Firearm Mortality and Mental Health Outcomes in U.S. Cities: A Comparison of Different City Classification Schemes
Location
Center for Advanced Learning and Simulation (CALS)
Publication Date
April 2025
Start Date
17-4-2025 8:00 AM
Description
Introduction: As urban development continues to increase globally, more focus has been directed toward understanding how one’s residence can impact mental health outcomes. Research on outcomes using rural/urban classifications have led to mixed results. On reason for these inconsistencies may be the lack of specificity of different types of cities, specifically ones that fall between true “urban” and “rural”. The purpose of this study was to examine firearm mortality and mental health outcomes using different city classification schemes. Method: Firearm homicides, firearm suicides, opioid overdose, binge drinking rates, and level of mental distress in U.S. cities (N=1040) were retrieved from NYU Langone Health’s City Health Dashboard Cities. Data was examined using two classification systems: The National Center for Health Statistics Rural-Urban Classification Scheme (NCHS) and the NYU Midsize City Types. Results: A Kruskal-Wallis with post-hoc tests was used to examine the classification schemes for the outcome variables. Significant differences were noted for all outcome variables based on NCHS designation (p<.001) with the exception of Binge Drinking. Micropolitan cities (populations between 10,00049,999) were noted to have higher rates of Firearm Suicide than all population groups, and higher Firearm Homicides and Opioid Overdoses for all population groups with the exception of Large cities. NYU’s Midsized City designations noted significant differences between city types in all outcome variables (p<.001). Small Industrial cities had the total highest rates across all outcome variables, particularly in Firearm Homicide and Opioid Rates. Working Towns were highest in Firearm Suicide Rates, while Emerging Cities evidenced highest levels of binge drinking. College Towns endorsed the highest rates of Frequent Mental Distress. Discussion: Results of this study highlight reasons for inconsistencies in outcomes based on rural/urban dichotomies. Understanding mental health outcomes and firearm morbidity is best studied by examining characteristics of cities as opposed to strictly examining population size.
Recommended Citation
Maher, Megan MD; Barker, Chikira H. MA; and Bailey, Rahn K. MD, "Firearm Mortality and Mental Health Outcomes in U.S. Cities: A Comparison of Different City Classification Schemes" (2025). Dept. of Psychiatry Research Symposium. 14.
https://digitalscholar.lsuhsc.edu/psych_rd/2025/presentations/14
Firearm Mortality and Mental Health Outcomes in U.S. Cities: A Comparison of Different City Classification Schemes
Center for Advanced Learning and Simulation (CALS)
Introduction: As urban development continues to increase globally, more focus has been directed toward understanding how one’s residence can impact mental health outcomes. Research on outcomes using rural/urban classifications have led to mixed results. On reason for these inconsistencies may be the lack of specificity of different types of cities, specifically ones that fall between true “urban” and “rural”. The purpose of this study was to examine firearm mortality and mental health outcomes using different city classification schemes. Method: Firearm homicides, firearm suicides, opioid overdose, binge drinking rates, and level of mental distress in U.S. cities (N=1040) were retrieved from NYU Langone Health’s City Health Dashboard Cities. Data was examined using two classification systems: The National Center for Health Statistics Rural-Urban Classification Scheme (NCHS) and the NYU Midsize City Types. Results: A Kruskal-Wallis with post-hoc tests was used to examine the classification schemes for the outcome variables. Significant differences were noted for all outcome variables based on NCHS designation (p<.001) with the exception of Binge Drinking. Micropolitan cities (populations between 10,00049,999) were noted to have higher rates of Firearm Suicide than all population groups, and higher Firearm Homicides and Opioid Overdoses for all population groups with the exception of Large cities. NYU’s Midsized City designations noted significant differences between city types in all outcome variables (p<.001). Small Industrial cities had the total highest rates across all outcome variables, particularly in Firearm Homicide and Opioid Rates. Working Towns were highest in Firearm Suicide Rates, while Emerging Cities evidenced highest levels of binge drinking. College Towns endorsed the highest rates of Frequent Mental Distress. Discussion: Results of this study highlight reasons for inconsistencies in outcomes based on rural/urban dichotomies. Understanding mental health outcomes and firearm morbidity is best studied by examining characteristics of cities as opposed to strictly examining population size.