In America's silent farm crisis, health officials are working to better understand why rural men undertake suicide with greater frequency.

A fiercely private group, many farmers never seek help for mental health problems because of the stigma, said Michael Rosmann, executive director of Agriwellness, a rural health outreach program based in Iowa.

Suicide data also can be distorted when families fail to accurately report suicides, or by inability to separate accidents from intentional injuries, he said.

The following is a list of common factors among rural suicides:

3 Suicide rates for farm men are four times higher than for farm women, who usually make more, less-lethal attempts. Society better accepts women showing emotion and seeking help, Rosmann said.

3 Farm men tend to commit suicide on Sunday or Monday mornings, whereas suicide among the general population occurs more often on Friday or Saturday nights. Rosmann suggests that feelings of frustration are most acute to farmers during Sunday church activities, and Monday represents a dreaded return to work.

3 Farm men attempt suicide using more lethal means, such as guns and hanging. The average number of guns per household among U.S. farmers is 2.6, compared to .6 for the general population.

3 Stress contributes to suicide, and farming is a high pressure occupation with many uncontrollable stress factors, such as weather, high debt and isolated working conditions. Farming typically falls among the top 10 percent of high-stress jobs.

3 Farming also regularly ranks in the top three most hazardous occupations for job-related illness, injury and death. Medical problems can increase depression and lead to suicide.

3 Seasonal fluctuations in rural suicide rates follow high expectations of financial loss. Rates increase during planting and harvesting seasons, when long work days contribute to high stress.

3 Pesticide exposure increases the risk of suicide. Toxic levels of certain farming chemicals, such as carbamates and organophospates, trigger symptoms mimicking depression. Rosmann said exposure also helps explain seasonal variations in suicide among farm men.

3 Substance abuse also increases suicide rates in rural areas, where alcohol use is more prevalent. North Dakota ranked highest for adult binge drinking rates in a 2003 National Survey on Drug Use and Health released this year.

Health officials also attribute the lack of mental health care clinics in rural areas to high suicide rates among farmers and ranchers.