Study maps out why rural people are dying faster

Jeremy Fugleberg
Forum News Service

SIOUX FALLS, S.D. — It’s been true since the ‘80s: people in rural areas are dying faster than city dwellers. The question, though, is why.

Now, researchers in Texas say they have some answers. They’ve isolated the three biggest reasons why mortality rates are higher in rural areas: socioeconomic status, lack of health insurance and a shortage of physicians.

Scott Phillips of Texas Tech University Health Sciences Center co-authored the study, published late last year, which found that those three factors accounted for just over 80% of the difference between rural and urban mortality rates.

“That’s an impressive finding and a very large number for this kind of study,” Phillips said, in a presentation of the data in December at a health forum in Washington, D.C., as cited in a TTUHSC news release. “The caveat is that correlation is not necessarily causation, but it’s certainly a very strong hint that this is the direction where we need to marshal our resources and pay more attention.”

One big caveat: Living in rural areas doesn’t automatically mean you’re at a great risk of dying sooner. It means you’re more likely to grapple with the factors that get in the way of good health care. The study actually indicates without such hurdles, rural residents would have a lower mortality rates than those who live in urban areas.

“We didn’t expect that, but it seems to be getting a lot of attention from people so far,” Phillips said. “What it indicates is that rural dwellers would have lived longer than their urban counterparts had their socioeconomic conditions and access to health care been similar.”

The study, “Higher U.S. Rural Mortality Rates Linked To Socioeconomic Status, Physician Shortages, And Lack Of Health Insurance,” was published in the December issue of the journal Health Affairs.

The study stemmed from a U.S. rural health report card that Phillips, lead author Dr. Gordon Gong and others have put together since 2016. The report card graded states based on health outcomes and access, but didn’t look at disparities between states.

The study examined five factors within each county: socioeconomic deprivation (for example: poverty status, access to housing and education, employment), uninsured rates, the supply of and access to primary care physicians, the percentage of racial or ethnic groups and the number of rural and urban residents.

Only socioeconomic status, insurance and access to doctors were determined to be significant factors to the rural mortality rate. The percentage of racial and ethnic groups and the number of rural or urban residents were not significantly associated with mortality.

Only three states — Colorado, Wyoming and Montana — had higher urban mortality rates than rural mortality.