Americans who live in rural areas are more likely than their urban counterparts are to die of the 5 leading causes of death, according to a CDC study of data from the National Vital Statistics System.
In 2014, 25,000 rural residents died of heart disease, 19,000 of cancer, 12,000 of unintentional injuries, 11,000 of chronic lower respiratory disease, and 4,000 of stroke. The study also found that unintentional injury deaths were about 50% higher in rural areas than in urban areas, partly due to a greater risk of death in vehicle crashes and of opioid overdoses. The problem is compounded by the fact that the distance between health care facilities and trauma centers can make rapid access to specialized health care difficult.
The study researchers say several factors could influence the rural-urban gap. For instance, many of the deaths are associated with sociodemographic differences. Rural residents tend to be older, poorer, and sicker with limited physical activity due to chronic conditions. But that “striking gap” in health can be closed, says CDC Director Tom Frieden, MD, MPH, by better understanding and addressing the health threats that put rural Americans at risk.
CDC suggests, for instance, that health care providers in rural areas:
- Screen patients for high blood pressure and make control a quality improvement goal;
- Increase cancer prevention and early detection—for example, by participating in state-level comprehensive control coalitions, which focus on prevention, education, screening, access, support, and overall good health;
- Encourage physical activity and healthy eating to reduce obesity;
- Encourage patients to stop smoking;
- Promote vehicle safety (rural residents are less likely to use seatbelts); and
- Engage in safe prescribing of opioids for pain, and use nonpharmacologic therapies
The report and a companion commentary are part of a new rural health series in CDC’s Morbidity and Mortality Weekly Report . The Health Resources and Services Administration, which houses the Federal Office of Rural Health Policy, will collaborate with the CDC on the series and help promote the findings and recommendations to rural communities.