In rural America, where there are more guns, fewer people, and fewer doctors than in the urban U.S., young people are at particular risk of suicide.
A study published Monday in JAMA Pediatrics analyzed suicides among people aged 10 to 24 between 1996 and 2010, and found that rates were nearly doubled in rural areas, compared to urban areas. While this gap existed in 1996 at the beginning of the data set, it widened over the course of this time period, according to Cynthia Fontanella, the lead author on the study, and a clinical associate professor of psychiatry at Ohio State University’s Wexner Medical Center.
Both adults and adolescents are at greater risk of suicide in remote areas of the U.S., according to a 2006 literature review. But suicide is in general more common among adolescents and young adults: It’s the third leading cause of death for people aged 15 to 24, according to the Centers for Disease Control and Prevention, the second for people 25 to 34, and the 10th most common among the general population.
More than half of the youths who killed themselves in this time period did so with a firearm, and gun suicides (though generally on the decline) were particularly common in rural areas—nearly three times more common. This may be because gun ownership is higher in rural regions. According to 2014 Pew data, 51 percent of people in rural areas kept a gun at home, compared to 25 percent in urban areas, and 36 percent in the suburbs.