A new Centers for Disease Control and Prevention (CDC) study demonstrates that Americans living in rural areas are more likely to die from five leading causes than their urban counterparts.
In 2014, many deaths among rural Americans were potentially preventable, including 25,000 from heart disease, 19,000 from cancer, 12,000 from unintentional injuries, 11,000 from chronic lower respiratory disease, and 4,000 from stroke. The percentages of deaths that were potentially preventable were higher in rural areas than in urban areas. The report and a companion commentary are part of a new rural health series in CDC’s Morbidity and Mortality Weekly Report.
“This new study shows there is a striking gap in health between rural and urban Americans,” said CDC Director Tom Frieden, MD, MPH. “To close this gap, we are working to better understand and address the health threats that put rural Americans at increased risk of early death.”
Some 46 million Americans—15% of the U.S. population—live in rural areas. Several demographic, environmental, economic, and social factors might put rural residents at higher risk of death from these conditions. Residents of rural areas in the United States tend to be older and sicker than their urban counterparts. They have higher rates of cigarette smoking, high blood pressure, and obesity. Rural residents report less leisure-time physical activity and lower seatbelt use than their urban counterparts. They also have higher rates of poverty, less access to health care, and are less likely to have health insurance. Increasing rural–urban disparities in life expectancy have emerged in the past few years.
The Health Resources and Services Administration (HRSA), which houses the Federal Office of Rural Health Policy, will collaborate with the CDC on the series and will help to promote the findings and recommendations to rural communities.
In the study, mortality data for U.S. residents was analyzed from the National Vital Statistics System.
Counties were placed in two categories—urban or rural—based on the National Center for Health Statistics urban–rural classification scheme for counties. The study found that unintentional injury deaths were approximately 50% higher in rural areas than in urban areas, partly due to greater risk of death from motor vehicle crashes and opioid overdoses. Also, because of the distance between health care facilities and trauma centers, rapid access to specialized care can be more challenging for people injured in rural areas.
To help address such gaps, health care providers in rural areas can:
Not all deaths can be prevented. Some rural areas might have characteristics that put residents at higher risk of death, such as long travel distances to specialty and emergency care or exposures to specific environmental hazards.