CHICAGO - Children in the most rural areas of the United States are as likely to die by gunshot as those in the biggest cities, an analysis of nearly 24,000 deaths from 1999 through 2006 has determined.

While homicides involving firearms are more common among city youths, gun suicides and accidental fatal shootings among rural youths level the score.

"This debunks the myth that firearm death is a big-city problem," said lead author Michael Nance, a pediatric surgeon at Children's Hospital of Philadelphia. "This is everybody's problem."

The findings, published Monday, are in the journal Pediatrics.

The researchers analyzed data on about 15,000 homicides, 7,000 suicides, and 1,400 accidental shootings among ages 19 and younger. The researchers sorted the deaths by county and compared counties that had a population of one million or more with counties far from cities or with fewer than 2,500 people.

They found essentially the same rate: about four deaths per 100,000 children.

A previous analysis of adult deaths found similar patterns.

The new findings add important information to what is known about guns and children, said Elizabeth Powell of Northwestern University's Feinberg School of Medicine, who has done research on firearms in Chicago, but was not involved in this study.

"Prevention strategies need to be targeted to youth in rural areas as well as urban areas," Powell said.