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Questions. Morbidity. Incept dates.
July 25, 2013 8:03 AM   Subscribe

Detroit, New Orleans, Oakland... some of the safer places in America to live! Sure, big cities might have more murders per capita... but residents in large cities are *MUCH* safer when it comes to injury deaths than those living in more rural parts of America, according to a new study in The Annals of Emergency Medicine.
"Cars, guns and drugs are the unholy trinity causing the majority of injury deaths . . . Although the risk of homicide is higher in big cities, the risk of unintentional injury death is 40 percent higher in the most rural areas than in the most urban. And overall, the rate of unintentional injury dwarfs the risk of homicide, with the rate of unintentional injury more than 15 times that of homicide among the entire population."
posted by markkraft (71 comments total) 13 users marked this as a favorite

 
That's because people in rural areas actually, you know, do things. Outside.
posted by michaelh at 8:09 AM on July 25, 2013 [4 favorites]


If rural Americans drive anything like the the rural Canadians who have shared hair-raising Tales of Irresponsible Vehicular Shenanigans with me, this comes as no surprise. Apparently being the only (visible) car on the road leads to delusions of omnipotence and immortality.
posted by The Card Cheat at 8:09 AM on July 25, 2013 [9 favorites]


Detroit, New Orleans, Oakland...

I've lived in two of these cities. If I move to Detroit do I get a free sandwich?
posted by brundlefly at 8:10 AM on July 25, 2013 [5 favorites]


Interesting article. It seems to say that one of the factors is that if you get injured in a rural location you are much less likely to wind up in a well-staffed ER that can actually keep you alive, so while the difference in injuries isn't as big as you'd think, the difference in deaths (rural vs. urban) really is.
posted by jessamyn at 8:12 AM on July 25, 2013 [9 favorites]


Detroit, New Orleans, Oakland...

I've lived in two of these cities. If I move to Detroit do I get a free sandwich?


Drop me a MeMail when you get here. I'll take you to Basement Burger Bar, and you'll thank me forever.
posted by Etrigan at 8:12 AM on July 25, 2013 [5 favorites]


That's because people in rural areas actually, you know, do things. Outside.

FTFA:

"The most common causes of injury death were motor vehicle crashes, leading to 27.61 deaths per 100,000 people in most rural areas and 10.58 per 100,000 in most urban areas. Though the risk of firearm-related death showed no difference across the rural-urban spectrum in the entire population as a whole, when age subgroups were studied, firearm-related deaths were found to be significantly higher in rural areas for children and people 45 years and older; however, for people age 20 to 44, the risk of firearm-related death was significantly lower in rural areas."

So no, not at all.
posted by MisantropicPainforest at 8:13 AM on July 25, 2013 [16 favorites]


You are also far, far less likely to get a free sandwich in a rural area.
posted by louche mustachio at 8:13 AM on July 25, 2013 [12 favorites]


but residents in large cities are *MUCH* safer when it comes to injury deaths than those living in more rural parts of America

This is not news to anyone who has ever seen the classic British farm safety film "Apaches."
posted by Sys Rq at 8:13 AM on July 25, 2013 [3 favorites]


That's because people in rural areas actually, you know, do things. Outside.

Like driving around. As opposed to walking places, which urban people do, which apparently isn't doing anything outside.
posted by General Malaise at 8:16 AM on July 25, 2013 [29 favorites]


The single most dangerous thing you can do in America is get in a car or have a largely sedentary lifestyle.

Or own water recreation vechichals.
posted by The Whelk at 8:16 AM on July 25, 2013 [5 favorites]


"That's because people in rural areas actually, you know, do things. Outside."

...with cars, guns, drugs, primarily.

People in S.F. do things outdoors all the time. In fact, we're a helluva lot more fit than people in West Virginia.

We have hills too. The difference is, we walk up and down them every day... and, unlike our counterparts in West Virginia, we tend to eat real food.
posted by markkraft at 8:18 AM on July 25, 2013 [6 favorites]


unintentional injury dwarfs

Are these the counter-entities to fairy godmothers? Oh, dwarf as in small or insignificant in comparison.


