• Am J Public Health · Oct 2004

    Urban-rural shifts in intentional firearm death: different causes, same results.

    • Charles C Branas, Michael L Nance, Michael R Elliott, Therese S Richmond, and C William Schwab.
    • Department of Biostatistics and Epidemiology, University of Pennsylvania, 829 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021, USA. cbranas@cceb.med.upenn.edu
    • Am J Public Health. 2004 Oct 1; 94 (10): 1750-5.

    ObjectivesWe analyzed urban-rural differences in intentional firearm death.MethodsWe analyzed 584629 deaths from 1989 to 1999 assigned to 3141 US counties, using negative binomial regressions and an 11-category urban-rural variable.ResultsThe most urban counties had 1.03 (95% confidence interval [CI]=0.87, 1.20) times the adjusted firearm death rate of the most rural counties. The most rural counties experienced 1.54 (95% CI=1.29, 1.83) times the adjusted firearm suicide rate of the most urban. The most urban counties experienced 1.90 (95% CI=1.50, 2.40) times the adjusted firearm homicide rate of the most rural. Similar opposing trends were not found for nonfirearm suicide or homicide.ConclusionsFirearm suicide in rural counties is as important a public health problem as firearm homicide in urban counties. Policymakers should become aware that intentional firearm deaths affect all types of communities in the United States.

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