Cities Are Actually Safer Than Rural Areas, Says Study

Brett Smith for – Your Universe Online

Despite having higher average homicide rates, cities tend to be safer than rural areas, according to a new study from researchers at the University of Minnesota.

The researchers came to their somewhat counter-intuitive conclusion by looking at county-level data for all injury deaths across the US from 1999 to 2006, excluding the September 11 terrorist attacks.

“Cars, guns and drugs are the unholy trinity causing the majority of injury deaths in the US,” said lead study author Dr. Sage Myers, of the University of Pennsylvania in Philadelphia. “Although the risk of homicide is higher in big cities, the risk of unintentional injury death is 40 percent higher in the most rural areas than in the most urban. And overall, the rate of unintentional injury dwarfs the risk of homicide, with the rate of unintentional injury more than 15 times that of homicide among the entire population.

“This has important implications about staffing of emergency departments and trauma care systems in rural areas, which tend to be underserved as it is,” Myers added.

Previous research has shown higher urban homicide rates compared to rural rates for all age groups except adults over 65 years old. The new study, however, which appeared in the Annals of Emergency Medicine, show higher suicide rates with increasing distance from urban counties. This increased suicide rate was statistically significant for children 14 years old and younger as well as for older teenagers.

While deaths caused by homicide and suicide can be traumatic, they are far outweighed by those caused by unintentional injury, such as car accidents. The new study found the rate of unintentional injury death is 15 times higher than the homicide rate and the risk associated with this kind of death is 40 percent higher among the nation’s most rural counties compared to cities.

Most of these unintentional injury deaths result from motor vehicle accidents, occurring at a rate over 1.4 times higher than the next leading cause of injury death. In rural areas, automobile injury-related death rates are twice that of the next highest cause – resulting in car accident deaths being twice as likely in rural areas as compared to the most urban.

“By digging deep into the data, we may be able to tailor injury prevention efforts to the populations that need them, such as seniors in cities who are more likely to fall and rural children who are more likely to drown,” Myers said about the study’s results. “This data is relevant to staffing issues as well. Injury-related mortality risk is highest in the areas least likely to be covered by emergency physicians and least likely to have access to trauma care, which argues for using a population-planning approach to improve emergency and trauma care systems in the US.”

“We think our work serves as a reminder that injury is an important health issue for Americans, wherever they live,” said senior author Dr. Brendan G. Carr, an epidemiologist at the University of Pennsylvania. “Our findings can inform both targeted prevention efforts and strategic efforts to improve trauma care in the US.”