The more rural a place, the higher its suicide rate is likely to be; interactive map gives county-by-county data

This is a screenshot of an interactive map, available by clicking here.

Suicide is more common in the U.S. today than at any time in decades, and "It's rural America that is sustaining the largest increases," Mike Maciag reports for Governing magazine. "The aggregate suicide rate for counties outside of metropolitan areas climbed about 14 percent over the five-year period ending in 2016. By comparison, the rate within metro areas also increased, but only by 8 percent." The more rural a place, the higher its suicide rate tends to be; the rate in the most rural places is 18.9 per 100,000; in big cities it's 10.6 per 100,000.

The rate is highest in the West, but "Regional differences are largely a function of demographics," Maciag writes. "White men die at the highest rates, roughly 10 times that of Hispanic women and black women, because they tend to have greater access to firearms. Women, on the other hand, carry out more suicide attempts but generally do so using less lethal means. Gun ownership, which is more prevalent in rural areas, also explains why certain regions have higher suicide rates. Firearms account for about half of all suicide deaths. Research has found that mandating waiting periods, gun locks and other gun control laws are associated with fewer deaths."

Another factor is probably the shortage of behavioral-health care in rural areas; "the vast majority" of people who kill themselves "suffer from a diagnosable mental-health issue,": Maciag notes. "The American Foundation for Suicide Prevention is pushing an approach known as 'Zero Suicide' that aims to improve care and outcomes for individuals at risk of suicide in health-care systems. The group is also focusing its efforts on emergency rooms and correctional facilities, two other places where people are at higher risk."

The foundation's Jill Harkavy-Friedman told Maciag, “It’s not the economics itself but the associated stress that leads to physical or mental effects on health,” such as loss of health insurance form unemployment. Maciag notes research by Anne Case and Angus Deaton of Princeton University that has focused on what they call “deaths by despair,” drug overdoses and alcohol-related fatalities as well as suicides. "They found mortality among non-Hispanic whites to be rising for those without college degrees, and improving for more educated whites, blacks and Hispanics," Maciag writes. "The cumulative effects of few labor market opportunities and weakening social structures have largely contributed to worsening mortality for less-educated whites, although the authors note that economics alone don’t fully explain increasing suicide rates."