Study Finds Gun Deaths More Likely in Small Towns than Big Cities

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City Skyline at Dusk A new study led by Columbia University and Children’s Hospital of Philadelphia (CHOP) has found that, contrary to popular belief, firearm deaths in the U.S. are statistically more likely in small towns rather than big cities. The study also found that the increase in gun deaths over the past two decades has been largely driven by an increase in gun suicides. The findings were published today in JAMA Surgery.

The researchers analyzed cause-of-death data files from the National Center for Health Statistics’ National Vital Statistics System, which catalogues death certificates at the county level. They assessed death certificates from 2001 to 2010 and from 2011 to 2020 and separated firearm deaths into gun homicides and gun suicides.

To determine whether a county was urban or rural, the researchers used the U.S. Department of Agriculture Economic Research Service to sort counties into nine categories, from most urban to most rural, based both on size and proximity to a metropolitan area.

The researchers found that overall, the most rural counties had more firearm deaths than the most urban counties. Between 2001 and 2010, the most rural county had a 25% higher overall firearm death rate compared the most urban county. Over that same period, the most rural county type had a 54% higher gun suicide death rate and a 50% lower gun homicide death rate compared with the most urban counties.

Over the next decade, however, all county types had higher total firearm death rates than the most urban counties. The most rural counties had a 37% higher overall firearm death rate compared with the most urban counties; when analyzing gun suicides versus gun homicides, the researchers found that the most rural counties had a 76% higher gun suicide death rate and a 46% lower gun homicide death rate compared to the most urban counties.

“Although gun violence in urban settings gets the most media coverage, our research shows that, in fact, rural communities experience the most intentional gun deaths, driven mostly by gun suicides,” said co-author Michael L. Nance, MD, Chief of the Division of Pediatric General, Thoracic, and Fetal Surgery and Director of the Pediatric Trauma Program at Children's Hospital of Philadelphia. “These findings have broad implications and should be considered in discussions about gun policy.”

Learn more about this study here.

Contact: Joey McCool Ryan, The Children’s Hospital of Philadelphia, (267) 258-6735 or mccool@chop.edu


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