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Suicide rates in Pennsylvania have increased considerably from 1999 to 2018, with the suicide rate among rural counties being higher, on average, than the rate in urban counties, according to recently released research sponsored by the Center for Rural Pennsylvania.
The research found that, on average, the gap between rural and urban county suicide rates has been increasing, especially over the last decade. In 2018, the rate in rural counties was 25 percent higher than the rate in urban counties. However, the overall rates mask substantial variation among rural and urban counties, according to report authors Dr. Daniel Mallinson, Eunsil Yoo, and Brandon Cruz of Penn State Harrisburg.
For example, while rural counties had the largest increases in suicide rates from 1999 to 2018, York County, which is defined as an urban county by the Center, had a substantially higher rate in 2018, and a greater increase from 1999 than other urban counties. York County has large rural areas, so it is important to consider how rural and urban trends vary even within counties.
Study Background
The research, conducted in 2020, examined the overall trends in suicide across Pennsylvania's 67 counties from 1990 to 2018, the suicide prevention programs currently used by counties, and the programs that are used in K-12 school districts.
The research used data from the Pennsylvania Department of Health and the U.S. Census Bureau to examine the trends in suicide rates, as well as which factors, such as access to firearms, correlate with county rates. Data on county and school district programs were gathered using two surveys fielded in June and November 2020. A total of 46 counties (69 percent) and 134 school districts (31 percent) responded to the surveys. Data were gathered on each program's description, clients served, engagement with external partners, resources, evaluation procedures, and the impact of COVID-19 on the program's operation.
In assessing the factors that correlate with higher or lower suicide rates in Pennsylvania, the researchers found that higher numbers of handgun sales per 1,000 residents, lower levels of education, lower incomes, larger populations over age 65, and higher levels of unemployment were all correlated with higher county suicide rates from 1999 to 2018. Even when controlling for all other factors, the rural county suicide rate was higher than the urban rate. Many of the above factors themselves have rural-urban divides, thus compounding the risks for rural residents. It also appeared that broadband internet access limitations correlated with county suicide rates in 2015 and 2016, but broadband could be serving as a substitute for rural in this case.
County, School Prevention Programs
Rural and urban counties reported a diverse array of suicide prevention programming. In general, rural counties were more likely to form cross-county partnerships to pool resources and expand their reach. Rural counties were also more reliant on non-county funds and networks of external partners for providing their programs. Urban counties tended to be more self-sufficient. Rural counties were also more likely to provide programs for broad audiences, whereas urban counties reported more programs that focused on a specific audience.
Rural county programs were harder hit by the COVID-19 pandemic, with many having to shutter. Urban programs exhibited greater resilience in shifting to online platforms.
School districts varied in their suicide prevention programming, but the differences between rural and urban districts in resourcing and programming were fewer than those among rural and urban counties. Awareness and education were the most common programs provided by both rural and urban school districts. Roughly half reported their programs as being part of their Student Assistance Program (SAP). Many programs, like student clubs, were reported to have no cost to the school district.
The research report, Suicide Trends and Prevention in Rural Pennsylvania Counties and Schools, is available on the Center's website.
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