Suicide Rates in Rural Ohio: The Role of Population Density, Social Association, and Healthcare Access

Background: This study explores differences between adult suicide rates in counties in Ohio from 2007-2016, specifically differences between urban and rural counties. Nationally, the least densely populated states in the nation have the highest rates of completed suicide, and that same trend was hypothesized to exist in the least densely populated counties in Ohio. Methods: Simple demographics and rates for sub-populations and counties were retrieved for adults over 18 years of age, and separated by rural and urban counties. A random effects meta-regression model was developed to assess the association among suicide death rate, rate of emergency rooms, rate of mental health providers, rate of social associations, and rural or urban counties. Results: There were differences in suicide rate between urban and rural counties. Suicide death rates were significantly associated with rate of mental health facilities, rate of social associations, and type of county (e.g., rural versus urban). As the rate of mental health providers increased, there was a significant decrease in the rate of suicide deaths. Conclusions: This study illustrates the positive effect that access to mental health service providers can have on decreasing suicides in rural areas. More studies are needed focusing on unmet needs in rural areas, specifically those looking at individual level predictors of suicide. Key words: Suicide, Population Density, Social Association, Mental Health, and Rura