“…Previous studies have shown that men are more likely to engage in risk-taking behavior once on the water and are also more likely to be under the influence of alcohol than women (Howland, Hingson, Mangione, Bell, & Bak, 1996;Lapa, Turgut, & Turgut, 2012). Further, men are more likely to overestimate their swimming skill and underestimate drowning risk (McCool, Moran, Ameratunga, & Robinson, 2008;Moran et al, 2012). Less well known, however, is our finding that males from rural areas drown at significantly higher rates than age-matched males living in non-rural areas.…”