By Miranda Hitti

Reviewed By Brunilda Nazario, MD

On Monday, September 27, 2004

WebMD Medical News

Sept. 27, 2004 -- Firearm death rates are as common in rural America as in the country's biggest cities, according to a new study.

Charles Branas, PhD, assistant professor in the biostatistics and epidemiology department at the University of Pennsylvania, and colleagues examined data from U.S. death certificates from 1989 to 1999. Branas' team focused on intentional firearm deaths -- suicides and homicides. They did not include accidental deaths caused by firearms or nonfatal gun-related injuries. More than 360,000 people died from intentional firearm injury during the 11-year period. Nearly 54% were categorized as suicides, while more than 45% were called homicides.

"The most urban counties [had] essentially the same [firearm] death rate as the most rural communities," say the researchers.

Big cities had more homicides by firearms, while rural areas had more gun-related suicides. The researchers found that America's most rural counties had more than 50% more gun-related deaths by suicide than the most urban counties. Likewise, the most urban counties in America had almost twice as many gun-related deaths by homicide as the most rural counties.

Firearm death is a pervasive public health problem in rural counties as it is in urban counties in the U.S., write the authors. "The uniformity was the product of opposing trends between firearms suicide and firearm homicide in rural and urban counties," they say.

"The rate of firearm suicide in America's most rural communities closely resembled that of firearm homicide in her largest cities," write the researchers in the October issue of the American Journal of Public Health.

Overall, firearm homicides decreased during the study, with the biggest drop being in the most urban counties. In contrast, annual firearm suicide rates increased, on average, in all urban-rural categories. Firearm suicide rates rose almost 1% per year in the most rural counties.

Gun deaths are a problem for the entire country, not just big cities, say the researchers. "Firearm death is a serious public health problem affecting both urban and rural America," they write. Branas and colleagues call for more studies, increased awareness, and improved interventions, especially for suicides by firearms and rural gun deaths. "The public awareness should be appropriately broadened to think about firearm death as a problem that can affect all types of communities in the United States," they write.

Branas is also a senior fellow at the Leonard Davis Institute for Health Economics and the lead epidemiologist at the Firearm & Injury Center at Penn.

SOURCES: Branas, C. American Journal of Public Health, October 2004; vol 94: pp 1750-1755. News release, University of Pennsylvania