Death by Gun Violence—Guns Are Not the Problem—Reply

In Reply We thank Dr Boyd for reading and thinking about our editorial on gun violence. Dr Boyd's argument rests on his belief that rural areas are safer because of more guns. Unfortunately, the data say otherwise. In an analysis of injury deaths in all 3141 US counties, there was no significant difference in the rate of firearm deaths in the most rural counties compared with the most urban counties. Dr Boyd also fails to recognize that over 60% of firearm deaths in the United States are suicides, and that there is a strong linear relationship between the number of guns in a state and the overall suicide rate. Suicide rates are higher in rural than urban areas and for youth, the rural-urban difference is increasing.