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More Chance of Death by Injury in Rural America than in Big Cities

You know I love South Dakota. Whether it's sunrise on Lake Herman or sunset on Lookout Mountain, South Dakota offers much to recommend it to folks seeking the good life.

But if you think the big reason to move to South Dakota is to escape the mortal danger of big-city America, a new study says you should reconsider:

Many US cities have experienced population reductions, often blamed on crime and interpersonal injury. Yet the overall injury risk in urban areas compared with suburban and rural areas has not been fully described. We begin to investigate this evidence gap by looking specifically at injury-related mortality risk, determining the risk of all injury death across the rural-urban continuum.

...A total of 1,295,919 injury deaths in 3,141 US counties were analyzed. Injury mortality increased with increasing rurality. Urban counties demonstrated the lowest death rates, significantly less than rural counties (mean difference=24.0 per 100,000; 95% confidence interval 16.4 to 31.6 per 100,000). After adjustment, the risk of injury death was 1.22 times higher in the most rural counties compared with the most urban (95% confidence interval 1.07 to 1.39) [Sage R. Myers et al., abstract, "Safety in Numbers: Are Major Cities the Safest Places in the United States?" Annals of Emergency Medicine, 2013.07.25].

Murder rates are lower in rural areas, but traffic crashes are a much larger cause of death, and traffic crashes are deadlier in rural areas than urban areas:

Crashes caused 28 deaths per 100,000 residents in the most rural counties, compared with 11 deaths per 100,000 in the biggest cities.

Previous studies, Myers noted, have found that rural crashes are more likely to involve no seat-belt use, poor road signage, and high speeds [Marie McCullough, "It's Safer in Cities, but Not in Phila.," Philadelphia Inquirer, 2013.07.24].

Another possible factor in the higher rural mortality risk is availability of health care. If you get in a wreck and are far away from a hospital, there's a greater chance you'll die before help reaches you. If we're being honest, that's one more cost of living the Dakota Roots kiosk at the Mall of America should include in its infographics to help Twin Cities residents decide if they want to move out here to seek their fortune in the wild and riskier rural West.

36 Comments

  1. El Rayo X 2013.07.25

    That study must have come out before the July 4th weekend. In Chicago there was 74 shot and 12 killed.

  2. Michael Black 2013.07.25

    If you want to move to the big city....go. Sioux Falls is bad enough.

  3. Jana 2013.07.25

    Michael Black may be right.

    Coming to the busiest street in SD...gun porn.

    Kind of like a gay rights parade except without the colors. Right boys?

    My kids and I won't be anywhere near any business on Minnesota Ave. that day.

    Seriously boys, put it back in your pants.

  4. WayneB 2013.07.25

    This isn't a shocker... but I'm not certain how significant some of the claims are.

    Accidents are the 5th most common form of death in the US. Stroke then Chronic Lower Respiratory Diseases are next in line (both roughly 6% of the pie). Cancer gets 23% and Heart Disease 25%. So when we're talking about the slice of the pie, we're focusing on a far 5th.

    In the Upper Midwest (IA, MN, MT, NE, ND, SD, & WY) accidents accounted for 5.2% of all deaths; nationally accidents accounted for 4.8% of all deaths. And yeah, response time is going to be poorer for the EMTs to get to farmer Bill who was silly and got his arm sucked into the PTO than for the jay walker who got hit by a taxi in Chicago.

    Am I reading that crash fatality statistic correctly? For every 100,000 traffic accidents, 28 are fatal for rural/suburban people vs. 11 for their urban counterpart?

    That seems intuitive; more collisions in metro areas would be at low speeds, or even just fender benders (I have yet to see a pristine car in Manhattan). That would drive down the rate of fatal traffic accidents by creating a glut of accidents (I'm welcome for someone to find data to support or debunk my gut guess).

    I'd be more interested in seeing fatalities per 100,000 miles traveled.

  5. Jana 2013.07.25

    Sorry...forgot the link.

    http://www.keloland.com/newsdetail.cfm/gun-group-promotes-open-carry-law/?id=151088

    "On Saturday, the group will hold an, "organized peaceful carry walk," in Sioux Falls. Members will walk along Minnesota Avenue, visibly carrying a variety of guns in plain site. South Dakota's Open Carry Law allows members to carry guns out in the open, as long as they are not using them in a threatening manner. In total, 45 states have varying open carry laws. Rierson has done walks like this before."

