Urban-Rural Shifts in Intentional Firearm Death: Different Causes, Same Results

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Urban-Rural Shifts in Intentional Firearm Death: Different Causes, Same Results

Category: Homicide, Suicide|Journal: American Journal of Public Health (full text)|Author: C Branas, C Schwab, M Nance|Year: 2004

Objectives

We analyzed urban–rural differences in intentional firearm death.

Methods

We analyzed 584629 deaths from 1989 to 1999 assigned to 3141 US counties, using negative binomial regressions and an 11-category urban–rural variable.

Results

The most urban counties had 1.03 (95% confidence interval [CI]=0.87, 1.20) times the adjusted firearm death rate of the most rural counties. The most rural counties experienced 1.54 (95% CI=1.29, 1.83) times the adjusted firearm suicide rate of the most urban. The most urban counties experienced 1.90 (95% CI=1.50, 2.40) times the adjusted firearm homicide rate of the most rural. Similar opposing trends were not found for nonfirearm suicide or homicide.

Conclusions

Firearm suicide in rural counties is as important a public health problem as firearm homicide in urban counties. Policymakers should become aware that intentional firearm deaths affect all types of communities in the United States.

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