According to the CNN article the study didn't really try to answer why there is a difference in urban and rural injury and death rates, but that article does touch on a key factor: response times and delays getting injured people to hospitals. The sooner someone can get into a hospital and get treatment, the higher the likelihood of survival.

So when there's a rural car crash, response vehicles have to 1) get alerted to the incident, 2) reach the incident site, 3) get past the vehicles stopped around the crash, then 4) get the injured people to the closest hospital. Other injuries are similar, though you don't have to deal with backed up traffic.
posted by filthy light thief at 8:23 AM on July 25, 2013


"That's because people in rural areas actually, you know, do things. Outside."

...with cars, guns, drugs, primarily.

People in S.F. do things outdoors all the time. In fact, we're a helluva lot more fit than people in West Virginia.

We have hills too. The difference is, we walk up and down them every day... and, unlike them, we tend to eat real food.


While the initial comment was wrong and unnecessarily provocative, this is pretty offensive. People in rural areas are doing things "primarily" with guns and drugs?* They're out of shape and don't eat real food? I mean I guess you could load up a few extra offensive stereotypes in there if you tried, but seriously, we can do better than this.

*I know you also put cars in there, but lumping those three things together is completely and obviously disingenuous.
posted by Bulgaroktonos at 8:23 AM on July 25, 2013 [25 favorites]


which apparently isn't doing anything outside.

Not in the way he means, it isn't. Walking down a city street is "outside" in the "out-of-doors" sense, but it's still a pretty damned controlled environment. If all you're doing is walking around, or even riding your bike, it seems to be that you'd be far less likely to be injured by the landscape in an urban area than a rural one. And things like BMX courses, ATV mud trails, and, you know, farms tend not to be in urban areas either, all of which involve activities which carry with them a relatively high possibility of injury.

Which is why, to quote that one guy in front of me at Wal-Mart last week, "A redneck's last words are usually 'Y'all watch this!'"
posted by valkyryn at 8:24 AM on July 25, 2013 [1 favorite]


And the CNN piece is silly in its vague attribution of media coverage to public perception of relative safety of cities:
But those statistics aren't convincing the country that cities are getting safer: a 2011 Gallup poll found that most Americans continue to believe that the nation's crime rate is getting worse, even though there's been a sharp and sustained drop in murders and other violent assaults since the mid-1990s. Perception — no doubt fueled in part by the media — beats reality.
No doubt, indeed.
posted by filthy light thief at 8:25 AM on July 25, 2013 [5 favorites]


...and, unlike our counterparts in West Virginia, we tend to eat real food.

The strange and terrible West Virginian in his natural habitat.
posted by A god with hooves, a god with horns at 8:26 AM on July 25, 2013 [3 favorites]


"People in rural areas are doing things "primarily" with guns and drugs?"

... when they get unintentional injured, yes. (Which is what the post was about.) Those three factors make up for the majority of all unintentional injuries. Not going for a hike / nice walk.

People in cities are likely to get injured doing the same things, of course.
posted by markkraft at 8:28 AM on July 25, 2013


From the Discussion section:
In fact, the rate of unintentional injury death is more than 15 times that of homicide among the entire population, with the risk resting heavily in rural areas such that the risk of unintentional injury death is 40% higher in the most rural counties compared with the most urban.

Motor vehicle crash deaths drive this finding as the top mechanism of injury death, occurring at a rate that is more than 1.4 times higher than the next leading mechanism of injury death overall and twice the next leading mechanism in rural areas (Figure 2). 49,50 By comparison, the risk of motor vehicle crash death in the most rural areas is 2 times that in the most urban areas. Factors likely to contribute to this elevated rural risk include speed
of travel, 51 increased risk taking, 52 adherence to traffic laws, 53 and distance to medical care.54

Oh my God. I live in a rural setting, along a well-traveled road where folks who know the road go WAY faster than they should, partly because they know that police are unlikely to be monitoring that section of roadway. Our non-police first responders are also locals, often volunteers, and I have sometimes heard the crash, then heard the town fire hall siren, and then heard the blue-light vehicles speeding toward the scene. It takes time. Calling in the trauma helicopter takes time. The flight or ambulance ride takes time. That cuts into survival rates. I'm not going to deny that I've seen some irresponsible driving out here, but filthy light thief makes a good point.
posted by MonkeyToes at 8:29 AM on July 25, 2013 [2 favorites]


If you watch the 11 PM local news in any city, you'd think that urban neighborhoods are these bullet ridden war zones only slightly safer than Baghdad. I live close to downtown and have a really hard time convincing suburbanites that where I live is a friendly, quiet, safe place to live. They really don't want to hear that they're in way more danger driving on the interstates in the suburbs than they are walking around the city.
posted by octothorpe at 8:30 AM on July 25, 2013 [5 favorites]


"The strange and terrible West Virginian in his natural habitat."

