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      Association Between Rural Residence and Nonfatal Suicidal Behavior Among California Adults: A Population-Based Study

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          Abstract

          Objective.

          Suicide mortality rates in rural areas of the United States are twice that of rates in urban areas, and identifying which factors—eg, higher rates of suicidal distress, lower rates of help-seeking behaviors, or greater access to firearms—contribute to this rural/urban disparity could help target interventions.

          Method.

          Using 2015–2016 data on adult respondents to the California Health Interview Survey (n=40,041), we examined associations between residence in a rural (vs. non-rural) census tract and nonfatal suicidal ideation and attempt.

          Results.

          We found that living in a rural area was not associated with nonfatal suicidal behavior (OR for past-year suicidal ideation = 0.87, 95% CI: 0.63–1.20; OR for past-year suicide attempt = 0.55, CI: 0.20–1.48). Women living in rural areas had higher odds of lifetime suicidal ideation compared to women living in non-rural areas, but this difference was not significant (OR = 1.17, CI: 0.94–1.44). We also found that, among individuals reporting suicidal behavior, there were few rural/non-rural differences in perceived need for treatment, such as seeing a physician or taking a prescription for mental health problems.

          Conclusions.

          Our results do not suggest higher suicidal distress or lower treatment-seeking behaviors as explanations for the rural/urban disparity in suicide mortality rates. Further attention is needed to the unique risk factors driving suicidality in rural areas, as well as exploring heterogeneity in these factors across different rural contexts.

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          Author and article information

          Journal
          8508122
          5249
          J Rural Health
          J Rural Health
          The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association
          0890-765X
          1748-0361
          23 January 2019
          31 January 2019
          March 2019
          01 March 2020
          : 35
          : 2
          : 262-269
          Affiliations
          [1 ]Department of Epidemiology & Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
          [2 ]Department of Public Health, School of Social Sciences, Humanities and Arts, University of California, Merced, California
          Author notes
          For further information, contact: Claire E. Margerison, PhD, Department of Epidemiology and Biostatistics, Michigan State University, 909 Fee Road Room B601, East Lansing, MI; cmargerison@ 123456epi.msu.edu
          Article
          PMC6436983 PMC6436983 6436983 nihpa1007428
          10.1111/jrh.12352
          6436983
          30703850
          673c642c-030d-426b-b08d-6266c06f9968
          History
          Categories
          Article

          mental health,rural,suicidal attempt,suicidal ideation,suicide

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