Closing the Gap: Characterizing Key Factors Leading to the Disparity in Suicide Rates along the Urban-Rural Continuum

Abstract

Suicide is a top ten cause of mortality in the United States. In previous literature the suicide rates in rural communities have been reported to be greater than those of more urban communities. Additionally, these studies have discussed many potential causes for the unfortunate disparity in rates. One cause often discussed is lack of mental health care providers in rural communities. The data for this study was gathered from the CDC's WONDER database and the NPPES NPI Registry. The urban-rural categorization of counties used the 2013 NCHS Urban-Rural Scheme. Statistical analysis included chi-square tests, paired t-tests, and stepwise regression analyses. Results indicate that both the number of residents per provider (r = 0.35, p ≤ 0.005), and urbanization level (r = 0.49, p ≤ 0.001) were significantly related to suicide rate. Additionally, even after controlling for provider rates, each additional level of rurality predicted an increase of 1.2 suicides per 100,000 residents. Ultimately, the number of providers may play a major role in suicide rates, but extra effort must also be made in rural communities to combat the other contextual factors leading to increased suicide rates.