• Jing Wang, Melissa M Brown, Asha Z Ivey-Stephenson, Likang Xu, and Deborah M Stone.
• Division of Injury Prevention, National Center for Injury Prevention and Control (NCIPC), Centers for Disease Control and Prevention, Atlanta, Georgia. Electronic address: zrr4@cdc.gov.
• Am J Prev Med. 2022 Jul 1; 63 (1): 117120117-120.

IntroductionThis study compares rural and urban differences in the rates of nonfatal self-harm in the U.S. in 2018.MethodsNationwide Emergency Department Sample and Census data were analyzed to calculate the RR of emergency department visits for self-harm between rural and urban residents. The analyses were conducted in 2021.ResultsAmong a weighted total of 488,000 emergency department visits for self-harm in the U.S., 80.5% were urban residents, and 18.3% were rural residents. In both settings, poisoning was the most common mechanism for self-harm, followed by cutting. Firearm-related self-harm and suffocation each accounted for <2% of total self-harm cases. Overall, the age-adjusted emergency department visit rate for self-harm was 252.3 per 100,000 for rural residents, which was 1.5 (95% CI=1.4, 1.6) times greater than the rate for urban residents (170.8 per 100,000 residents). The rates of self-harm among rural residents were higher than those of urban residents for both male and female residents, for all age groups except people aged ≥65 years, and by all mechanisms.ConclusionsComprehensive suicide prevention strategies tailored to rural communities may mitigate the rural-urban disparity in morbidity from suicidal behavior.Published by Elsevier Inc.

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