    Of course they could be thinking that a woman's right to choose is legal and there are batsh*t crazy activists trying to take that right away, so we better stand our ground and make sure they know we are armed and dangerous.

  6. WayneB 2013.07.25

    El Rayo X, those 74 deaths won't be tallied as accidents.

    The CDC defines accidents and homicides quite differently.

    Remember, the study essentially says "when you die in rural America, there's a slightly better chance it'll be from an accident than from a host of other things"

  7. El Rayo X 2013.07.25

    The 74 just had gunshot wounds and 12 others died. I'll be sure to note the CDC classification in the future, big city living is much safer overall.

  8. WayneB 2013.07.25

    Ah, my apologies. The data dealt with here is purely for mortality. Injuries that don't kill you don't count.

  9. MC 2013.07.25

    Tell you what. If you are that frightful of guns, freash air, open spaces, Y'all just pack up and move to New York, or L.A. I'll stay here and cover your get away.

    Honest! no one will know you're gone.

  10. Jana 2013.07.25

    Come on MC. The "if you don't like it leave attitude" isn't exactly chamber of commerce stuff and makes us appear a little backwoods-hillbilly.

    How much of South Dakota's current population are you trying to alienate...might not be the majority, but it's enough to make a difference.

  11. Eve Fisher 2013.07.25

    I like fresh air and open spaces, but I don't know anyone who wants a guy walking down Main Street (Madison, Sioux Falls, Spearfish) carrying an assault weapon whenever he damn well feels like it. And him (or someone) carrying an assault weapon was part of the clip that Kelo-Land showed.

  12. Jana 2013.07.25

    I think the guys who feel it necessary to brandish their firepower are lacking the same in other areas...if you know what I mean. But if that's the case...carry on boys. It's better than being an Andy Weiner...what? wait?...wanting to expose yourself in public...

    Sounds like the same thing to me.

    I certainly hope someone takes pictures of the boys on Minnesota Avenue. Maybe someone will be carrying a "Get a Brain Morans" sign just to capture the full flavor of the event.

  13. Roger Elgersma 2013.07.25

    As long as I can remember farming was the second highest death rate to accidents, second to mining. Sure we do not shoot each other very often, but we tip our tractors over when in a hurry.

  14. Douglas Wiken 2013.07.25

    Construction and grain bin accidents, etc. are aggravated by senseless resistance to safety practices which statistics show work and are cost effective.

    I found it interesting that an out-of-state outfit doing construction work around here, when I told them I might put photos on Dakota Today, said, "That's OK, just don't put any on showing us without our helmets on." They knew there would be hell to pay. Their owners and bosses weren't saying under the table, just ignore those safety regulations and our rules.

  15. John 2013.07.25

    Of course the study and news article are accurate. In rural America it's our god-given right to drive drunk, not wear a seat belt, and to use violence to keep the family in line. Insurance companies have told us this is case for generations - witness the higher causalities and rates, etc. It's myth, legend, and folklore that it's better to raise a kid in rural America - because the statistics show that in order for it to be a better place to raise a kid, the kid has to beat the odds of his urban cousin and first survive to adulthood.

    Folks a hundred and fifty years ago had a lot more common sense than do the right wingnut gun toters today. Some SD historian ought to run the trapline as was done in Wyoming. Five of six sampled towns in the mid-1800s had ordinances barring concealed or open carry of firearms in town - to include the state capitol, Cheyenne. That ordinance was virtually in place with establishment of the town.
    http://wyofile.com/wyofile-2/historic-perspective-on-gun-control-in-wyoming-2/

    Gun control is as old as America and pre-dates America. Tories didn't want Patriot supporters and communities to arm; Patriots didn't want Tories to arm; both sides didn't want the Indians to arm - unless, of course, the Indians supported them, in which case arming the Indians was encouraged. It's long past the time to have reasonable background checks, no-toting in town laws, and confiscation of guns for those who've lost their 2d Amendment right.

  16. caheidelberger Post author | 2013.07.25

    Wayne, the traffic crash stats given speak of deaths per 100,000 residents. If you have 100,000 urban residents, expect 11 of them to die in traffic accidents. If you have 100,000 rural residents, expect 28 of them to die in traffic accidents.

