[imgcontainer][img:suicideratebyrural2+copy.jpg][source]Daily Yonder based on data from from JAMA Pediatrics[/source]The suicide rate for males aged 10 to 24 years is on the rise in the smallest rural counties (top line, blue). But the rate for the most urban areas (1 million residents and up) is declining (bottom red line). A margin of error could affect individual years (the confidence interval is 95%), but the trend lines are consistent. Also, the vertical axis starts at 10, not zero. This separates the lines for clarity but exaggerates the slope of the lines. Click the chart to enlarge it.[/imgcontainer]

Researchers have known for years that rural residents are more likely to commit suicide than urban residents.

A new study examines this trend for young people aged 10 to 24 years.

Besides confirming that rural areas have higher suicide rates, the new study shows that gap is getting wider.

NPR and The Atlantic have done some good reporting on the study, which was published in the Journal of American Medical Association Pediatrics (though we could have lived without the dystopic art choices those news outlets made).

To this discussion, we’ll add one chart generated from data in the study. (And, obviously, our rather crude graphic art suffers from its own brand of dystopia.)

The various lines represent the suicide rates per 100,000 residents for eight categories of counties, sorted from most rural to the most urban for males, aged 10 to 24.

The blue line at the very top of the graph shows the suicide rate over the past 14 years for counties at the extreme rural end of the continuum (counties with fewer than 2,500 residents living in Census-defined urban areas).

During the period of the study, not only did these very rural counties have a higher suicide rate for 10- to 24-year-old males, the rate increased by nearly a point, from 18.98 per 100,000 residents to 19.93 per 100,000.

Conversely, the red line at the bottom of the graph shows the change in suicide rates for the largest urban areas – metro areas of 1 million residents and up. In those counties, the suicide rate dropped by about a point and a half – from 11.95 in 1996-98 to 10.31 in 2008-2010. Again, those represent suicides per 100,000 residents.

One line that sticks out is that of group 5. It’s the purple line with X’s that slopes upward in the middle of the chart. That line represents the male suicide rate in counties that have an urban population of 20,000 or more but are not metropolitan and are not adjacent to a metropolitan area. In those counties, the suicide rate climbed 2.5 points, or nearly 19% for the study period. That’s the highest increase out of all the different county groupings.

(The study sorted counties into eight categories using the USDA Economic Research Service’s Rural Urban Continuum Codes. The researchers lumped categories 8 and 9 into one group because the raw number of suicides in those counties was small.)

The suicide rates for females aged 10-24 were much lower – about a fifth of the male rates. But the rate of increase was larger. And, again, the counties that are the most rural had the highest suicide rate and the highest growth in suicide rates.

The suicide rate increased for every county category for females, while the rate fell in five out of eight categories for men.

The authors of the study say reducing the disparity in suicides between urban and rural young people means improving access to mental health services and removing the stigma of seeking such treatment.

The study also noted that rural suicides are more likely to be completed with guns than suicides in urban areas. A separate editorial in JAMA Pediatrics argues for safer methods of storing guns. “Safe storage of firearms in the homes of children or others at risk for suicide is a pragmatic rather than ideological issue that should not be contentious,” the editorial states.

Suicide is the third-leading cause of death among 10 to 24 year olds, ranking behind homicides and accidental injuries. 

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