Every community, whether rural or urban, has residents who are the cultural backbone of their communities. Cultural leaders are probably more apparent in rural communities where geographical isolation occurs, but there is common agreement in nearly all communities about who "sets the tone" of their social environment.

Culture has many meanings. The Webster's Unabridged Dictionary definition is appropriate for this article: "the behaviors and beliefs characteristic of a particular social, ethnic or age group."

Sometimes the persons who are most representative of the culture of a community are not necessarily elected leaders, other persons in positions of authority or the most famous citizens of the community. The cultural icons of the community are usually those who are most esteemed.

Generally, these are the persons whose approval is most sought. They are popular and considered "cool."

People in the community, especially younger persons looking for role models, emulate their actions. They are the persons whom candidates for elected positions want to reach to influence voters' opinions.

"Keepers of the culture" is a useful term to describe the cultural leaders of communities. They tend to be most important in determining what is acceptable and not acceptable within the standards of their community.

For example, parents providing beer or wine to minors in their homes is considered to be encouraging delinquency of minors by some communities but acceptable in other communities where consumption of alcohol is part of daily dinner. What is considered beneficial or detrimental depends on one's point of view.

What is considered culturally acceptable behavior for most rural communities? Dr. David "Scotty" Hargrove, professor emeritus at the University of Mississippi and former chair of the Department of Psychology at the University of Nebraska-Lincoln, said the characteristics of personal and family living are substantially different in rural areas and are particularly apparent in our health behaviors.

Findings reported in recent editions of The Health United States, Urban and Rural Chartbook, which is an annual survey that compares rural and urban residents on health indicators in four regions of the U.S., confirm Hargrove's pronouncement. In comparison to urban residents, rural residents more frequently undertake risky behaviors, like using tobacco products, binge drinking, not having health insurance and not seeking healthcare services when needed.

Some of these health risks stem from rural people being poorer than urban people as a whole, as well as from having reduced access to healthcare. The prevailing attitude of many rural residents to "tough it out" and keep one's problems to oneself also significantly contributes to health risks.

This attitude is particularly apparent about behavioral health issues. Many rural residents, especially males, do not like to talk about their emotional vulnerabilities.

It is not commonly acceptable for rural men gathered in coffee shops, bars or other social groups to talk about personal insecurities. It is more acceptable for rural women to reveal their personal concerns to other women in social circles.

Past generations of rural women often gathered in monthly or more frequent club meetings, sewing circles or other social gatherings where they openly discussed personal concerns and obtained emotional support from their friends. The cultural leaders of these groups made it acceptable for women to talk about their emotional matters.

Talking freely about important personal matters, including emotional health, probably contributes to women having a lower rate of self-imposed death than men.

Overall, men in the U.S. take their own lives four times as frequently as women undertake suicide, according to a 2002 analysis by Drs. Gopal Singh and Mohammed Siahpush in the American Journal of Public Health that examined the suicide rate for every county in the U.S. from 1970 to 1997. The rates of self-imposed death have changed little since then.

Singh and Siahpush also found that males in rural areas are about 60% more likely to end their own lives than men who do not live in rural areas. The cultural norm among rural men about keeping a stiff upper lip even when unhappy probably contributes to this heightened risk for suicide.

Cultural norms change slowly. It is appropriate for rural males to reach out for help when needed, even from among male colleagues.

One way to change the cultural norms regarding help-seeking is integrating health topics into agriculture courses in rural high schools and in agricultural college curricula so that future "keepers of the culture" in rural communities establish beneficial practices that remove the negative stigma about seeking healthcare when needed, including behavioral healthcare.

Another way to change the prevailing cultural norm is for rural men who know they are keepers of the culture to model to their colleagues that it is okay to talk frankly about the topic of suicide and seeking help.

It is not "sissy" to reveal self-doubts and insecurities. It is a sign of good judgment and personal strength to seek help when needed.

Mike Rosmann is a Harlan, Iowa, psychologist and farmer. To contact Rosmann go online to: www.agbehavioralhealth.com.