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Rankings Illustrate Health Challenges for Rural America

Analysis  |  By John Commins  
   March 23, 2016

The latest County Health Rankings report shows dramatic differences between rural and urban counties on several measures, problems that are exacerbated by a lack of access to healthcare.

Another study has quantified the health hazards faced by many rural Americans.

The 2016 County Health Rankings compares health disparities in more than 3,100 counties across 30 measures that include social determinants such as education, jobs, housing, exercise, and commuting times.

As in its previous six annual editions, the latest report shows dramatic differences between rural and urban counties on several measures, most notably premature death rates, for which the gap is widening. Rural counties have higher rates of premature death and one-in-five rural counties saw rises in premature death rates over the past decade while most urban counties improved on that measure.

Much of this could be attributed to rural America’s higher rates of smoking, obesity, child poverty, and teen births, and higher numbers of uninsured adults, says Bridget Catlin, co-director of County Health Rankings.

“Across the nation in general, everybody is getting healthier. But it doesn’t apply to every location and this is the wake-up call,” Catlin says. “A lot of people tend to think there are not a lot of people in rural areas, but that is not true either, because one-in-six Americans lives in a rural county.”

Catlin says problems around rural health are exacerbated by a lack of access to healthcare.

“It is difficult for rural residents to have access to medical care and it is difficult for the healthcare system to provide services,” she says. “You cannot build a hospital in every rural town. It is not sustainable or feasible. What you can start doing is moving towards telemedicine services. There are a lot of medical services where there is no physician contact between the provider and the patient, so those services can be provided remotely.”

Other Lagging Indicators

The data also show that many rural counties are lagging on other health behaviors.

“There are still higher numbers of smokers in rural communities, and the level of obesity is higher in rural communities,” Catlin says. “People have an image of rural living as active on the farm and moving all the time so you don’t need exercise. That is not the reality. A lot of people living in rural areas are not that physically active during the day, but they also can’t get out and walk down the street or exercise after work because rural areas don’t have sidewalks and there certainly isn’t a gym on every corner to use when the weather is bad.”

And there are social and economic barriers that make life stressful for rural Americans.  

“Those are things like good jobs that pay at least a living wage, and education that helps you get a good job, and public transit [which is]is few and far between in rural areas,” Catlin says.


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John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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