I was thinking more this.

Suffice it to say, there are lots of people in cities that eat healthy and get plenty of exercise, just as there are lots of people in rural America who stay indoors and play Xbox with cookies and a soda at hand.

Surprisingly enough, people go out and do things, even in the middle of cities.
posted by markkraft at 8:32 AM on July 25, 2013


That's because people in rural areas actually, you know, do things. Outside.

I'll be right in to comment as soon as I put away this Black and Decker Cordless Hedge Trim........................OUCH, GODDAMMIT.
posted by FelliniBlank at 8:34 AM on July 25, 2013 [5 favorites]


[Do not turn this into a "Let's all rag on one state for one data point that we find wanting" thing. Article is not about obesity, don't make this thread about it. Thank you.]
posted by jessamyn at 8:38 AM on July 25, 2013 [2 favorites]


Also worth remembering is that the main way people get murdered is by an accomplice.

Oh, you don't have one?

You're at risk of death from old age, then.
posted by ocschwar at 8:39 AM on July 25, 2013 [1 favorite]


Like driving around. As opposed to walking places, which urban people do, which apparently isn't doing anything outside.

It is well known that sitting in your air-conditioned car, immobile except for the occasional inch-scale movement of your hands or foot, you are the hardiest of outdoorsmen—a modern-day explorer, really, heir to the legacies of Shackleton and Hilary, whereas anything you do in proximity to a major metropolitan area, whether it be walking or biking or sailing or rock-climbing, is basically paper-pushing. Or at least that is what all of my suburb-dwelling friends seem to believe.
posted by enn at 8:48 AM on July 25, 2013 [5 favorites]


The most common causes of injury death were motor vehicle crashes, leading to 27.61 deaths per 100,000 people in most rural areas and 10.58 per 100,000 in most urban areas

Compared with rates of about 4 per 100,000 people in Western Europe. This is a death rate that needs fixing.
posted by ambrosen at 8:48 AM on July 25, 2013 [2 favorites]


If motor vehicles are the main source of injury/death, then obviously it's more dangerous in a rural setting, where one drives more and higher rate of car ownership.
posted by stbalbach at 8:52 AM on July 25, 2013 [1 favorite]


One of my old roommates was an EMT in our suburban neighborhood and by far her most common complaint was people using chainsaws without safety procedures of any kind while cleaning up their yards.
posted by jetlagaddict at 8:52 AM on July 25, 2013


This can be true but not make cities any "safer" in the way we think of safety. Motor vehicle deaths are largely due to either reckless or drunken behavior and gun deaths are usually self inflicted (in the country anyway). Drugs are self inflicted too obviously. All this means that I have a higher chance of dying in the country but I own agency over those factors (I could of course be hit and killed by a drunk driver but this is nitpicking). Where are incidents of homicide and muggings higher the city or the country? The city.

So a safe responsible person living in the country is more likely to be safe than a safe responsible person living in the city all other things being equal.
posted by ishrinkmajeans at 8:57 AM on July 25, 2013 [2 favorites]


If motor vehicles are the main source of injury/death, then obviously it's more dangerous in a rural setting, where one drives more and higher rate of car ownership.

I'd really like to see some figures on this. I know some urban areas have CRAZY high crash rates, just because of the sheer number of cars moving through certain intersections. Then there are rural routes, where crashes happen because of inattentive or distracted driving, natural things in the road (rocks, trees, animals), or unsafe speeds, but there are a LOT less people traveling.

