Public Health Research in Rural Communities

How CDC Studies and Reports on Rural Health Disparities

People who live in rural areas of the United States are more likely than urban residents to die prematurely from all of the five leading causes of death: heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke.

CDC’s National Center for Chronic Disease Prevention and Health Promotion uses several approaches to help improve the health of rural residents. One approach is studying and reporting on rural health disparities and innovative programs to reduce those disparities.

CDC’s Morbidity and Mortality Weekly Report has published a series of 13 articles on rural health disparities. Topics included leading causes of death, health behaviors, diabetes education programs, and cancer deaths. In conjunction with this research effort, CDC developed a rural health website to share study results and offer resources.

CDC also hosted rural stakeholders from around the country for a workshop titled “What Works for Rural: From Research to Reality” in December 2017. Ninety-four people from 40 organizations met to identify what tools, resources, and evidence can help states reduce the leading causes of death in rural communities, build relationships with others working in the field, and share resources that work in rural areas.

Other recent CDC publications on rural and urban health differences have included a variety of topics, such as arthritis symptoms, chronic pain, and oral health:

Compared to urban areas, rural areas have:
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higher rates of unhealthy behaviors
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less access to health care
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less access to healthy foods

Potentially excess deaths from the five leading causes of death in metropolitan and nonmetropolitan counties — United States, 2010–2017. MMWR Surveillance Summaries

Rural-urban and racial/ethnic disparities in invasive cervical cancer incidence in the United States, 2010–2014. Preventing Chronic Disease

Rural cancer control: bridging the chasm in geographic health inequityexternal icon. Cancer Epidemiology, Biomarkers & Prevention

Chronic Obstructive Pulmonary Disease

Urban-rural county and state differences in chronic obstructive pulmonary disease — United States, 2015. MMWR

Chronic Pain

Prevalence of chronic pain and high-impact pain among adults — United States, 2016 pdf icon[PDF – 159KB]. MMWR


Disparities in recommended preventive care usage among persons living with diabetes in the Appalachian regionexternal icon. BMJ Open Diabetes Research and Care

U.S. Associated Pacific Islands health care teams chart a course for improved health systems: implementation and evaluation of a non-communicable disease collaborative modelexternal icon. Journal of Health Care for the Poor and Underserved

Issues that impact type 2 diabetes self-management in rural communitiesexternal icon. Journal of the American Association of Nurse Practitioners

Rural–urban disparities in the prevalence of diabetes and coronary heart diseaseexternal icon. Journal of the American Association of Nurse Practitioners

Heart Disease and Stroke

Widespread recent increases in county-level heart disease mortality across age groupsexternal icon. Annals of Epidemiology

What is the evidence for existing state laws to enhance pre-hospital stroke care? pdf icon[PDF – 2.38MB] Division for Heart Disease and Stroke report

Improving stroke outcomes in rural areas through telestroke programs: an examination of barriers, facilitators, and state policiesexternal icon. Telemedicine Journal and E Health

Nutrition, Physical Activity, and Obesity

CDC programs to reduce obesity in high obesity areas (HOP) special collection (rural focus). Preventing Chronic Disease

Trends in meeting physical activity guidelines among urban and rural dwelling adults, National Health Interview Survey, 2008-2017external icon. MMWR

National-level environmental perceptions and walking among urban and rural residents: informing surveillance of walkabilityexternal icon. Preventive Medicine

Sugar-sweetened beverage intake among adults, by residence in metropolitan and nonmetropolitan counties in 12 states and the District of Columbia, 2017. Preventing Chronic Disease

Use of mass communication by public health programs in nonmetropolitan regions. Preventing Chronic Disease

Geographic and urban–rural differences in walking for leisure and transportationexternal icon. American Journal of Preventive Medicine

Racial and ethnic differences in perceived safety barriers to walking, United States National Health Interview Survey — 2015external icon. Preventive Medicine

Nutrition-related policy and environmental strategies to prevent obesity in rural communities: a systematic review of the literature, 2002-2013external icon. Preventing Chronic Disease

Obesity Prevalence Among Adults Living in Metropolitan and Nonmetropolitan Counties — United States, 2016. MMWR

Oral Health

Disparities in Preventive Dental Care Among Children in Georgia. Preventing Chronic Disease

Page last reviewed: July 15, 2020