Top Things to Know: Call to Action: Rural Health
Published: February 10, 2020
- Rural populations have a three years lower life expectancy, a 20% higher overall death rate, and higher cardiovascular disease and stroke death rates than urban populations. Rural women’s maternal mortality rates are twice those of urban women, largely driven by cardiovascular deaths.
- The Presidential Advisory serves as a call to action for AHA and other stakeholders to make rural populations a priority in programming, research, and policy.
- The advisory first summarizes existing data on rural populations, communities, and health outcomes. It then explores three major groups of factors underlying urban-rural disparities in health outcomes, including individual factors, SDOH, and health delivery system factors. Finally, it proposes a set of solutions spanning health system innovation, policy, and research aimed at improving rural health.
- As of 2017, 19% of the rural population was over age 65. Rural areas also have lower population growth. Since 2000, the rural population growth rate of 3% trails well behind that of urban (13%) and suburban (16%) areas), with half of rural counties seeing a population drop in that same time frame.
- There are slightly higher rates of poverty in rural areas: as of 2016, poverty rates in rural counties averaged 18% compared with 17% in urban areas and 14% in suburban ones.
- Overall, rural areas are more racially and ethnically homogeneous than urban ones, but there is great racial and ethnic diversity in rural America by geography with a high proportion of non-Hispanic black individuals in the rural South, Hispanic individuals in the Southwest, and American Indian/Alaska Natives also in Oklahoma, the Great Plains, the Southwest and in Alaska.
- Rural populations have higher rates of tobacco use, physical inactivity and obesity, as well as higher rates of diabetes and hypertension. People in rural areas also are more likely to experience mental and behavioral health challenges than those in urban areas.
- Social determinants of health, including income level, education level, access to transportation, housing, and food insecurity, contribute to poorer health outcomes in rural areas.
- Innovative policy approaches are needed to address and improve rural health and research is needed to identify which work best.
- The AHA is committed to working with strategic partners to develop solutions to improve rural health in America. In partnership with others, the AHA will utilize the capacity we have built in research, education, quality improvement, programs and policy capacities to advance these aims in support of health equity.
Citation
Harrington RA, Califf RM, Balamurugan A, Brown N, Benjamin RM, Braund WE, Hipp J, Konig M, Sanchez E, Maddox KEJ. Call to action: rural health: a presidential advisory from the American Heart Association and American Stroke Association [published online ahead of print February 10, 2020]. Circulation. doi: 10.1161/CIR.0000000000000753.