Premature Death Rates Worsening in Rural Counties, Study Finds

Rural counties not only have high rates of premature death but in many cases also have seen those rates rise over the past decade, a study by the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute finds.

The 2016 edition of the County Health Rankings provides in-state rankings based on the length and quality of life, as well as factors that affect those outcomes, including insurance coverage, access to primary care physicians and mental health providers, educational attainment, housing, and pollution. The study found that while most large urban counties experienced consistent declines in premature death rates, one in five rural counties has seen them rise in recent years. According to the 2016 Rankings Key Findings Report, while there is no single factor that explains the disparity, rural counties tend to have higher rates of smoking, obesity, child poverty, and teen births, as well as higher numbers of uninsured adults, than urban counties.

The study also found that the level of housing segregation — a fundamental cause of health disparities — is highest in counties in the Northeast and Great Lakes regions and lowest along the Southeastern seaboard; that deaths from drug overdose death have increased 79 percent nationwide since 2002 and have reached epidemic proportions in parts of the U.S., with the highest rates in northern Appalachia and parts of the West and Southwest; and that one in three adults get fewer than seven hours of sleep a night — with consequences for their health and productivity, including higher levels of stress and depression, hypertension, higher rates of heart and kidney disease, and higher rates of suicide.

"The Rankings data are only as valuable as the action it inspires and the lives it improves," said Bridget Catlin, co-director of the County Health Rankings. "Whether it's addressing health gaps between counties or the concentration of poverty in rural and residentially segregated communities of color — targeting resources to the people and places in greatest need is essential to building a Culture of Health."