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Rural-Urban Comparisons in the Rates of Self-Harm, U.S., 2018.

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Rural residents in the U.S. experienced higher rates of nonfatal self-harm emergency department visits compared to urban residents in 2018. Targeted suicide prevention strategies are needed for rural areas.

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Area of Science:

  • Public Health
  • Epidemiology
  • Injury Prevention

Background:

  • Nonfatal self-harm presents a significant public health challenge in the United States.
  • Understanding geographic disparities, such as rural-urban differences, is crucial for effective prevention.
  • Previous research indicates potential variations in healthcare access and outcomes between rural and urban populations.

Purpose of the Study:

  • To compare the rates of nonfatal self-harm emergency department visits between rural and urban residents in the U.S. in 2018.
  • To identify specific demographic and mechanism-based differences in self-harm between these geographic groups.

Main Methods:

  • Analysis of the Nationwide Emergency Department Sample and U.S. Census data for the year 2018.
  • Calculation of the relative risk (RR) of emergency department visits for self-harm comparing rural and urban populations.
  • Age-adjusted rates were computed to account for population age structures.

Main Results:

  • A total of 488,000 weighted emergency department visits for self-harm were identified.
  • Rural residents had a significantly higher age-adjusted rate of self-harm emergency department visits (252.3 per 100,000) compared to urban residents (170.8 per 100,000).
  • The rate for rural residents was 1.5 times greater than for urban residents, with higher rates observed across most demographics and self-harm mechanisms.

Conclusions:

  • Rural populations exhibit a higher burden of nonfatal self-harm compared to urban populations.
  • Tailored suicide prevention strategies focusing on rural community needs are essential to address this disparity.
  • Interventions should consider the specific mechanisms and demographic factors contributing to self-harm in rural settings.