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Rural Health Information Hub

Need for Addressing Chronic Disease in Rural Areas

Chronic diseases including heart disease, diabetes, chronic lung disease, and cancer are some of the leading causes of death and disability in America.  Rural areas face higher rates of many of the most prevalent chronic diseases, with some rural residents experiencing multiple chronic conditions, and higher rates of related mortality. A 2017 Morbidity and Mortality Weekly Report (MMWR) article reports that rural residents have higher age-adjusted death rates for heart disease, stroke (often caused by cardiovascular disease, obesity, and diabetes), cancer, and respiratory disease, compared to their urban counterparts.

Rural communities also have higher rates of diabetes-related hospital deaths and only 62% of rural communities have access to diabetes self-management education and support. Additionally, a 2015 study found that, in addition to poverty, rural residence was an independent risk factor for COPD. The Chronic Disease in Rural America topic guide provides more statistics on the prevalence and age-adjusted mortality rates for these chronic diseases in rural areas.

Chronic diseases are an increased concern for many rural communities compared to urban communities because of risk factors that are prevalent in rural communities and decreased access to a variety of services. Risk factors for chronic disease in rural areas include:

  • An aging population
  • Health-related behaviors that increase risk factors for chronic disease
  • Environmental and occupational factors
  • Health access challenges
  • Less availability of healthy foods
  • Lower disease screening rates
  • Lower income and education levels

For some chronic diseases, rural environmental and occupational exposures can put residents at increased risk. For example, occupational hazards are estimated to account for nearly 14% of COPD cases. Coal mine dust and crystalline silica exposures are known risk factors for COPD, which are common byproducts of rural industries like coal mining and construction. Other exposures that are common in rural settings are also associated with respiratory illnesses, such as mold spores, nitrogen dioxide, and organic toxic dust.

Resources to Learn More

Continuing Challenges in Rural Health in the United States
Examines the challenges of rural health including the health disparities and prevalence of chronic diseases in rural areas. Covers the changes in technology and policy affecting rural healthcare, and the importance of research in addressing rural health concerns.
Author(s): Coughlin, S., Clary C., Johnson J., et al.
Citation: Journal of Environment and Health Sciences, 5(2), 90-92
Date: 12/2016

Overlooked Americans: The Toll of Chronic Disease in Rural America
Describes the disparity of chronic diseases among rural residents and determining factors including: health workforce shortages, greater distances to healthcare, social determinants increasing onset of chronic disease, and structural urban bias.
Organization(s): RTI International
Date: 1/2023