Contrary to what many believe, the risk of dying from an injury is far less in the city than in the country, U.S. researchers found.

Although homicides in cities far outpace those in rural areas, overall the risk of dying from some form of accident or injury is 20 percent greater in the most rural counties of the United States than in the nation's biggest cities.

The findings may give pause to people tempted to flee cities for the bucolic ideal of rural life, says Dr. Sage Myers, a pediatric emergency medicine specialist at the University of Pennsylvania and the Children's Hospital of Philadelphia.

"As you moved further and further away from cities you got less and less safe. Even going into the suburbs dropped your safety a little bit," said Myers, whose study was published in the Annals of Emergency Medicine. "It's a little counterintuitive."

Myers said when people think of their personal safety, they tend to think about intentionally inflicted injuries, such as being attacked or shot. But the researchers found that the risk of dying from an accidental injury is 40 percent higher in the nation's most rural counties than in its most urban.

The study also revealed:

  • Motor vehicle crashes led to 28 deaths for every 100,000 people in rural areas, versus only 11 deaths per 100,000 in urban areas
  • Firearm-related death rates were higher in rural areas for children and people over 45 years of age, but for 22- to 44-year-olds this risk was higher in urban areas.

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