Researchers analyzed differences in urban and rural intentional firearm deaths - homicides and suicides - by examining over 580,000 death certificates from 1989–1999 in every county in the United States. Over the 11 year period, nearly 370,000 people died from intentional firearm injuries. Over 54 percent of these deaths were categorized as firearm suicides and 45 percent as firearm homicides.

After adjusting for differences in income, education, employment rates and other factors, researchers found that rural counties had over 1.5 times the firearm suicide rate that urban counties had. Correspondingly, urban counties had twice the firearm homicide rate of rural counties.

A demographic analysis of Iowa reinforces the conclusions of the nationwide study. The difference between rural Iowa counties (less than 10,000 pop.) of which there are 18, and urban counties, of which there are 9, in terms of gun suicides is quite dramatic. The rate per hundred thousand in the 18 counties with the smallest populations is 8.17, while the rate in the 9 counties with the largest populations is 4.52. The rate in the small counties is 180% that of the large counties.

Over the period of study, gun homicides nationwide decreased at a rate of about 5 percent per year and suicides increased by 1-2 percent each year. The researchers cited the one-sided nature of legislation aimed at firearm deaths as contributing towards this disparity. Over the same period of time, five to six times as many bills were introduced in Congress that dealt with firearm homicide as opposed to firearm suicide.

This trend applied only to firearm related intentional injuries. Other non-gun forms of homicide and suicide were found to be similar in both urban and rural areas. “ A major take home from these findings is that although prevention efforts must be continued in big cities, , dispelling the urban myth that gun death does not touch areas outside of big cities should be a high priority,” said lead author of the study Charles C. Branas, PhD.