This then gets back to response times. If a major crash happens 5 miles from the nearest hospital, and the crash is a 5-car pile-up at rush hour, getting to and from the crash site will take emergency responders time to get through the traffic. But they can probably get there and back faster than a rural accident, where the only one injured was the driver, cell coverage is spotty, and the next driver comes by 10 minutes later.

Without any treatment, someone could bleed out due to a major, but treatable injury. In other words, the danger isn't inherent in the rural nature of the roads, but the low density of first responders and reporting public.
posted by filthy light thief at 8:57 AM on July 25, 2013 [3 favorites]


The real lesson of this report is not that cities are safer, but that vehicles are incredibly dangerous. Look forward to Elon Musk's vacuum tube announcement in a few days. And driverless cars from Google.

Motor vehicle deaths are largely due to either reckless or drunken behavior

Try spending time watching ru-chp. Most accidents are just.. accidents. People are not perfect and it takes one moment of not paying attention.
posted by stbalbach at 8:59 AM on July 25, 2013 [2 favorites]


I'm guessing another difference between urban and rural driving is speeds; I do 95% of my driving on city streets and I'm seldom moving faster than 45 MPH (and rarely that fast). I could obviously die in a 45 MPH accident, but it's not as likely as when I'm out on some country highway and everyone's going 70.
posted by Bulgaroktonos at 9:00 AM on July 25, 2013


I was just about to say the same thing. In Manhattan during rush hour, it would be a real challenge to get a car moving at a speed capable of killing someone.
posted by baf at 9:04 AM on July 25, 2013 [1 favorite]


Appalachian Emergency Room deserves a review.
posted by otto42 at 9:09 AM on July 25, 2013


Interesting article. It seems to say that one of the factors is that if you get injured in a rural location you are much less likely to wind up in a well-staffed ER that can actually keep you alive, so while the difference in injuries isn't as big as you'd think, the difference in deaths (rural vs. urban) really is.

My grandad lives in quasi-rural Yorkshire and, while he lives somewhere big enough to have a hospital, they shut the A&E a few years back. You had better not sustain any sort of quickly fatal injury or allergic reaction late at night as you're just going to die before you get to a doctor, never mind whether the closest hospital is well-equipped (I suspect it isn't). This is all a little worrying, as my grandad has in the past walked to the hospital at 3am with his throat swelling closed.
posted by hoyland at 9:10 AM on July 25, 2013


In Manhattan during rush hour, it would be a real challenge to get a car moving at a speed capable of killing someone.

I disagree. It is easy to get a car in Manhattan traffic moving at a speed capable of making me want to die. Usually that speed is between 0 and 1 mph.
posted by Wretch729 at 9:10 AM on July 25, 2013 [6 favorites]


"So a safe responsible person living in the country is more likely to be safe than a safe responsible person living in the city all other things being equal."

Which is of small consolation when you are in a rural area, waiting for an ambulance.
posted by markkraft at 9:12 AM on July 25, 2013 [1 favorite]


Interesting article. It seems to say that one of the factors is that if you get injured in a rural location you are much less likely to wind up in a well-staffed ER that can actually keep you alive, so while the difference in injuries isn't as big as you'd think, the difference in deaths (rural vs. urban) really is.

Not sure which article you are talking about. The study (linked under "new study") says (emphasis mine):
It is thus reasonable to consider access to specialized care, or lack thereof, as a mediator of the relationship between the rural nature of a county and its level of injury-related mortality.To address this issue, we introduced a variable related to access to trauma center care into our model as a covariate to determine whether it would erase the increased injury-related mortality risk that we observed to be associated with the most rural counties. In fact, we observed very little change in the rural-urban relationship when we accounted for “access” to trauma center care. This would argue against access to specialized care being the driving force behind the disparity in injury related mortality found for rural areas. We were able to use only a simple count of trauma centers per county as our determination of access to care, and it is possible that a more sophisticated model of trauma center access, using true distances and drive times, could have more influence on this relationship. However, given the very minor effect of our crude adjustment variable, it is unlikely that the addition of a more accurate access variable would account for all of the increased risk of injury-related mortality found in the most rural counties compared with the most urban.
posted by Homeboy Trouble at 9:15 AM on July 25, 2013 [1 favorite]


> (I could of course be hit and killed by a drunk driver but this is nitpicking).