    MC, it's not about any attitude or fear; it's about data. These data show that you are more in peril of being killed by injury in rural areas than in urban areas.

  17. Joseph G Thompson 2013.07.25

    John,
    The Dakota Territorial penal code of 1887 says, and I quote"6658-Every person who carries concealed about his person any description of firearms, being loaded or partly loaded or any sharp or dangerous weapon, such as is usually employed in attack or defense of the person, is guilty of a misdemeanor." You could open carry in Dakota Territory but no one could carry concealed. People then were more civilized, the entire codified laws of Dakota Territory (political, civil, probate, and criminal) fits in a single volume that is about 6 inches thick, check out how many volumes are needed for the codified laws of South Dakota today. We pride our selves on being more civilized than the people who settled here, but civilization doesn't require laws it requires civil behavior and manners.

  18. WayneB 2013.07.25

    Oh, well that makes even more sense. Look at car ownership rates for rural vs urban, and percent of trips taken by vehicle vs. other modes of public transportation (or good old fashioned foot / pedal power), and that could explain a good chunk of that.

    It'd be nice if we could keep the open carry rally out of this topic... it's not really germane to the discussion about accidental deaths (especially not how Jana's couching it).

  19. Bill Dithmer 2013.07.25

    "If you are that frightful of guns,"

    MC, no I have never been scared of a gun of any kind .Only little girls like you that think they know how and when to use em give me any problems. I have been shot at a couple of times in my life while hunting at night, and once taking a friend home to his drunk dad. I'm still standing here because people like you don't understand that your guns are not mightier then a mind. So holster up sweetheart your panties are showing.

    "freash air," nope I'm fourth generation in this state living on the same ranch my ancestors lived on. I've breathed more fresh air, walked more miles, both in this state and many others, and done more hunting then any other person in the state, bar none. I raised and trained coon and cat dogs for thirty years every damn day so dont get cute with me about leaving if I don't like the way things are being done, I've earned the right to say what I think.

    "open spaces," you should really have to know what an open space is before you start bragging about your exclusive rights to it. By the way you aint got any.

    And you have the nerve to invite me to leave? Honestly, you hide behind a couple of letters MC and expect anyone to fear you because you have a gun? That's funny, my guess is that you couldn't get a round off unless someone was walking away from you. You would have better luck if you had bad gas getting me to leave then waving a gun around, that would only make me mad.

    Now if you cant scare an old fat blindman with your bull, how in the world do you think you'd do with someone that had an IQ, could really see, and was in shape?

    You would be cleaning your panties out while that person was shoving that gun where the sun don't shine.

    Sorry Cory I know this thread didn't have anything to do with little girls toting guns in the first place but "what the hell." It's getting harder and harder to be a sane person living in an insane world.

    Guns don't make the man, they only give them the mistaken impression that they are one.

    The Blindman

  20. MC 2013.07.26

    Rural living is dangerous. There is a lot out here that can hurt and even kill you. You have to keep your wits about you. The work is hard and the hours long.

    But the rewards of living in a rural areas are be worth it. The view from Lookout Mountain in Spearfish, is far better than the view from Lookout Mountain above Denver, (But not quite as grand as the view from Pike's Peak in Colorado Springs.) The town fairs great time with friends. Getting up in the morning to a hot of coffee and field of freshly fallen snow can be breath taking The family cook out by the river is a good time, Even the DQ Miracle Treat Day in Madison(shameless plug) is part of our rural living I will take this any day over city life. (yes I will have a Blizzard in Madison SD, before I have a dinner with Donald Trump in New York)

    If you want to be 100% safe, don't move to a rural area.

    Do we have guns? By George, we sure do. We hunt with them, we use them to kill varmints, and for general protection. They are a tool, and we treat them with respect. Do not fear me because I have own a gun. I would much rather you respect my words, then fear my rifle. I don't go walking around Sioux Falls carrying a handgun, I don't go around showing how small I am by waving it around. But, I do have it locked up in the pick up ready to use, should I need it.

    If you up to the task of rural life and ready to reap the rewards. Please join us, we are glad to have you.
    If not, I-90 will take you to Chicago or Seattle.

