"First, it is important to try to dispel the myth that cities are dangerous and this information shows that when you consider injury-related death, overall cities aren't more dangerous. In fact we found them to be safer," she says.
"Second, we saw the predominance of injury-related death risk tended to be in areas of the country where we have the least access to emergency physicians and trauma care and maybe we should use this to do more of a population planning evaluation of how do we put the resources where the needs are as opposed to what is happening now, which is a little more organic."
For example, Myers' data showed that elderly falls represented a more significant injury death risk in urban areas than in rural areas. "So it may be more cost-effective and effective in general to tailor safety and injury prevention in urban areas around falls among the elderly, rather than what we are doing now, which is a bit of a global technique of 'here is something that is important in safety. Let's do something to prevent it across the country,'" she says. "There may be parts of the country where you don't need that same message with whatever it is you are trying to change."
As a practical tool, Myers says her study underscores the implications of proper staffing of emergency departments and trauma care systems in rural areas, which she says tend to be underserved as it is.
"It can only help in the quest to make sure rural hospitals have access to the resources that are needed to care for the population they're serving," she says. "There are lots of rural emergency departments that are staffed by people who may or may not have the full training they need to care for these patients who are severely injured or severely sick. This could help support them as they are trying to move forward."