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The reasons for the trend are numerous, besides the seat belt issue: In rural areas, inebriated drivers can't call a taxi or an Uber, and may be tempted to drive home. There are fewer traffic lights and stop signs, giving drivers more room to speed. Drivers in rural areas drive older cars on average, which may be more prone to mechanical failure. Deer are more likely to jump out into the road in rural areas. And when a crash does happen, it could take a lot longer for an ambulance to get there and drive the victim to a hospital.