Rural Health Disparities

What are health disparities?

National Institute of Health (NIH) defines health disparities as avoidable differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States.

An integral part of the UA Zuckerman College of Public Health’s mission is to work to promote health equality and respond to health disparities that are based on ethnicity, gender, socioeconomic status, lifestyle preferences, health status, nationality and geographical location. Numerous initiatives and programs that focus on the elimination of health disparities are encompassed within our community activities and partnerships.

What is special about rural health disparities?

Approximately 20 percent of the U.S.population lives in rural areas. Rural communities have higher rates of chronic illness and disability and poorer overall health status than urban communities. See "What is Rural? And why does it matter?" published by Cornell University's Community and Rural Development Institute (January 2007)

Age and Income
Rural residents tend to be older and poorer than urban residents. Eighteen percent of rural residents are over 65 compared to 15 percent of urban residents. Sixty-nine percent of rural residents live below the poverty level compared to 61 percent of urban residents. Rural communities have a disproportionately higher percentage
of Medicare beneficiaries.

Rural residents have more health issues
Rural elders are more often disabled and diagnosed with more severe occupation-related illnesses than those found among urban residents. Chronic conditions are more prevalent in rural areas. Injury-related deaths are 40 percent higher in rural communities than in urban communities. Heart disease, cancer and diabetes rates are higher in rural areas. People living in rural areas are less likely to use preventive screening services, exercise regularly or wear safety belts.

Some potential reasons for disparities in rural areas
Transportation—Many individuals lack access to treatment because appropriate transportation is too expensive, limited by weather factors, or because the patient is too sick to use the options that are available.

Lack of physicians — Residents of rural areas have less contact and fewer visits with physicians. Although 20 percent of Americans live in rural areas, only 9 percent of the nation’s physicians practice in rural areas. Only 10 percent of specialists practice in rural areas.

Lack of services — Most of the “frontier counties” have limited health care services and some have none at all. Many rural hospitals have negative operating margins and, from 1984 to 1997, over 500 rural hospitals closed.

Limited services — Rural residents are more likely to report that their provider does not have office hours at night or on weekends.

Insurance — One study found that almost 20 percent of rural residents were uninsured compared with 16 percent of urban residents. Rural residents under 65 are disproportionately

Income — Among urban residents, the percent of high-risk people ages 18 to 64 who had influenza vaccination in the past year is similar across income groups. Among rural residents, higher income people are significantly more likely to have had the vaccination.

Source: National Public Health Week | April 5-11, 2004 | Eliminating Health Disparities: Communities Moving from Statistics to Solutions


Reducing Disparities Through Data

A new tool from Hospitals in Pursuit of Excellence tells how to reduce health care disparities using data, including a 4-step approach on how to obtain the data, and a detailed discussion about how hospital systems can use the data to achieve clinical results: “Reducing Health Care Disparities: Collection and Use of Race, Ethnicity and Language Data.” Read more at