It's really, really not.
posted by Space Coyote at 9:20 AM on July 25, 2013


Not sure which article you are talking about.

I may have been making an error in not conflating emergency room discussion and trauma care/center discussion. Are they the same thing?
These findings can also be considered in the context of the ongoing ED workforce debate. Hospitals in rural areas are less frequently staffed by emergency physicians and have less access to on-call specialists, including trauma surgeons, neurosurgeons, and orthopedists. Although the emergency medicine–trained and board-certified workforce has the most direct training in the care of the severely injured patients among the physician types who may staff EDs, it is unlikely that the workforce pool of emergency medicine–trained physicians will be large enough to cover all EDs completely at any point in the near future The fact that the injury-related mortality risk is highest in the areas least likely to be covered by emergency physicians and least likely to have access to trauma care (http://www.traumamaps.org) could be used to support ongoing efforts to improve emergency and trauma care systems in the United States, using a population planning approach. Additional efforts should focus on expanding access to expert care by using less traditional methods, including certification or postresidency training programs for physicians who will be providing care in EDs from non–emergency medicine backgrounds and the continued examination of how technology-based solutions, including telemedicine, can expand the traditional reach of medical expertise into rural areas.
posted by jessamyn at 9:24 AM on July 25, 2013


Most accidents are just.. accidents. People are not perfect and it takes one moment of not paying attention.

Most accidents are the result of multiple people not paying attention or one person not paying attention for multiple moments. Drifting into the lane beside you because you weren't paying attention is only a problem when the person in that lane isn't paying attention to you as well.
posted by Etrigan at 9:31 AM on July 25, 2013 [2 favorites]


The most common causes of injury death were motor vehicle crashes, leading to 27.61 deaths per 100,000 people in most rural areas and 10.58 per 100,000 in most urban areas

Compared with rates of about 4 per 100,000 people in Western Europe. This is a death rate that needs fixing.

Probably overly simplistic but here in America people want bigger and more cars and cheaper infrastructure that's somehow simultaneously optimized for those selfsame SUVs instead of small sedans, let alone bikes or pedestrians. That's where my money would be with regards to the discrepancy in death rates between the two locales. TL;DR - 'because Amurica!

Countdown to someone pointing out how wrongminded that is and how a study has actually show a causal relationship between the number of bodies of water or owl population density or something and vehicular death rates starts now...
posted by RolandOfEld at 9:35 AM on July 25, 2013


I have to agree about the terror of rural roads. Living in Quebec outside of Montreal, my newspaper is filled daily with people (mostly young'uns) who have died on local roads due to excessive speed, drink-driving, or both. There is a gorgeous local highway to take during the warm months down to the Vermont/Quebec border, but it terrfies me to take it sometimes because while the max speed is 90 KPH, not many other drivers--including semis--follow that.
posted by Kitteh at 9:42 AM on July 25, 2013


Motor vehicle deaths are largely due to either reckless or drunken behavior

Literally everyone think's they're a safe driver.
posted by kiltedtaco at 9:47 AM on July 25, 2013


The most common causes of injury death were motor vehicle crashes, leading to 27.61 deaths per 100,000 people in most rural areas and 10.58 per 100,000 in most urban areas

Compared with rates of about 4 per 100,000 people in Western Europe. This is a death rate that needs fixing.


If there's a fixed rate of crashing per mile then driving more miles gives you a greater overall chance of being in an accident. Driving rates are lower for people who live in urban areas, and probably for most of western Europe, than they are for people who live in rural areas. OF COURSE the people who live in rural areas and HAVE NO CHOICE BUT TO DRIVE EVERY DAY IF THEY WANT TO GO ANYWHERE THAT ISN'T THEIR OWN HOUSE are going to have higher rates of getting into crashes than people who can go weeks at a time without driving at all?
posted by titus n. owl at 9:50 AM on July 25, 2013 [3 favorites]


Where are incidents of homicide and muggings higher the city or the country? The city [...] So a safe responsible person living in the country is more likely to be safe than a safe responsible person living in the city all other things being equal.
Your hypothetical safe, responsible citizen has agency over their likelihood of being mugged or murdered while in an urban environment. I'm sure walking alone at night and/or doing so in more dangerous neighborhoods than is advisable is a factor you can control if you are seriously worried about this happening. Do you think mobs of drug-crazed muggers are beating down our doors and murdering people randomly just for shits and giggles, or what? I have to laugh at the perception suburban and rural dwellers seem to have of the city.

