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Report: COVID-19 Pandemic Caused More Death in Rural Communities

Analysis  |  By Melanie Blackman  
   March 12, 2021

A recent McKinsey & Company report found the 46 million people who reside in rural counties have faced major racial and ethnic health inequities during the pandemic.

During the pandemic, rural communities with diverse populations experienced 1.7 times more COVID-19 deaths per capita than other rural communities around the country, according to a recent McKinsey & Company report.

In rural counties where the population is comprised of at least 33% of racial or ethnic minority groups, deaths due to the pandemic were 1.5 times higher than in other communities.

Communities where the largest population group were American Indians or Alaska Natives saw 2.2 times more COVID deaths, communities where the largest population group were Black or African American saw 1.7 times more COVID deaths, and communities where the largest population group was Hispanic saw 1.5 times more COVID deaths.

The McKinsey report underscores the severity of the impact of COVID-19 on underprivileged and under-resourced communities across the nation.

Other key findings from the report found that the 46 million people who reside in rural counties have faced major racial and ethnic health inequities during the pandemic, where diverse communities saw more deaths per 100,000 individuals than other rural counties.

  • More than 60% of counties with at least 30% more racial and ethnic minority residents have had at least 150 COVID deaths per 100,000, in comparison to 32% for other rural counties.
  • Ninety percent of Mississippi’s rural counties that have a large Black or African American population have had more than 150 COVID deaths per 100,000, in comparison to 62% for all other rural Mississippi counties.
  • Nearly three-quarters of Texas’ rural counties that have a large Hispanic population have had more than 150 COVID deaths per 100,000, in comparison to 51% for all other rural Texas counties.

The report identified four factors that appear to contribute to the spread of the coronavirus in diverse rural communities:

  1. More likely to have a higher underlying health risk or are older
  2. Face greater socioeconomic vulnerabilities compared to urban communities
  3. Have lower access to care including healthcare professionals and resources
  4. Are less likely to adopt public health interventions including wearing facemasks or social distancing


To help protect rural communities, the report also identified short-term and long-term steps that public, private, and social sector stakeholders can take to help mitigate the racial and ethnic health inequities.

In the short-term, stakeholders can:

  • Expand workforce capacity and ensure essential supplies such as PPE are stocked and accessible
  • Ensure public health measures and accelerated vaccination is taking place across the state
  • Address social determinants of health and non-COVID related health and social needs

In the long-term, stakeholders can invest in measures to "transform access and care quality in the rural healthcare system," including:

  • Pursue value-based care models
  • Implement population health measures
  • Increase the healthcare workforce and increasing healthcare access
  • Invest in social determinants of health

Melanie Blackman is the strategy editor at HealthLeaders, an HCPro brand.


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