Young people who live in rural areas of the United States die by suicide nearly twice as often as those who live in cities, a new study finds.
Researchers analyzed national data from 1996 through 2010 and found that nearly 66,600 young people aged 10 to 24 took their own lives during this period.
Guns were used in half of those suicides, although the researchers also found that hanging is rising among this age group.
The study was published online March 9 in the journal JAMA Pediatrics.
There are a number of possible reasons why young people in rural areas are more likely to kill themselves, including less access to mental health services, greater social isolation and greater availability of guns, said study co-author Cynthia Fontanella, of Ohio State University, and colleagues.
Easy access to guns is a significant part of the problem, said one expert.
"Suicide is in many ways the oft-ignored part of gun tragedy in America, the part that few talk about, especially those who resist any efforts to decrease access to guns," journal editor-in-chief Dr. Frederick Rivara wrote in an accompanying editorial. He is the division chief of general pediatrics at the University of Washington in Seattle.
"However, safe storage of firearms in the homes of children or others at risk for suicide is a pragmatic rather than ideological issue that should not be contentious. The problem of suicide and the issue of firearms are very complex public health concerns. But, in the United States, they also appear to be integrally linked and demand our attention," he concluded.
Suicide rates, per 100,000, were 19.93 for rural males and 4.40 for rural females, compared with 10.31 for urban males and 2.39 for urban females, the researchers said.
Overall, the most common methods of suicide were by gun (51 percent), hanging/suffocation (34 percent), poisoning (8 percent), and other means (7 percent).