as a way to prevent violence. 

In rural Dillon County, South Carolina, the gun death rate was 88.91 in 2020. At more than six times the national rate, Dillon had the worst gun-death rate of all nonmetropolitan counties that year. 

In 2020, the gun death rate in Dillon County was 61.9% higher than Mississippi County, Arkansas, the next highest nonmetropolitan county. But in contrast to most other rural counties, the high gun deaths were a result of homicide instead of suicide.

In 2020, 4.4% of all deaths in Dillon were homicides, compared to only 1% of all deaths in the state of South Carolina. Reporter Braley Dodson said that, in 2020, one in every 25 deaths in Dillon County was a murder. 

“In 2021, we saw the number of shootings in Dillon and Darlington County skyrocket in areas that used to have maybe one homicide a year… we were seeing several at the beginning of the year,” Dodson said in an interview. 

Dodson told the Daily Yonder that local law enforcement thinks the increased murders are from drug-related activity that recently moved to the area from elsewhere. 

Law enforcement repeatedly told Dodson that “the players are the same.” In other words, the violent perpetrators are often the same people. 

“There was a guy out on bail for a double or triple homicide that got arrested for another shooting,” Dodson said. “The pandemic put off some of these trials, and judges had a certain amount of time to try a person or they were going to release them on bail.” 

Although red flag laws could have prevented some of these crimes by confiscating the firearms of individuals who had already been arrested for gun violence, some violence is committed using stolen weapons. This is why local police departments urge residents to keep their guns locked, safe, and out of reach of children. Dodson said she found that a quarter of the shooting victims in the area last year were under 19 years old. 

Earlier this month, a five year old in Dillon County accidentally shot himself and his sister after getting his hands on an improperly stored handgun. 

Overwhelming Support for Protection Measures

Siegel said that support for red flag laws and mandatory waiting periods tend to transcend the political divide. 

“It transcends urban versus rural, it transcends red state versus blue state, it transcends even political party,” said Siegel. “Even if you just look at Republican gun owners, there is very widespread support for [mandatory waiting periods and red flag laws].”

Siegel said he found that over 60% of Republican gun owners support red flag laws. 

U.S. Senator Marco Rubio (R-FL) introduced the Extreme Risk Protection Order and Violence Protection Act, a bipartisan protection effort to incentivize states to enact red flag legislation “while still providing due process protections.” 

Rubio is not the only Republican to support similar legislation. Senator Lyndsey Graham (R-SC) has supported bipartisan protection orders.

“There are a lot of conservatie states that have adopted domestic violence or red flag legislation,” he said.  

In a recent interview with gun safety organization Everytown, Siegel said his research also demonstrates widespread support for other safety measures such as background checks. Survey results reveal that 87% of gun owners support background checks for concealed carry permits, while 79% support removing firearms for those subject to domestic violence restraining orders. 

“Other than the NRA [National Rifle Association], there’s really nobody who says that people who are known to be a risk to themselves or other people should have access to a gun,” said Siegel. “When you’re talking about these laws that are really intended to keep guns out of the hands of people who are at high risk of violence, that seems to be a principle that everybody agrees with.”

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