BRADFORD, Pa. — A study on suicide trends in rural Pennsylvania showed that three of four nearby counties have seen increases in the number of suicides over the past two decades.
The study was completed by Daniel J. Mallinson, Ph.D., Eunsil Yoo and Brandon Cruz, of Penn State-Harrisburg, for the Center for Rural Pennsylvania. Titled “Suicide Trends and Prevention in Rural Pennsylvania Counties and Schools,” the study gathered information on suicide trends in rural counties and schools from 1999 to 2018.
Rates per 100,000 residents were used in order to provide data since Pennsylvania counties vary widely in the number of individuals in residence. In 2018, McKean County had a suicide rate of 12.2, Cameron County had a rate of 66.8 (the highest number shared on the map of the state’s 67 counties), Potter County had a rate of 24.1 and Elk County had a rate of 16.8.
The change in suicide rates for each county from 1999 to 2018 showed an increase for McKean (+1.2), Cameron (+33.8) and Potter (+7.1) counties and a decrease for Elk County (-6.4).
Elk County was one of six counties in the state that saw declines in suicide rates; five of the counties were rural. Per the study, however, it is important to note that counties with small populations can see suicide rates fluctuate considerably from year to year.
Conclusions from the study showed that:
- Suicides are not only increasing in Pennsylvania but increasing at a faster rate in rural counties.
- Even when controlling for suicide predictors, like access to lethal means (firearms), education, marital status, unemployment and income, there is still a statistically significant difference in rural and urban suicide rates.
- There are more handgun sales per 1,000 residents in rural counties than urban.
- Unemployment is higher in rural counties (on average).
- College completion is substantially lower in rural counties.
- Household income is substantially lower.
- There is a larger population of residents age 65 and older in rural areas.
All of these were predictors of higher suicide rates. The only factor that reduced suicide rates and showed an advantage for rural counties was the marriage rate.
COVID-19 introduced new concerns and issues to the rural trend for suicide rates, as the pandemic required isolation and limited in-person interaction. It also increased reliance on the internet, which in rural areas can be yet another issue.
“Internet connectivity also has a complicated place in the story of rural suicide,” the study noted. “Geographic isolation is a problem in rural areas and the lack of social integration is an important risk factor for suicide. Broadband internet connectivity not only provides a means for social connection, but internet-based cognitive behavioral therapies help overcome limitations in brick-and-mortar mental health services in rural areas.
“Thus, the limitations in broadband access and high cost of access in rural Pennsylvania are highly relevant for suicide prevention efforts.”
Following efforts to evaluate the success of telehealth and other programs hastily enacted in light of COVID-19 shutdowns, the study authors found that the pandemic has the potential to impact the suicide rates in rural communities in a negative way.
The study explained, “The pandemic raised alarm among suicide prevention experts due to the potent mixture of increased social isolation from state mitigation efforts, ongoing deep economic crisis for low wage workers, increase in domestic violence, and negative coping through alcohol and substance abuse. Predictions of increases in deaths of despair in the United States, including suicides, that are due to COVID-19 and its social effects have ranged from more than 10,000 to more than 100,000 over the coming decade.”
Results from research on the effect of COVID-19 on suicide rates in 2020 are mixed, the study noted — more time and research are required to understand the full effects. In the meantime, it was noted there is a concerning statistic found correlating broadband access and suicide rate.
According to the study, “as the percentage of a county’s residents without broadband access climbed, so did the suicide rate. This was based on only two years of Pennsylvania data, meaning the sample size was small.”
However, the rate increase was not as notable when other factors were included in the statistical comparison, meaning that the broadband may simply be acting as a representation of the rural geography of the area, a lack of income or other factors, rather than being a key factor in itself.
The study reports that the best way to understand this would be further investigation and stated “a focused study on telehealth, broadband access and mental health, suicide and other deaths of despair is warranted given the major issues with broadband deployment in the Commonwealth.”