    Now, my sincere apologies to Cory. I know this is your blog and it is your opinion that counts here. However Mr. Dithmer has posted a comment I believes needs to be answered (again)

    Mr. Dithmer, I use my initials on this and other blogs to remain consistent. I am in no way hiding who I am. I have posted several videos of my story at the War College.
    http://dakotawarcollege.com/who-i-am/

  21. Eve Fisher 2013.07.26

    Mr. Thompson has captured what's wrong with the whole "open carry" debate - a lack of civility. Just because something is a legal right does not make it morally right, or even a good idea. I know every legal gun owner is a paragon of moral probity and gun expertise, but there's always the possibility that - carrying that assault weapon down main street with pride - a sudden sneeze, cough, or tripping over a crack could lead to a sudden spray of bullets into an innocent public. Of course, if that happened, the argument would be that was the price we pay for a free society - and it's too damned high, if you ask me.

  22. Bill Dithmer 2013.07.26

    The thing is MC I dont give a damn who you are. Just dont expect someone to respect you because you carry a gun because it isn't going to happen. Been there done that, "not scared."

    When you invite me to leave, I get mad. The fact that you post anything on the War Crapper means nothing to me.

    I'm a South Dakotin born and raised here and dont take kindly to anyone that thinks they can force me to respect them because they pack heat. You can either get over it or get bent I really dont care as long as you dont make statements like you did last night. I will leave when I'm good and ready, not before.

    Respectfully, well maybe not so much The Blindman

  23. Barry Smith 2013.07.26

    I grew up in the western Rockies. Guns were a part of our world, they were a tool that put food on the table and kept pests and predators at bay, but that was just it they were a tool.I still consider my guns as tools and I care for them and treat them with the respect that I would any tool. The difference between them and say my claw hammer or shovel would be the safety factor, so when my guns are not being used to hunt or practice then they stay locked in the gun closet. I would no more parade around with any of my guns than I would parade around with a claw hammer , ridicules really. This whole deal in Sioux Falls tomorrow reminds me of my Grandfather. He was from a pioneer family, one of the first into Wyoming and he was born in the 1800s and I loved to hear his stories about the early years of his life. When I was small I would stay with him ( My grandmother had passed and he was alone) at his house in the summertime when I didn't have school. In my short experience no one that I noticed but men in uniform wore a gun. One day when we were trout fishing on one of the slow meandering streams that Grandpa loved to fish we came across another fisherman fishing by his car that had Utah plates on it and he was wearing a holstered gun just like the cowboys in the movies and on TV and just like the cops. After we passed I said to my Grandpa that that must be a Utah Sheriff or something. He said that he didn't think so. So I asked why he had the gun and holster then. He told me that in America anyone who wants too, can wear a gun and holster. So I asked him why he didn't wear one, thinking that would be pretty neat if he did. He got kinda stern with me and I will never forget what he said. He said " I don't wear a gun and holster because I am not afraid and I don't want to make anyone else afraid either".

    So yea marching around with guns is not a sign of civility folks it is a sign that we are losing our civility. I have spent half my life watching folks in the middle east on TV marching around their towns with guns. and I have always said God I am glad I live in America.

    Please pardon my terrible writing skills. I usually try to keep my comments short.

  24. Eve Fisher 2013.07.26

    Barry, thank you for saying it better than I could.

  25. Bill Dithmer 2013.07.26

    There's nothing wrong with your writing skills Barry. We should all be so lucky.

    The Blindman

  26. Jenny 2013.07.26

    Excellent piece, Barry. You should put that in editorial newspapers all over SD. Who knows, maybe a few SD men would finally get it, then.

  27. WayneB 2013.07.26

    I appreciate Barry's eloquence.

    I don't carry. I don't feel the need. South Dakota is a relatively safe place to live.

    But I don't think people who carry (open or concealed) are due any more or less of the respect I try to give everyone in this world. It bothers me to see people make sweeping generalizations and try to belittle each other. I'm not a good Christian, but that seems like a pretty unChristianly way to be, and just as much a poor way to view our fellow neighbors.

    If we as a society are uncomfortable with people carrying around firearms, and those people have no ill will towards others, then we have the problem. I'll admit a college roommate was an MP in the army, and he open carried everywhere. Even though I knew he had training, and was a pretty responsible guy, it still made me a little nervous. But that's my problem, not his.

