Rural Gun Suicide Risks Shaped by Socioeconomic and Environmental Factors.
In an attempt to address the escalating rate of self-inflicted firearm injury deaths in rural America, researchers from the School of Public Health and the School of Medicine are proposing interventions to reduce these suicides be community-based and include programs to reduce other diseases of despair, such as heart and liver diseases, diabetes, and accidental opioid overdose. The recent decline in life expectancy of Americans has been attributed to these diseases of despair and appear to primarily afflict white rural America.
Given the gaps in understanding the socioeconomic and environmental factors related to firearm suicide deaths, the researchers sought to understand the patterns and clustering of rural counties in the US based on firearm suicide and drug-related death rates in the context of economic and socioeconomic characteristics. Their findings were published in the Journal of Surgical Research.
“Our findings suggest that the affected rural populations are very diverse and there are collective environmental risk factors, including the primary economies that play an important role in firearm suicide rates. Hence, focusing on actions related to firearms alone without considering the built environment may not reduce these deaths,” says corresponding author Bindu Kalesan, assistant professor of community health sciences.
The researchers examined rural county-specific data from 2012 to 2016 of firearm suicide deaths, homicide rate, drug related mortality rate, opioid prescription rate, median home price, veteran population, violent crime rate, primary economic dependence of counties, and county socioeconomic characteristics such as low employment, persistent poverty, population loss and whether the county is a retirement destination.
The study has important policy and prevention implications, says Kalesan, who also is an assistant professor of medicine at the School of Medicine. “While most programs focus on risk factors, including the temporary removal of firearms from home, safe storage and denying sale of firearms, we need to incorporate other factors such as primary economies, using a broader public health approach to target interventions in high-risk areas which can simultaneously reduce gun suicides and opioid deaths.”
The study was co-authored by Siran Zhao, who was a research assistant at the School of Medicine while working on the study; Michael Poulson, Miriam Neufeld, Tracey Dechert, and Jeffrey J. Siracuse, all from the Department of Surgery at Boston Medical Center and the School of Medicine; Yi Zuo of Vanderbilt University School of Medicine; and Feng Li of the Central University of Finance and Economics in Beijing.
The National Suicide Prevention Lifeline 1-800-273-TALK (8255) is a free, 24/7 confidential service that can provide people in suicidal crisis or emotional distress, or those around them, with support, information, and local resources.