Also, I'm going to go out on a limb here and guess the vast majority of those young men who were victims of firearm homicide are disproportionately from a demographic more specific than "aged 25-44, male". Indeed, if you are a young black man, the city might very well be quite dangerous for you. This is news to nobody. I don't have the time to dig into all the sources, but get the sense this was side-stepped entirely in favor of numbers for the population on average, which seems a pretty poor basis for drawing any meaningful conclusions about any particular person's likelihood of being the victim of random violent crime.

In any case, it's a bit ridiculous to argue this point and ignore the car issue, but Americans seem largely content to do just that, for reasons I can't even begin to guess. Who doesn't know someone who died in a car? It's depressingly common.
posted by cj_ at 9:51 AM on July 25, 2013


So higher homicide rates exist among people who live much closer to one another? And there is a positive correlation between accidental deaths and automobile miles driven per person?

Sounds about right to me. Wrapping it up in a package of "Cities are safer" is entertaining, I guess.
posted by stupidsexyFlanders at 9:55 AM on July 25, 2013


Wrapping it up in a package of "Cities are safer" is entertaining, I guess

And also entirely relevant to what these scholars are studying.
posted by MisantropicPainforest at 9:57 AM on July 25, 2013 [1 favorite]


I may have been making an error in not conflating emergency room discussion and trauma care/center discussion. Are they the same thing?

I think that it goes a little bit both ways; that it probably is a factor at some level, but they have shown it's not a massive factor.

I was thinking about this on the way in to work this morning, and they are using county of death versus the population (i.e. the number of people living in) that county. This doesn't account for four things, which might have an interesting effect:
1). During the day, people commute from more rural to more urban counties - the daytime population of the city I live in is about 4% higher for the six hours in the middle of the day, and it's 2% higher for 11 hours. This would tend to increase the number of deaths ascribed to urban counties (i.e. rural residents who have commuted in and die).
2). One special group of people who commute into urban areas are those who commute by ambulance or air ambulance. If you get in a life-threatening injury on a ranch 30 miles out of my city, a helicopter will carry you into a hospital in town, where if you die, you would presumably get ascribed to the urban area. This will also tend to increase the deaths in urban counties; true, not many people are taken in by ambulances and helicopters, but they are pretty literally the highest risk group of people out there.
3). To provide a counterpoint, one thing that people I know who live in the city do is go out to rural areas to do the dangerous shit you can't do in a city; hunt, drive ATVs, have really big bonfires. That would tend to increase deaths in rural areas.
4). A similar dangerous thing that people from cities do in rural areas is drive through them. If you live in LA and drive to San Francisco, you are doing the dangerous act of driving through relatively rural counties. This would also tend to increase deaths in rural areas.

My guess is that the net effect is probably fairly small, especially since 1 and 2 work in an opposite direction from 3 and 4. (I'd also like to note that counties are not a great measure of urban/rural in the western half of the US; if you die in the Mojave Desert, you actually died in San Bernardino county, which is an urban county.)
posted by Homeboy Trouble at 10:01 AM on July 25, 2013 [1 favorite]


Compared with rates of about 4 per 100,000 people in Western Europe. This is a death rate that needs fixing.

If there's a fixed rate of crashing per mile then driving more miles gives you a greater overall chance of being in [a crash].


The death rate per mile in the US is excessively high compared to similarly developed nations, too. This is wrong, and should be fixed.
posted by ambrosen at 10:06 AM on July 25, 2013 [1 favorite]


ambrosen, don't people in rural America literally drive more miles per year than people in western Europe? On an anecdotal level I'm constantly hearing that sort of claim.
posted by titus n. owl at 10:11 AM on July 25, 2013


Oh, I'm sorry, you SAID "per mile." I apologize for not reading properly. Do you have numbers?
posted by titus n. owl at 10:12 AM on July 25, 2013


