Rural and Urban Differences in Suicide in the United States, 2018-2021

View Policy Brief

05/2025

Suicide remains a leading cause of death in the United States. This policy brief examines state-level differences in crude suicide rates by demographics and geography, focusing on rural and urban areas from 2018 to 2021. National data from the National Vital Statistics System and the American Community Survey were used to explore trends across urban and rural areas.

Key Takeaways:

• Crude suicide rates have remained around 14.5 per 100,000 from 2018-2021, with rural areas consistently higher than urban areas overall and across all subgroups of interest.
• Males have higher crude suicide rates compared to females (23.2 vs. 6.0 per 100,000).
• Groups aged 25-34 and 45-54 in rural areas have the highest crude suicide rates (28.8 and 25.3 per 100,000, respectively).
• Western states generally report higher crude suicide rates than other Census regions, while Northeastern and Southern states have lower rates in both urban and rural areas.

ETSU/NORC Rural Health Research Center

Qian Huang, Nicole Galler, Michael Meit, Amy Wahlquist

Healthcare access, Mental and behavioral health, Public health, Rural statistics and demographics