I'm not sure which of these two points you're trying to make: 1) These specific counties could be flukes because of their small population. We can account for

I'm not sure which of these two points you're trying to make: 1) These specific counties could be flukes because of their small population. We can account for that by making multiple observations--i.e. look at multiple years of data--and seeing if the counties change rank. The visualization has yearly data for 1980-2014, and the specified counties are consistently high compared to the national average https://vizhub.healthdata.org/subnational/usa https://vizhub.healthdata.org/subnational/usa 2) The 'rural' component of these counties isn't necessarily a factor, since the counties with lowest rates may be rural as well. A bit of searching turns up a clear correlation between population density and suicide: https://www.researchgate.net/figure/How-population-density-affects-suicide-rates-in-the-United-States-1989-1998-The-death_fig6_240918084 https://www.researchgate.net/figure/How-population-density-a...