Health and Wellness Concerns: Rural vs. Urban Populations

November 28, 2022

Many may not be aware that there are significant health disparities between rural and urban Americans. Simply put, rural Americans are at greater risk of poor health outcomes than their urban counterparts.

According to the CDC and as defined by U.S. Census Bureau, roughly 46 million, or 15%, of Americans live in rural areas. To outline the issue, the CDC has conducted a series of studies to draw attention to the gap in health between rural and urban Americans.

Significant statistics the CDC has drawn from these studies show that Rural Americans are more likely than urban Americans to die from the 5 leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke. In fact, unintentional injury deaths are 50% higher in rural areas than in urban areas, at least partly due to greater risks of death from motor vehicle accidents and opioid overdoses. Generally speaking, people who live in rural areas tend to be older and sicker than urban dwellers.

Children in rural areas with mental, behavioral, and developmental disorders face more community and family challenges than children afflicted by these disorders in urban areas.

Why are rural Americans at greater risk of poor health outcomes? The CDC cites characteristics of rural areas such as:

  • Long travel distances to specialty and emergency care
  • Exposures to specific environmental hazards
  • Higher rates of cigarette smoking
  • More leisure time than the physical activity prevalent in urban areas
  • Lower seatbelt use than urban counterparts

Chronic Conditions

The CDC reports that chronic diseases are the leading causes of death and disability in America. Rural Americans are more likely to die prematurely from major chronic conditions like cancer, heart disease, and chronic lower respiratory disease. The National Center for Chronic Disease Prevention and Health Promotion has been actively working to improve health in rural areas by:

  • Measuring how many Americans have chronic diseases or chronic disease risk factors and reporting data down to the county level.
  • Studying and reporting on rural health disparities and innovative programs to reduce those disparities.
  • Funding and guiding states, territories, and tribes to reach rural populations through proven interventions and innovative programs.
  • Developing programs and promoting care through digital formats, such as online classes or “telehealth” approaches that reduce barriers to health care access for rural residents.

According to Georgetown University Health Policy Institute, adults in rural areas are less likely to be tested for chronic conditions. Small proportions of adults in rural areas are screened for various types of cancer, including prostate, breast, colon, and skin cancer.


Studies show that adults living in rural counties are still more likely to be obese than adults in urban counties. Specifically:

  • Obesity prevalence was significantly higher among adults living in rural counties (34.2 percent) than among those living in metropolitan counties (28.7 percent).
  • The greatest differences in prevalence were in the South and Northeast regions.
  • The findings held true for adults in most sociodemographic categories, including age, sex, and household income.

Obesity is a risk factor for many chronic diseases including type 2 diabetes, coronary heart disease, some cancers, and arthritis. The main drivers of obesity in rural areas are:

  • Lack of healthy food choices
  • Lack of nutritional education
  • Lack of community planning, including bicycle paths, paved sidewalks, and outdoor public recreation facilities

High Rates of Limitation

In rural areas, 1/3 of adults report that is limited in performing a major activity such as paid work, housework, or school. This is compared to 1/4 of adults in urban areas who report such limitations.

Among adults, larger proportions of rural residents than urban residents report limitations related to social, recreational, or family activities.

As for physical limitations, 14% of rural residents (compared to 9%) or urban residents report a physical limitation such as:

  • Walking 10 steps, 3 blocks, or 1 mile
  • Lifting 10 pounds
  • Standing for 20 minutes
  • Bending or stooping
  • Reaching over their head
  • Using their fingers to grasp

Health Insurance

According to the U.S. Census Bureau, “residents of rural counties still lack insurance at higher rates than those living in urban areas. About 12.3 percent of people in completely rural counties lacked health insurance compared with 11.3 percent for mostly rural counties and 10.1 percent for mostly urban counties.”

Risky Behaviors

A study by Indiana University found that from 2010-2020, a larger proportion of rural Americans smoked cigarettes, and their odds of smoking were lower, compared to urban residents.

Smoking prevalence:

  • rural areas: 19.2%
  • urban areas: 14.2%

Quit ratios for smoking:

  • rural areas: 52.9%
  • urban areas: 53.9%

As for alcohol consumption, BMC Public Health found that lifetime prevalence for alcohol consumption differs significantly:

  • rural areas: 97.7%
  • urban areas: 86.6% (large cities); 89.1% (small cities)

Availability of Care and Health Information

The NCBI reported that compared to urban residents, rural residents have lower access to several common sources of healthcare – both primary care providers and specialist doctors.

Rural residents also have less use of search engines for health information, likely due to limited media exposure in those areas.

What Can Workers in Rural Areas do to Reduce Health Risks?

Individuals in rural areas can obtain better healthcare and reduce the risk of health issues by seeking out more preventative care. Further, workers who are exposed to dangerous conditions need to be aware of the importance of preventative care, check-ups, and utilization of their rights.

Workers who are injured on the job should understand the options available to them. Often this can involve consulting with attorneys who can help them secure the right types of specialized treatment they may need.

Examples of high rates of fatal injuries on the job include:

Maritime Workers

Maritime workers often face many dangers in the course of their job duties. Examples of maritime jobs include:

  • Commercial fishing
  • Transportation, including
    • Tugboats
    • Shipping barges
    • Long voyage vessels
  • Oil and gas, including
    • Oil rigs
    • Oil rig service vessels
    • Exploratory vessels

These types of jobs subject workers to severe weather, slippery conditions, and dangerous work.

Workers that are injured on-the-job while out at sea are protected by certain laws, such as general maritime laws and The Jones Act. Exercising your rights under these laws can be complex, so it is important to speak with top-rated Jones Act attorneys at Morrow & Sheppard LLP to determine what types of claims you may have.

Oilfield workers

Oilfield workers often work in rural areas and return home from work to rural areas. Access to high-quality medical treatment is often not available when these workers suffer injuries from dangerous work. Our oilfield accident attorneys know how to quickly evaluate serious injuries and help coordinate a plan for your potential claims.

Construction Workers

Construction accidents occur frequently from dangerous activity, and workers often seek treatment for injuries they sustain from falls, falling objects, heavy equipment, structural issues, crane accidents, and more. Our firm has experience dealing with injuries on construction sites, often from a lack of safety measures and protocols.

Commercial Drivers or Truckers and Other Drivers on the Road

Commercial Drivers spend more time driving than average citizens that use the roads. Auto accidents are extremely common and are exacerbated by overworked drivers, high speeds, and lack of attention.

If you are injured in an auto accident while on the road, either when working or simply driving, it is important to speak with experienced trucking accident attorneys to determine what course of action you should take.

About Morrow & Sheppard LLP

Our experience with many cases has led us to understand the importance of detection and treatment of specific injuries. Some injuries may not be apparent at first and may worsen over time. If you do not visit the right doctors and experts, these injuries can go undiagnosed and untreated. We are experienced in helping our clients find the right doctors and experts to make sure that such conditions are not missed. Our firm has experience representing wonderful clients from rural areas, and we pride ourselves on being able to help those individuals find the specialized treatment they need. If you or a loved one is injured while on the job, contact our lawyers at Morrow & Sheppard for a free consultation.

Get a Free Case Review by Calling Morrow & Sheppard Now.

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