Accidental Injuries Higher in Rural Areas

By NICHOLAS BAKALAR
The New York Times
Published: Jan 06, 2009

Is living in a city more dangerous than living in a rural area? Maybe not.

Writing in the January issue of The American Journal of Preventive Medicine, researchers report that there is a much higher rate of hospitalization for most kinds of accidental injury in rural areas than in cities. But the rate of injuries from assaults is significantly higher in urban areas.

In the largest urban neighborhoods, the injury-hospitalization rate is 610 per 100,000, compared with 826 per 100,000 in the smallest rural areas, with rural car accidents contributing disproportionately to the difference.

Unintentional injuries are the leading cause of death among people ages 1 to 53, and the fifth leading cause of death over all.

Among those under 40, suicide is the second leading cause of death, and homicide the third.

The study used a ranking from the Department of Agriculture that lists the nation’s 3,141 counties on a scale of 1 to 12, with 1 having the greatest population density. For example, Manhattan and Bergen County, N.J., are coded 1, while Litchfield County, Conn., is a 5, and Forest County, Pa., is coded a 10.

The researchers, led by Dr. Jeffrey H. Coben, a professor of emergency medicine at West Virginia University, reduced these categories to four groups from the most urban to the most rural, then examined hospital records to calculate injury rates.

“Injuries impose a huge financial and public health burden upon all of us, regardless of where we live,” Dr. Coben said. “To confront this problem, we need to better understand the specific and differential risks in different locales so that we can better target the right interventions to the right people in the right places.”

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