FIGURE 2-5 Suicide Rates by Urbanization and Use of Firearms Among Persons 65 Years and Older: United States, 1996–1998. Source: NCHS (2001). Provided by LA Fingerhut.

there is a high concentration of counties with the lowest suicide rates, there are a few counties that exhibit the highest suicide rates. What are the protective factors that have produced these spatial anomalies? Are these spatial anomalies simply due to reporting bias or some other unmeasured characteristic that has produced the outliers? Examining these spatial anomalies in greater detail is certainly a fruitful area for further research.

POPULATIONS AT RISK

Gender Differences

In western nations such as Greece, Mexico, and the United States, male suicides outnumber female suicides 3- to 5-fold (WHO, 2001a). The gender gap is narrower in Asian nations, where the difference tends to be less than 2-fold. China is singular in this regard, with more female than male suicides, although this gap has narrowed in recent years (WHO, 2001a). Risk factors for suicide differ significantly by gender. Although



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