Rural counties have had consistently higher suicide rates than urban counties over the past fifteen years. In fact, suicide rates increased by more than 20% between 2001 to 2015. The rate is four to five times higher for men than for women. Among other factors, high rates of suicide in rural areas can be linked to social isolation, poverty, lack of access to health care and insurance, and easy access to firearms.

While the rise in suicides is taking place across all rural areas, the highest concentration is in the Western states (Colorado, New Mexico, Utah, and Wyoming), Appalachia (Kentucky, Virginia, and West Virginia), and the Ozarks (Arkansas and Missouri).