Substance Use, Depression, and Suicide: What Are the Individual and Policy-Modifiable Correlates Amongst Metropolitan and Non-metropolitan Adults?

Research center:
Lead researcher:
Project funded:
September 2017
Project completed:
May 2019

Very little research has investigated the associations between substance use, depression, and suicidal ideation amongst adults residing in rural and urban areas nationally. Using nationally representative data from the National Survey on Drug Use and Health (NSDUH), this study a) estimated the prevalence of major depression and suicidal ideation and attempts in metropolitan, micropolitan, and other non-metropolitan areas nationally and b) investigated the individual-level (e.g., demographic, socioeconomic, region of residence, and health status) and policy-modifiable healthcare (e.g., insurance, access to a regular healthcare provider, and access to mental health and substance use treatment) correlates of depression and suicide indicators among metropolitan, micropolitan, and other non-metropolitan residents. With up-to-date estimates of the prevalence of depression and suicidal ideation and attempts amongst metropolitan, micropolitan, and other non-metropolitan residents nationally, health policy makers at national, state, and local levels could better target resources and programs toward particular geographic areas. Our findings about the correlates of depression and suicidal ideation/attempts can be used by policy makers at multiple levels to target services toward the highest risk groups and identify factors that could be potentially modified (e.g., healthcare access) to reduce depression and suicide.


  • Suicidal Thoughts, Plans, and Attempts by Non-Metropolitan and Metropolitan Residence
    Policy Brief
    Rural and Underserved Health Research Center
    Date: 05/2019
    Suicide is among the leading causes of death in the US, and rates in non-metropolitan (rural) counties have historically exceeded those in metropolitan (urban) counties. This study examined the prevalence of suicidal thoughts, plans, and attempts by year (2010-2016) and county type (non-metropolitan, small metropolitan, and large metropolitan).