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Release: June 21, 2001

Risk factors for injury identified in UI's Keokuk County Rural Health Study

IOWA CITY, Iowa -- Studies have shown that injuries are more common in rural areas than in urban communities. However, the risk factors for these injuries are not evenly distributed among rural populations, according to University of Iowa College of Public Health researchers conducting the Keokuk County Rural Heath Study.

Identifying people in rural areas with higher risks for certain injuries could ultimately help prevent such injuries from occurring. These findings come from a study published in the April issue of the American Journal of Preventive Medicine.

"Little attention has been paid to the distribution of injury risk factors in rural communities or to identifying the rural subgroups at high risk for injury," said Craig Zwerling, M.D., UI professor of occupational and environmental health and internal medicine.

UI researchers studied 1,583 participants enrolled in the Keokuk County Rural Health Study, a population-based, longitudinal study of a rural Iowa county. The study population consisted of approximately one third of families living in Keokuk County. The 10-year study is in its sixth year.

The researchers studied three groups of Keokuk County residents: farmers, rural nonfarmers and townspeople. Participants were asked in face-to-face interviews about a number of risk factors: seatbelt use, motorcycle and moped use, all-terrain vehicle use, bicycle use, firearms in the home, fired guns in previous year, alcohol abuse, and binge drinking.

Each of the three population groups were divided into subgroups based on gender and age. After statistical analysis, the researchers found that for some risk factors, such as binge drinking, there were no notable differences among the groups. However, other risky behaviors were more common among certain groups. Elderly farm men were much less likely to wear seatbelts than farm women, younger farm men or other members of the rural community. Also, farmers were twice as likely as rural nonfarmers and three times more likely than townspeople to have used an all-terrain vehicle in the previous year.

Farmers and rural nonfarmers were more likely than townspeople to have firearms in their homes and to have fired them within the previous year. This is problematic, the study authors suggest, because other studies have shown that farmers have higher rates of depression than people in other occupations. Several studies have found associations between suicide and the presence of firearms in the home, and some studies have suggested increased suicide rates among farmers.

Male farmers ages 25 to 64 were less than half as likely as other men the same age to report a history of alcohol abuse. Binge drinking was equally frequent among farmers, rural nonfarmers and townspeople.

Zwerling said that the study findings can help researchers better understand not only the types of injuries that occur, but who among the different populations are more likely to experience such injuries.

"The point of this study is to identify where the high-risk segments are in each community and use the knowledge gained from the study to think creatively about how to intervene to change the behaviors and lower the risks of injury and/or death," said Zwerling.

For more information about the Keokuk County Rural Health Study, call Zwerling at (319) 335-4428.