Lyme Disease Diagnoses Show 357% Increase in Rural Areas, According to Private Insurance Claims


Lyme disease has reportedly spread geographically and increased in rural and urban populations during the past 15 years.

Claims of Lyme disease diagnoses in rural areas rose by 357% between 2007 and 2021, according to a study by FAIR Health. Urban areas saw a 65% increase of private insurance claim lines for the disease.

“Lyme disease remains a growing public health concern,” said Robin Gelburd, JD, president of FAIR Health, in a press release.

Lyme disease is a bacterial illness caused by a tick. It is treatable with antibiotics, but some patients develop conditions post-treatment, which can be linked to chronic Lyme disease (post-treatment Lyme disease syndrome). Symptoms of chronic Lyme disease can include fatigue, cognitive issues, joint pain, and muscle pain.

To further understand trends in Lyme disease, FAIR Health analyzed the prevalence of Lyme disease health insurance claims over 15 years. To conduct this analysis, researchers consulted a database of more than 36 billion privately billed health care claims for the condition.

In addition to this information, investigators also identified late Lyme disease diagnoses. All age groups reported symptoms of malaise, fatigue, and soft-tissue-related issues, which were more common among Lyme patients than the control patients in the general population.

Between 2016 and 2021, rural areas had a 60% increase in their claim lines for Lyme disease diagnoses. Urban areas reported a 19% increase in Lyme disease diagnoses. During each year, data showed that June and July saw the largest uptick in diagnosed cases. In general, claim lines in rural areas exceeded those in urban areas during summer months, whereas urban areas filed more claim lines from November through April.

New Jersey, Connecticut, North Carolina, Rhode Island, and Vermont (percentage ranked highest to lowest) all hosted the highest proportions of Lyme disease claims in 2017. Historically, Lyme disease was associated with the Northeast and Midwest. The claim lines of 4 of the top-ranking states support this, but the percent of claim lines pushing North Carolina to third suggests that Lyme is spreading beyond its historical territory, according to the study.

In 2021, New Jersey again led the ranks for highest percentage of claim lines of Lyme disease. It was followed by Vermont, Maine, Rhode Island, and Connecticut. Maine took the position of North Carolina, which suggests cases in North Carolina have decreased but also moved much further north.

The analysis for this study builds on a previous infographic published by FAIR Health, who studied 10 years of Lyme disease data, as well as a white paper published in 2019. FAIR Health is a national, independent nonprofit organization with the goal of making health insurance costs and information transparent.


Lyme disease diagnoses increased 357 percent in rural areas over past 15 years, according to private insurance claims. FAIR Health; Aug 2, 2022. Accessed Aug 3, 2022.

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