Higher suicide rates in rural areas are almost entirely explained by a greater use of firearms, according to new research from the Johns Hopkins Bloomberg School of Public Health.

By the numbers: Researchers analyzed nearly 6,200 suicides in Maryland between 2003 and 2015, finding 16 deaths per 100,000 people in urban areas and 24 deaths per 100,000 in rural areas. About half of the suicides in the state were by firearm, and the suicide rate by firearm was 66 percent higher in rural areas. But suicide rates not involving firearms did not differ significantly between rural and urban areas. Men committed 80 percent of all suicides and 89 percent of firearm suicides.

Bottom line: The design of study did not allow researchers to determine if there was a causal connection between the availability of firearms and suicide rates. However, the study adds to a considerable amount of evidence linking access to firearms and suicide. Previous research has found that areas with more firearms have higher suicide rates, particularly among children. And other studies have found that 71 percent of people act on suicidal thoughts within one hour of having them, increasing the risks with easy access to lethal means.

— Markian Hawryluk, The Bulletin