By Eric Lyttle

Rural youths are nearly twice as likely to commit suicide as their urban counterparts, according to a study by Ohio State University researchers.

The study, published Monday in the Journal of the American Medical Association's JAMA Pediatrics, analyzed the nearly 67,000 suicides of young people ages 10 to 24 in the United States between 1996 and 2010.

Researcher Cynthia Fontanella, clinical assistant professor of psychiatry and behavioral health at Ohio State's Wexner Medical Center, found that among male youths, the suicide rate in rural areas was 19.93 per 100,000 compared with a rate of 10.31 among youths living in urban areas.

Similarly, the suicide rate of young rural females was 4.40 compared with a rate of 2.39 among urban females.

And the disparity is widening, said Fontanella.

"We kind of expected that there would be a larger suicide rate among rural youth than urban," said Fontanella, who worked on the study for a year with fellow researcher John Campo, chair of psychiatry and behavioral health at the Wexner Medical Center, and a team of five co-authors. " There are a number of possible reasons: a significant shortage of mental-health care in rural areas, geographic, social and economic isolation and a greater access to guns."

"What we didn't expect was that the disparities are widening over time," said Fontanella.

She said that one possible explanation is that access to guns is declining in urban settings while remaining stable in more rural areas.

Campo said that about 90 percent of those who attempt suicide suffer from some sort of mental or physical illness. Among the younger population, substance abuse was one of the largest risk factors. About half of the suicides were committed with a gun, although that number is falling, while 34 percent died by hanging, a number that has been increasing in recent years.

Ohio's suicide rates reflect the national trends, said Fontanella.

She said that in Ohio, there were 1,484 suicides in 2011. Of those, 211 were committed by youths ages 10 to 24.

The state's highest suicides rates by county occurred in Morgan (26.6 per 100,000), Athens (23.2), Adams (22.4), Monroe (20.5) and Meigs (19.4) -- all largely rural counties.

The largely metropolitan counties had significantly lower suicide rates, including Cuyahoga (10.8), Franklin (11.4) and Hamilton (11.5).

Holmes County has the lowest suicide rate at 6.1, possibly because of its large Amish population. Fontanella said, "There's a lot of stigma around suicide around the Amish, and it's a very close-knit community."

The results could help target how a $1 million suicide-prevention fund, established for 2015 by Gov. John Kasich and administered by the Ohio Department of Health, might be used.

That fund is designated for suicide education and awareness, treatment, screening for high-risk individuals, mitigating access to lethal means and better follow-up with those who have made a suicide attempt.

(c)2015 The Columbus Dispatch (Columbus, Ohio)