Rural Americans at High Risk of Death from the 5 Leading Causes

Rural Americans may be at an increased risk of death from heart disease, cancer, unintentional injuries, chronic lower respiratory disease, and stroke.

A new study shows that rural Americans are at a higher risk of dying from the 5 leading causes of mortality compared with those living in more urban areas.

Deaths among rural individuals in 2014 included 25,000 from heart disease, 19,000 from cancer, 12,000 from unintentional injuries, 11,000 from chronic lower respiratory disease, and 4000 from stroke, according to a study published by the Morbidity and Mortality Weekly Report.

"This new study shows there is a striking gap in health between rural and urban Americans," said CDC Director Tom Frieden, MD, MPH. "To close this gap, we are working to better understand and address the health threats that put rural Americans at increased risk of early death."

Approximately 15% of Americans live in rural areas, and many demographic, environmental, economic, and social factors could lead to a higher mortality risk for these individuals.

Rural Americans tend to be older, sicker, have high blood pressure, have obesity, and have higher rates of cigarette smoking compared with individuals living in urban areas. Rural residents self-report less physical activity and seatbelt use, and these individuals also have higher rates of poverty, less access to healthcare services, and are less likely to have health insurance, according to the study.

The Health Resources and Services Administration (HRSA) will work with the CDC to promote health recommendations to rural Americans, the study authors said.

"We have seen increasing rural-urban disparities in life expectancy and mortality emerge in the past few years. CDC's focus on these critical rural health issues comes at an important time," said HRSA Acting Administrator Jim Macrae.

In the study, the investigators analyzed mortality data from the National Vital Statistics System, and found that unintentional injury deaths were 50% higher in rural areas compared with urban areas. This was likely due to an increased risk of death resulting from a motor vehicle accident or an opioid overdose, according to the study.

Accessing care also presents a problem in rural areas since the distance between healthcare providers and hospitals may be challenging to receive timely care, and may play a role in high mortality rates.

The study authors outlined several ways healthcare providers can address gaps in healthcare. Healthcare providers should screen patients for high blood pressure, and make it a goal to improve blood pressure control, since it is a leading cause of heart disease and stroke, according to the study.

Providers in rural areas should focus on prevention and early detection of cancer. Healthcare providers should participate in comprehensive cancer control programs that emphasize prevention, education, screening, and overall health.

Adopting a healthy lifestyle, such as good eating habits and physical activity, should be encouraged to reduce the risk of obesity and related conditions, such as diabetes, heart disease, cancer, and arthritis, according to the study.

Rural healthcare providers should remind patients of the dangers of smoking, and that it is the leading cause of preventable death in the United States. Patients should also be encouraged to practice safe driving habits, including wearing a seatbelt.

Healthcare providers should engage in safe prescribing habits, and always follow CDC guidelines when prescribing opioids for pain. Providers should educate patients about alternative therapies, such as yoga to alleviate pain.

While not all causes of death are preventable, patients should be aware of the steps they can take to reduce their risk of mortality for the leading causes of death, the study concluded.