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Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation


Social Work


Social Work

First Advisor

Dr. Julie Cerel


Purpose: Rural residents and veterans are at a greater risk of death by suicide but there is little research to compare rural versus urban suicide decedents. There is also a lack of research specific to rural veteran suicide. This three-manuscript dissertation study explores 1. epidemiology of suicide specific to rural areas comparing rural veterans to rural non-veterans 2. veteran suicide decedents that lived in rural areas compared to veterans that live in urban areas and 3. How the continuum of rurality is related to demographic and circumstantial variables associated with suicide Methods: Data was obtained from the Centers for Disease Control Restricted Access Database. The data included suicide decedents from 40 states from 2003-2017 n=199,730. Within this sample, the rural population was n=36,032 and the veteran population was n=7,421. Findings: Rural decedents had a mean age (M=61.16 SD=18.08 when compared to urban decedents (M=45.14 SD=16.45). Rural decedents died using firearm (77.9%) compared to urban residents (58.6%). Rural veterans had a reported issue with on-going physical health problems 35.7% compared to rural non-veterans 17.2%. When controlling for age the suicide decedents in the sample were 11.70 times likely to be male veterans. When looking at only the veteran population within the sample rural veterans were 1.43 times more likely to die using firearm compared to urban veterans. When looking at suicide across the rurality gradient death by firearms increased as the gradient moves from urban to rural. Conclusions: Rurality influences the reported characteristics of suicide decedents. Rural residents are less likely to have reported mental health treatment, report of alcohol problems, report of substance abuse problems, are more likely to die by suicide using a firearm, and there is increased use of long guns as rurality increases. Rural veterans were 1.43 times more likely to die using firearm compared to rural non-veterans. Firearms are more accessible in rural areas, rural residents are more familiar with firearms, and there is greater variety of firearms, namely long guns, in rural areas.

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