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Suicide on the Rise in Rural America

Rates far outpacing those in cities and suburbs

FRIDAY, June 28, 2002 (HealthDayNews) -- Many Americans think of rural life as peaceful and stress-free, full of natural beauty and caring neighbors. But a new study contends that life in the boondocks isn't bucolic for everyone.

Over the past three decades, suicide rates outside of cities and suburbs have risen dramatically, it found.

In fact, the suicide rates among young women in rural areas actually outpaced that in urban areas in the 1990s, said study co-author Gopal K. Singh, a statistician with the Centers for Disease Control and Prevention.

"The increasing gap is definitely of concern," he said.

While it lacks the high public profile of some diseases, suicide is the 11th leading cause of death in the United States, outpacing liver disease, kidney disease, and homicide. An estimated 29,000 Americans killed themselves in 1999, the most recent year for which full figures are available, according to federal statistics.

While researchers have compared suicide rates in urban and rural areas, Singh said his study is one of the first to look at changes in the rates over time.

Singh and an Australian colleague examined federal statistics on deaths that occurred between 1970 and 1997. They then determined how many of the deaths occurred in rural and urban counties, using a formula devised by the U.S. Department of Agriculture.

The findings appear in the July issue of the American Journal of Public Health.

Among men, the suicide rates in the most rural counties were 54 percent higher than those in the most urban counties -- home to the biggest cities -- from 1990 to 1997. Just 10 years earlier, the gap was only 21 percent.

From 1970 to 1974, the annual suicide rate for men in the most urban counties was about 20 per 100,000. But from 1990 to 1997, the male suicide rate grew to 27 per 100,000 in rural areas, versus 17.5 in the biggest cities.

From 1970 to 1997, the suicide rate for women dropped from 8.7 to four per 100,000 in urban areas, while staying steady at about four per 100,000 in rural areas.

But when the researchers adjusted the figures to reflect similar divorce rates and ethnic makeup, they found that the suicide rates for women in rural areas had topped those in urban areas.

There are several theories about why rural people are more prone to kill themselves.

"The usual explanations are that there are physical isolation and limited social interactions in rural areas," Singh said. "You have limited opportunity for social interaction and networks."

Ronald W. Maris, director of the Suicide Center at the University of South Carolina, said it's important to consider the main factors contributing to suicide -- depression, alcoholism, and isolation.

Health care can also play a role, he said.

"The No. 1 cause of suicide is undiagnosed and untreated depression," he added, and rates may be higher in rural areas if depressed people aren't getting proper treatment and medication.

Even within urban areas, he said, suicide rates can be higher in some neighborhoods.

"To the degree that people urban areas are more educated and have more income, better jobs, more life amenities, and better health care, you would expect suicide rates to be lower. But not everybody who lives in the city benefits from those kinds of resources."

What To Do

For suicide prevention resources, try the American Association of Suicidology, the American Foundation for Suicide Prevention, or the National Center for Injury Prevention and Control.

SOURCES: Gopal K. Singh, Ph.D., M.S., statistician, Centers for Disease Control and Prevention, Atlanta; Ronald W. Maris, Ph.D., director, Suicide Center, University of South Carolina, Columbia; July 2002 American Journal of Public Health.
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