Assessment of rural-urban and geospatial differences in perceived handgun access and reported suicidality among youth in Colorado

Objectives  To understand the associations of rurality, school-level prevalence of easy handgun access, and suicidality measures in Colorado youth, to explore spatial distribution of school-level measures, and to identify communities with high prevalence of both easy handgun access and suicidality. Design, Setting, and Participants  This cross-sectional study used data from the 2019 Healthy Kids Colorado Survey, an […]

Social support and its effects on attempted suicide among American Indian/Alaska Native youth in New Mexico

Objective: How social support (SS) affects the odds of suicide attempt among American Indian/Alaska Native (AI/AN) youth in New Mexico and is modified by school location and metropolitan status. Methods: Multiple logistic regression for complex design was used to produce the adjusted odds of suicide attempt by SS using the New Mexico Youth Risk and Resiliency Survey (NM-YRRS) […]

“Togetherness:” The role of intergenerational and cultural engagement in urban American Indian and Alaskan Native youth suicide prevention

In a collaborative study with an Urban Indian Health Organization (UIHO) and a University, we conducted six talking circles over three years with American Indian and Alaskan Native (AI/AN) elders, adults, and youth to examine perceptions of suicide and suicide prevention strategies within their community. Results of a thematic analysis indicated that normalization of suicide, […]

Nonfatal suicidal behaviors of Chinese rural-to-urban migrant workers: Attitude toward suicide matters

Objective To examine the attitude toward suicide (ATS) and its influence on nonfatal suicidal behaviors of Chinese rural‐to‐urban migrant workers (MWs). Method Altogether, 3031 MWs completed the positive ATS Scale and structured questions regarding lifetime suicide ideation, plan, and attempt. Mental health help‐seeking behaviors of MWs were also investigated. Results Overall, MWs held a more […]

What are we aiming for? Comparing suicide by firearm in Toronto with the five largest metropolitan areas in the United States

Background: US suicide rates correlate with firearm availability. Little is known about variability in rates across countries. Aims: To observe the relationship between firearm/overall suicide rates in Toronto, Canada, and the five most populous US metropolitan areas. Method: Centers for Disease Control suicide rates by age and sex for New York, Los Angeles, Chicago, Dallas-Fort Worth, and Houston metropolitan areas […]

Rural/urban disparities in adolescent nonfatal suicidal ideation and suicide attempt: A population-based study

Adolescent suicide rates exhibit stark geographic disparities, with rates highest in rural areas. The causes of this disparity remain unclear. We investigated whether adolescent nonfatal suicidal ideation and attempt—leading risk factors for suicide—demonstrate the same rural/urban disparity. Using adolescent data from the 2011–2014 waves of the population‐representative California Health Interview Survey (CHIS; N = 4,616), we estimated associations between residence […]

Urban-rural differences in suicide in the state of Maryland: The role of firearms.

OBJECTIVES: To assess whether the use of firearms explains rural-urban differences in suicide rates. METHODS: We performed a retrospective analysis on all 6196 well-characterized adult suicides in Maryland from 2003 through 2015. We computed rate ratios by using census data and then stratified by sex, with adjustment for age and race. RESULTS: Suicide rates were […]

Suicidal ideation among the Chinese elderly and its correlates: A comparison between rural and urban populations.

Abstract : Background: As China is going through a profound aging process, the mental health of the elderly is becoming an issue. As in many other societies, the elderly in China is a population at high risk of suicide; Methods: Data for the study were taken from the Sample Survey of the Aged Population in […]

Rural-urban differences in the prevalence of major depression and associated impairment.

BACKGROUND: The possibility of a rural and urban difference in the prevalence of major depression has been of interest to researchers and mental health service providers. The objectives of this analysis were to determine the rural and urban difference in the 12-month prevalence of major depressive episode(s) (MDE) in Canada and whether participants in rural […]

Associations of suicide seasonality with rural-urban residence and mental disorders in Ilam, Iran.

Suicide is one of the ten leading causes of death in Western countries and the second leading cause in people aged 15-19 years. In recent decades, annual suicide attempts reportedly ranged from 2.6 to 1,100 per 100,000 people, while the rate of lifetime prevalence ranges from 750 to 5,930 per 100,000 worldwide.1 Studies regarding suicide […]

Self-harm and suicide attempts among high-risk, urban youthin the U.S.: Shared and unique risk and protective factors.

