The quick availability of EMS, hospitals close by, or even bystanders to call 911 when something happens probably plays a large role in the higher mortality among rural folks.

I would assume they broke down the injuries by type. The kinds of injuries suffered in rural areas might be more severe than your typical urban injuries. Less heavy machinery or chemicals involved in the city, I would imagine.

DUI could be important. There are more options to get home after drinking in urban areas besides getting behind the wheel yourself and driving long distances.

The rural population is generally older than the general urban population in many locales. Older folks are more prone to various injuries and more likely to succumb to their injuries than younger people.

My two cents from a city boy.