Cynthia A. Fontanella|Danielle L. Hiance-Steelesmith|Gary Phillips|Jeffrey A. Bridge|Natalie Lester|Helen Anne Sweeney|John V. Campo
Widening Rural-Urban Disparities in Youth Suicides, United States, 1996-2010
The Ohio State University Wexner Medical Center|The Ohio State University|The Ohio State University|Nationwide Children's Hospital|The Ohio State University Wexner Medical Center|The Ohio State University Wexner Medical Center|Ohio Department of Mental Health & Addiction Services|The Ohio State University Wexner Medical Center
little known recent trends ruralurban disparities youth suicide particularly sex methodspecific changes documenting extent disparities critical development policies programs aimed eliminating geographic disparitiesto examine trends us suicide mortality adolescents young adults across ruralurban continuumlongitudinal trends suicide rates rural urban areas january 1 1996 december 31 2010 analyzed using countylevel national mortality data linked ruralurban continuum measure classified 3141 counties united states distinct groups based population size adjacency metropolitan areas population included suicide decedents aged 10 24 yearsrates suicide per 100000 personsacross study period 66595 youths died suicide rural suicide rates nearly double urban areas males 1993 1031 per 100000 respectively females 440 239 per 100000 respectively even controlling wide array countylevel variables ruralurban suicide differentials increased time males suggesting widening ruralurban disparities 19961998 adjusted incidence rate ratio irr 098 20082010 adjusted irr 119 difference irr p 02 firearm suicide rates declined rates hangingsuffocation males females increased however rates suicide firearm males 19961998 205 20082010 269 times higher hangingsuffocation males 19961998 124 20082010 163 times higher disproportionately higher rural areas ruralurban differences increased time p 002 males p 06 femalessuicide rates adolescents young adults higher rural urban communities regardless method used ruralurban disparities appear increasing time research carefully explore mechanisms whereby rural residence might increase suicide risk youth consider suicideprevention efforts specific rural settings