I'm shocked that people in rural areas are more likely to work with dangerous agricultural equipment. I mean just the other day I was talking to my friend about how often we have to cut down trees and bush-hog our apartment complex and he told me all about how much he hates when his combine gets stuck in rush hour traffic, shocking!
posted by The 10th Regiment of Foot at 10:17 AM on July 25, 2013


Sooo, quick hypothetical here: If I eliminate one of the legs of the tripod, is everything drastically changed statistically? Like, I can still get fucked up on whatever suits my fancy while strapped to the gills like a boss as long as I'm rolling around on a bicycle in my rural township?
posted by NoRelation at 10:26 AM on July 25, 2013


If my town is any indication, probably.
posted by jessamyn at 10:28 AM on July 25, 2013 [1 favorite]


Like, I can still get fucked up on whatever suits my fancy while strapped to the gills like a boss as long as I'm rolling around on a bicycle in my rural township?

Why would that be so far outside the norm? I've lived in plenty of rural townships and what you describe is usually called "Tuesday".
posted by The 10th Regiment of Foot at 10:30 AM on July 25, 2013


Our non-police first responders are also locals, often volunteers, and I have sometimes heard the crash, then heard the town fire hall siren, and then heard the blue-light vehicles speeding toward the scene. It takes time. Calling in the trauma helicopter takes time. The flight or ambulance ride takes time. That cuts into survival rates.

In the context of the complete lack of trauma centres in Chicago's south side there were initial academic studies showing that there was no increase in mortality despite the extra time required to transport trauma cases to north side facilities. There is supposedly a new study soon to be published showing that it does have an effect but the fact there is even disagreement about it suggests that the effects are probably small.
posted by srboisvert at 10:52 AM on July 25, 2013 [2 favorites]


There's something both amusing and infuriating about this thread: the whole point of this study is "people's assumptions about rural and urban life are rooted in popular myths that have no relationship to the data: here are the data"; this thread is mostly people trotting out various stereotypes and assumptions that they have about either rural or urban life (or both) that also bear no relationship to the data in the study.

No, the differences they have found do not have anything to do with eating habits, exercise patterns, operating farm equipment etc. etc. etc. By far the main driver of the difference is car accidents, plain and simple.

I'm trying to imagine a Hollywood movie where somebody announces their intention to move from a small family farm in Iowa to New York City because it's a safer place to bring up kids and where everyone just ruefully nods their heads because, well, duh!
posted by yoink at 11:03 AM on July 25, 2013 [9 favorites]


Like, I can still get fucked up on whatever suits my fancy while strapped to the gills like a boss as long as I'm rolling around on a bicycle in my rural township?

Not only that, but for your convenience, you can do one-stop shopping at the liquor-guns-ammo store or the liquor-and-power-tools store in my rural area.
posted by FelliniBlank at 11:03 AM on July 25, 2013


With a side trip to the medical marijuana dispensary.
posted by FelliniBlank at 11:04 AM on July 25, 2013


as I'm rolling around on a bicycle in my rural township?

You're still at a non-trivial risk of someone driving into you.
posted by yoink at 11:13 AM on July 25, 2013


"Is your town safe?"

"Well, yeah. We have fewer car crash fatalities per capita than your town"

"That didn't really answer my question"
posted by joseppi7 at 11:35 AM on July 25, 2013


" All this means that I have a higher chance of dying in the country but I own agency over those factors (I could of course be hit and killed by a drunk driver but this is nitpicking). Where are incidents of homicide and muggings higher the city or the country? The city.

So a safe responsible person living in the country is more likely to be safe than a safe responsible person living in the city all other things being equal.
"

This week in fallacies
posted by klangklangston at 11:42 AM on July 25, 2013


"Is your town safe?"

"Well, yeah. We have fewer car crash fatalities per capita than your town"

"That didn't really answer my question"


Or, rather, "that answered the question I asked, but not the one I had in my mind." There are threats to our safety that scare us and threats--often far more profound ones--that don't. This is only partially a matter of our inability to understand statistics (though they plays a reasonably large part in it, of course). That is, there are harms that can come to us which we will accept as simply "the way things go" and harms that profoundly offend our sense of being "secure." Had 3000 odd people died in NY on 9/11 because a building collapsed in an earthquake or a gas mains explosion or what have you we would largely have forgotten about it by now. Those are risks that we are willing to put into the "ah well, them's the breaks" category; terrorists flying planes into buildings--no matter how fantastically small the odds of that happening to us--is not that kind of risk. It is one which we find profoundly upsetting.

