For people age 44 and younger in the United States injury — in the form of homicide, suicide and unintentional injuries such as car accidents — is the most common cause of death.
When it comes to these kinds of deaths urban areas have a reputation for being more dangerous than country towns. But is this perception justified?
After analyzing nearly 1.3 million injury deaths in the United States between 1999 and 2006, physicians report in a new study (in Annals of Emergency Medicine, see abstract) the answer is a definitive no. They found that the risk of injury death was 22 percent higher in rural counties than urban ones.
In other words, Houston is safer than Hempstead.
But what of those big city murders?
The researchers did find homicide rates in urban areas were significantly higher for people ages 20 to 44, but were lower in urban areas for people under 20, and those 45 and older. Even so, the researchers found, the magnitude of homicide-related deaths, even in urban areas, is outweighed by the magnitude of unintentional injury deaths, particularly those resulting from motor vehicle crashes. For all ages.
Why? The authors, emergency physicians from Pennsylvania, explain:
The risk of motor vehicle crash death in the most rural areas is two times that in the most urban areas. Factors likely to contribute to this elevated rural risk include speed of travel, increased risk taking, adherence to trafﬁc laws, and distance to medical care.
Although by and large the increased injury–related mortality risk to rural residents is driven by these motor vehicle crash–related injury deaths, other less common injury mechanisms with increased risk of death in rural areas include machinery injuries, injuries from being struck, and environmental/exposure injuries.
The bottom line, the researchers conclude, is that when all types of injury death are factored in large cities such as Houston are significantly safer than their rural counterparts.
And bear in mind, this does not factor in the equally high risk of deaths in rural areas due to frequent Bigfoot attacks.