The notion that cities are shrouded in perversion and death has persisted for centuries. Politicians, evangelists, and disillusioned naturalists have all taken turns casting the city as a grisly home to chaos and danger. But new data shows that old ideas about the relative safety of the country may be totally misguided: you’re actually more likely to get hurt and die in rural areas than urban ones.
After looking at all injury related deaths in the United States between 1999 and 2006, researchers from the University of Pennsylvania found that “despite public perception to the contrary, when all types of injuries are considered together, rural areas, not urban, bear a disproportionate amount of injury-related mortality risk in the United States.” Wait a minute. What about violence and muggers and falling air conditioners?
Nope. Think about cars.
“The majority of injury-related deaths come from motor vehicle injuries,” Dr. Sage Myers, lead author and University of Pennsylvania professor of pediatrics, says. “Homicides were higher in urban areas, but we also found that overall, across the population accidental deaths are so much higher than homicides that they outweigh any difference we found there.”
Researchers found that the death rate in most rural areas was roughly 20% higher than the death rate in the most urban areas. Unintentional deaths, meanwhile, account for 15 times the number of deaths caused by homicide, and dying in a car crash is more than twice as likely to happen in the country than in the city.
Overall, the study also found no real difference in the risk of gun death between rural and urban areas. But looking more closely at the data, different risks correspond with different age groups: rural areas showed more risk of accidental gun death for kids and the elderly, while urban areas had more gun deaths in adults older than 20 and younger than 44.
Researchers also picked up on differences along racial and ethnic lines. For example, rural areas with the highest number of black residents had significantly fewer injury-related deaths than rural areas with the fewest black people. For Latinos, the opposite held true–rural areas with more Latinos had increased risk of accidental death. In urban areas, it made no difference.
Another surprising finding: higher incomes and levels of education didn’t matter in the context of increased rurality. In fact, in the most rural areas, those with higher incomes and degrees had more risk of injury-related death. “Once again we don’t know why–it could be location, it could be they’re closer to major highways, it could be that they’re in counties that have larger hospitals, and the deaths happened at the hospitals,” Myers says. She also notes that the study called for further inquiry into why those differences exist.
“I think there are definitely people out there who have a fear of cities, and that is a concern for them spending time there. I hope that this makes people reevaluate preconceptions,” Myers says. “I think it’s important for us as a nation to think about how our health care system is set up,” she adds, noting that rural areas may have less access to trauma care.