Rural Americans are at higher risk of early death than urbanites: CDC

Rural Americans are more likely to die early from one of the five leading causes of death than those who live in urban areas, according to new federal data.

Researchers looked at the number of potentially preventable deaths from 2010 through 2022. The report was published Tuesday by the Centers for Disease Control and Prevention.

Rural Americans were more likely to die from heart disease, cancer, unintentional injuries, stroke and chronic lower respiratory disease before age 80 compared to urbanites, researchers said.

"There is a well-described, rural-urban divide in the United States, where rural residents tend to be sicker and poorer and to have worse health outcomes than do their non-rural peers," Dr. Macarena Garcia, a senior health scientist in the CDC's Office of Rural Health, said during a press conference on Monday.

About 20% of the U.S. population lives in rural areas while the remaining 80% live in urban areas, according to data from the U.S. Census Bureau.

Previous research has indicated that rural Americans face numerous health care challenges including long travel distances to special and emergency care and are less likely to have health insurance. Additionally, rural Americans have higher rates of high blood pressure and obesity.

For the report, researchers identified premature deaths as occurring before age 80. The average life expectancy in the U.S. was 79 in 2010. The number of preventable early deaths was calculated by subtracting the number of expected deaths by the number of actual deaths.

Although COVID-19 has been the third- or fourth-leading cause of death since 2020, the CDC said deaths from the virus were "excluded to maintain consistency and facilitate the assessment of trends over time."

Since 2010, an estimated 6.37 million Americans have died prematurely from the five leading causes over the 12-year study period. Researchers found that about 64% of deaths from unintentional injury -- which includes car accidents, falls, accidental shootings, unintentional poisonings, overdose deaths and drownings -- could have been prevented.

The report found 34% of stroke and heart disease deaths were preventable as were 26% of deaths from chronic lower respiratory disease.

Results showed the percentage of preventable deaths were highest in rural counties versus urban ones.

For example, 44% of heart disease deaths among people below age 80 in rural areas were potentially preventable compared with 27% in urban areas. More than half of early deaths from unintentional injury and chronic lower respiratory disease in rural areas were preventable.

For deaths from cancer, less than 20% of deaths were preventable in rural counties.

"We have to remember that screening prevention services as well as treatment services are much more accessible in urban areas," Garcia said. "So that means they are limited in rural areas. Sometimes people have to drive two, three hours to the nearest center that provides specialty care."

She went on, "So that means people go without preventive services. People in rural areas likely have lower rates of screening and certainly have less access to treatment."

When it came to geographic variation, Garcia said the CDC analysis showed consistently that the southeastern U.S. was the region with the highest prevalence of preventable early deaths.

In 2022, for example, the CDC found that when in came to unintentional injuries, between 70% and 100% of early deaths in several southeastern states including South Carolina, Louisiana, Mississippi, Kentucky and Tennessee could have been prevented. By comparison, between 30% and 66% of deaths could have been prevented in the majority of states.

The CDC said it is trying to improve rural health by funding and guiding public health programs in rural communities such as increasing cancer screenings for women and promoting physical education in schools.

"We believe these findings can help guide focused public health interventions at the local and community levels to effectively reduce the risks of premature death," Garcia said during the press briefing. "The findings also suggest a need to better understand potential shifts in social, environmental and structural inequities contributing to disparities in preventable early deaths between rural and urban areas."