We may be much, much less likely to face a violent death in the city than in the country, but we are more likely to face a violent death of the kind that inhabits our nightmares in the city than we are in the country. Car crashes are so common that we chalk them up pretty readily to the "acts of god" category, like earthquakes, tornadoes and other natural disasters.
posted by yoink at 11:44 AM on July 25, 2013 [2 favorites]


Just back from vacation in Chicago, visiting friends in the area, and I can vouch for the fact that people actually seem to do a lot more in cities than in the rural places I've lived. The availability of convenient public transportation and all the things around to do and see would make it seem ridiculous to just stay cooped up in your home all the time in a city like Chicago. I'm sure people do it, but it's hard to imagine why, unless you happen to live in a sketchy neighborhood with a history of gun violence or something. My city-dwelling friends seem to spend a lot more of their time out and about doing things--generally, travelling by foot, bus or train--than my friends in small towns and suburbs. (Also Chicagoans were nicer and far more personable than I'd ever expected, coming from the South.)
posted by saulgoodman at 12:05 PM on July 25, 2013


The death rate per mile in the US is excessively high compared to similarly developed nations, too. This is wrong, and should be fixed.

This says the US is maybe not the safest, but on par with Germany and Austria. I'm a little wary of a direct comparison of the numbers, though, since the various countries almost certainly do their accounting a bit differently. And I've seen conflicting numbers for the countries I have found any data for (e.g., the NHTSA says the US's motor-vehicle-related-death rate is 1.27 per 100 million vehicle miles).
posted by aubilenon at 12:07 PM on July 25, 2013


Thanks for linking that, aubilenon. I was meaning to come back to it. I think 1.27 fatalities per 100 million vehicle miles does equal 8.5 fatalities per 1 billion vehicle kilometres. Not sure what that is rods per hogshead, though.
posted by ambrosen at 12:18 PM on July 25, 2013


Motor vehicle deaths are largely due to either reckless or drunken behavior...

Everyone thinks they are a safe driver. Even if you are The World's Safest Driver, that means precious little when surrounded by other drivers who could kill you.

Unless you could argue that the vast majority of motor vehicle deaths are caused by one-car accidents or accidents in which the person who died was the one at fault for the crash AND the only person injured in the accident, I don't think the argument can be made that by being a safe and sober driver, you eliminate the risk.
posted by inertia at 12:23 PM on July 25, 2013


ambrosen: Buh. Thanks. Somehow I overlooked that the wikipedia table was in km.
posted by aubilenon at 12:39 PM on July 25, 2013


Kind of a roundabout way of correlating the lengths of ambulance rides to ER outcomes.
posted by klarck at 1:14 PM on July 25, 2013


A sad rural death by vehicle: State flags to fly at half-staff for Quentin firefighter Bruce L. Sensenig. A sober, responsible driver on his way to help a fellow citizen in trouble accidentally loses control of his vehicle, crashes, and dies almost at the doorstep of his parents' farm. That's not a stereotype; that's a damn shame.
posted by MonkeyToes at 2:43 PM on July 25, 2013


I'm going to tell you my rural nightmare scenario, it really happened so stop reading now if you don't want nightmares. Rural areas are full of not-quite-fatal risks, and help can be farther away than you could imagine. That's what I'm really afraid of.

The interstate between my city and the neighbor is a congested commute, but runs through farms and wooded areas that are notorious for deer crossing accidents. Quite a few years ago, a woman swerved off the road and drove into a culvert full of water. The crash site was hidden from the road due to tall weeds, and apparently nobody saw her go into the ditch, or at least, nobody called the police. She was trapped in her car, which filled with water up to about her waist. She was stuck there for a week and started to get gangrene in her arms and feet. Finally the farm owner saw the car and called for help. She survived, but all four of her limbs had to be amputated.

When I heard about that, I bought a cell phone and I have never gone anywhere without it.
posted by charlie don't surf at 5:04 PM on July 25, 2013 [3 favorites]


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