The extent to which self-harm and suicidal behavior overlap in community samples of vulnerable youth is not well known. Secondary analyses were conducted of the “linkages study” (N = 4,131), a cross-sectional survey of students enrolled in grades 7, 9, 11/12 in a high-risk community in the U.S. in 2004. Analyses were conducted to determine […]

Detecting specialization in interpersonal violence versus suicidal behavior.

Research suggests that interpersonal violence and suicidal behavior often co-occur and share a common set of risk factors. This study examined (1) the extent to which individuals specialize in interpersonal violence or suicidal behavior and (2) the shared and unique covariates of individual specialization. Interventions that address both self- and outward-directed violence must be evidence […]

Widening rural-urban disparities in youth suicides, United States, 1996-2010.

Suicide rates for adolescents and young adults are higher in rural than in urban communities regardless of the method used, and rural-urban disparities appear to be increasing over time. Contact us for a copy of this article, or view online at

Childhood trauma and childhood urbanicity in relation to psychotic disorder.


Suicide ideation and attempt in a community cohort of urban Aboriginal youth: A cross-sectional study.

There has been increasing attention over the last decade on the issue of indigenous youth suicide. A number of studies have documented the high prevalence of suicide behavior and mortality in Australia and internationally. However, no studies have focused on documenting the correlates of suicide behavior for indigenous youth in Australia. Suicide ideation and attempt […]

The geography of self-injury: Spatial patterns in attempted and completed suicide.

This study uses hospital discharge data, death certificates and medical examiner data for New Jersey for 1999Ð2001 to investigate whether fatal and non-fatal self-injury exhibit similar geographic patterns. Findings show that the demographic characteristics of individuals committing fatal and non-fatal self-injury are quite different. Furthermore, attempted and completed suicides have a somewhat different geographical pattern.

Determinants of adolescent suicidal ideation: Rural versus urban.

The existing literature on disparities between rural and urban adolescents as they pertain to suicidal behavior is limited; identifying these distinctions could be pivotal in the decision of how to efficiently allocate scarce resources to reduce youth suicide rates. This study aimed to identify dissimilarities in predictors of suicidal ideation across the rural/urban threshold, as […]

Determinants of suicidal ideation and suicide attempts: Parallel cross-sectional analyses examining geographical location.

Suicide death rates in Australia are higher in rural than urban communities however the contributors to this difference remain unclear. Geographical differences in suicidal ideation and attempts were explored using two datasets encompassing urban and rural community residents to examine associations between socioeconomic, demographic and mental health factors. Differing patterns of association between psychiatric disorder […]

Race, urban context, and Russian roulette: findings from the National Violent Death Reporting system, 2003-2006.

Previous work on Russian roulette has focused on data from large cities. It is unclear if the epidemiological patterns based on large cities will replicate for the nation as a whole, and if the influence of minority status will be moderated by urban context. The present investigation fills these gaps by providing descriptive epidemiological data […]

Suicide among patients in the Veterans Affairs health system: rural-urban differences in rates, risks, and methods.

Objectives. Using national patient cohorts, we assessed rural-urban differences in suicide rates, risks, and methods in veterans. Methods. We identified all Department of Veterans Affairs (VA) patients in fiscal years 2003 to 2004 (FY03-04) alive at the start of FY04 (n = 5 447 257) and all patients in FY06-07 alive at the start of […]

Rural/urban background, depression and suicidal ideation in Chinese college students: a cross-sectional study.

The objective of this study was to examine, first, the relationship of having a rural vs. urban background with suicidal ideation in Chinese college students, and second, whether a potential relationship was mediated by depression.

Protecting Urban American Indian Young People From Suicide

This study examined the likelihood of a past suicide attempt for urban American Indian youth, given salient risk & proective factors. Survey data from 569 urban in-school youths, ages 9-15, was used. Logistic regression determined probabilities of past suicide attempts. For girls, suicidal histories were associated with substance use (risk) & positive mood (protective). For […]

Assets as Predictors of Suicide Attempts in African American Inner-City Youths

This study assessed whether developmental assets & risk-taking behaviours, as measured by the Search Institute instrument, were related to attempted suicide in African-American, inner-city youth. A survey of 336 youth was conducted. Significant odds ratios were found for 4 assets questions & 11 risk-taking behaviour questions by attempted suicide behaviour. The odds ratios ranged from […]