    I'm more afraid of the person who has a cell phone and a 3,000 lb motorized carriage than I am the person who's toting around a 12 guage. THAT is what's most likely to kill me in this state!

    I'm not terribly comfortable with public displays of affection. I don't appreciate people groping each other in Central Park or snogging downtown. That's my problem - they're free to do what they like, so long as they aren't being indecent.

    If our liberties are truly to be secured, we need to really espouse tolerance of the activities, behaviors, and views we disagree with. Tolerance isn't a kind word. It's not a positive thing. It's grinning and bearing the stuff you dislike because you have a higher value to uphold - the freedom to act as we see fit so long as it doesn't cause tangible harm to others.

    So show a little tolerance for each other, rather than saying "it's my way or the highway"

  28. caheidelberger Post author | 2013.07.26

    Rural areas are relatively more dangerous places to live, according to the data above... and guns won't protect you from the main heightened dangers... unless you plan to shoot bad drivers before they crash into you... and that seems to be an excessive response.

    I do appreciate the fact that Wayne appears to grasp the priority of the threats to our safety.

  29. caheidelberger Post author | 2013.07.26

    And on this open-carry exhibition Saturday: isn't walking around with a gun merely for show an irresponsible use of that tool? I have every right to walk around with a fully loaded Makita drill, and I could do so to demonstrate how much I enjoy screwing, but all I'd really be doing is increasing the chance of hurting someone in an accident. I don't get out my drill unless there's screwing to be done. Why would I behave differently with a firearm?

  30. Barry Smith 2013.07.26

    Bingo - Cory

    And Wayne I do respect their right to march with their guns. It is their right no matter how foolish and counter - productive I think it is. I have felt the same way about a lot of different marches. The only thing that would make me lose that respect would be any actions of brandishing that went on. In my book that would be where the line was crossed as to rights.

  31. MC 2013.07.26

    I invited to those who fear guns to leave the state because, in this state many people own guns. Most of those owners are responsible enough to keep them locked up when they are being used. Still I know there are people who fear them.

    There are people who dislike wide open spaces. They prefer the comfort of concrete, and knowing that if they called 911, help will be there in minutes. That is not the case here. Many times we have to rely on ourselves. Also our foot tends to get a tad heavy when there is open road.
    There are some poeple who can't stand freash air. To be fair, it isn't it always so freash, as on several farms there are many odors to deal with. Some not so sweet. It is part of rural life. We have gravel roads, dust, sounds of animals and farm machinery.

    If this type of life offends you, then yes, you are invited to leave. If you enjoy this life, then please stay. I would be happy to share a Blizzard or other beverage as we watch our Govenor jump out of plane for a good cause.

    I have been accused of hiding behind my initails; I'm not hiding. just being consistent across the blogosphere.

  32. Stan Gibilisco 2013.07.26

    Hmmmmmm.

    I feel safer here in Lead than I did in Miami Beach. But then, those two places do not constitute median examples.

    Now as for all our faults and foibles out here in the sticks ...

    Cory ... How, exactly, do you plan to turn any part of South Dakota into a big city?

    I reckon it'll be easier for you to get a personal state income tax bill passed into law here.

    But hey, don't give up man.

  33. interested party 2013.07.26

    Stan, you slay me, man.

  34. caheidelberger Post author | 2013.07.26

    That conversion, Stan, is beyond me. It also might make South Dakota even more dangerous, at least in the short run. See Sioux Falls: filled with country folks who don't know how to handle city traffic—serious danger!

  35. Stan Gibilisco 2013.07.27

    More seriously ... as I contemplate finding a remote getaway in Montana, where I can do electromagnetic wave experiments far away from the electrical noise produced by power lines ... I can imagine, one slip of the axe, one wrong move with the chain saw, one bad encounter with a grizzly or rattler ... I'd likely die before help could reach me.

    All in all, that sort of living could prove more dangerous than Miami or Los Angeles ever was.

    But one thing they would say in Miami Beach ... When your number's up, it's up. Can't let fear of death get in the way of fulfillment in life. As to how much fulfillment one might find in a rural setting as opposed to an urban setting ... depends on the person!

    I've evolved, just like our President. Twenty years ago, if you had told me that two decades hence I'd live in South Dakota and my favorite season would be the winter ... I would have called you nuts, or worse.

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