Rural and urban suicide rates were about the same in the early 1970s. By the late 1990s, rates of suicide were 54% higher in U.S. rural areas than in U.S. cities.
Attempted and completed suicides take place at higher rates in rural communities, especially in areas that have more bars and taverns than other rural places, according to a new study.
The numbers of suicides were highest among white men.
Suicide rates were higher in both urban and rural places with concentrations of bars and taverns, according to the report by Fred Johnson, Paul Gruenewald and Lillian Remer. The authors speculate that a wide range of factors contributed to higher suicide rates in rural areas, including widespread use of firearms, local economic problems and alcoholism. Three out of four rural suicides involved firearms, according to the report.
The study shows a sudden and sharp increase in the rural suicide rate beginning a generation ago. In the early 1970s, suicide rates of rural men exceeded the urban rate by just 4%. But by the late 1990s, the suicide rate for rural men exceeded the urban rate by 54%.
The urban suicide rate didn’t decline. The gap between rural and urban rates widened because of an increase in rural suicides.
To conduct their study, the authors of the report (“Suicide and Alcohol: Do Outlets Play a Role?”) tracked 581 California zip codes over six years, from 1995 to 2000. They counted the number of attempted and completed suicides and a host of other demographic and business data, including the presence of bars, taverns and restaurants.
The authors reasoned that alcohol consumption and the presence of bars have been found to be related to a number of problems. The suicide rate in the U.S., for example, declined during Prohibition. Suicides decreased in Denmark during World War I, when taxes on alcohol were raised dramatically. Other researchers have found that as the number of bars goes up in a community, so do the number of traffic accidents, the number of sexually transmitted diseases and the cases of child abuse and neglect.
In their study of the 581 California zip codes, these authors found that the suicide death rate was higher in rural areas and in places with larger numbers of older, lower income whites. And they found that suicide rates went up with the increased density of bars and taverns.
The authors only speculate as to how the increased number of bars and taverns contribute to higher suicide rates. “It is not difficult to imagine a scenario where a person, more likely white, male, older, and low income, rinks at a bar, proceeds home, and disinhibited by ethanol, uses hi own firearm against himself,” they write.
There is no evidence that this actually happens, the authors concede.
Nor do the authors come to any sound conclusion about why rural suicide rates have jumped ahead of urban rates in recent years. They quote some social scientists who say that social ties are weaker in rural areas. Others speculate that outmigration, rural-urban income disparities and declining family size may contribute to “social disruption” that could increase the chance of suicide.
Some of these factors have been part of rural life for most of the last century, of course, and the authors don’t explain why they would suddenly begin causing an increase in rural suicides in the 1980s or 1990s. (And, of course, bars and taverns have been a staple of rural life since before Prohibition.)
The authors make several policy suggestions, including reducing the number of bars and taverns and restricting firearm ownership. (They allow that neither of these changes is likely to occur.) “Fostering a greater sense of community in rural areas might reduce the isolation of rural life and lead to stronger communal bonds outside the immediate family and provide a sense of belonging to those living alone,” they write.
The authors warn that the increasing suicide rates in rural America have been overlooked. They conclude that their report “draws attention to an easily overlooked problem in a society dominated by its urban centers, culture, and media. Rates of completed suicide were highest in rural America and were largely ignored because its victims were part of the vanishing landscape of rural American life.”
The full report will appear in the December issue of Alcoholism: Clinical and Experimental Research.