Life Expectancy of Rural Americans Falling Further
Behind City Folks
70% of gap in life expectancy over last 40 years
attributed to higher rates of accidents, cardiovascular disease, COPD,
lung cancer in rural America
By Stephanie Stephens, HBNS Contributing Writer
Jan. 24, 2014 - Reducing health inequalities and
increasing life expectancy in the United States have both been primary
goals of the national health initiative, Healthy People 2020.
Unfortunately, according to a new study in the American Journal of
Preventive Medicine, over a 40-year period, rural residents have
experienced smaller gains in life expectancy than their urban
counterparts and the gap continues to grow.
“We’ve had information about life expectancy by
gender, racial or ethnic and socioeconomic groups, but to our knowledge,
nobody has looked at how disparities in life expectancy have changed
over time - whether they’re widening or narrowing,” said the study’s
lead author Gopal K. Singh, Ph.D, of the U.S. Health Resources and
Services Administration (HRSA).
“In fact, disparities have been increasing over the
past two decades as opposed to the last four.”
Understanding the magnitude and causes of these
disparities has implications for both public health planning and
decision-making, Singh said, as rural residents “remain at a higher risk
of mortality from major chronic conditions and injuries.”
The study notes consistent overall increases in
U.S. life expectancy during the past 40 years, from 70.8 years in 1970
to 78.7 years in 2010.
In contrast, the study reveals the rural-urban gap
widening from 0.4 years in 1969 to 1971 to 2.0 years in 2005 to 2009.
Accidents, cardiovascular disease, COPD and lung
cancer accounted for 70 percent of the overall rural–urban gap in life
expectancy and 54 percent of the life expectancy gap between the urban
rich and rural poor in 2005 to 2009.
A number of factors likely explain the disparity,
said SIngh. “When compared to urban areas, rural areas have higher rates
of both smoking and lung cancer, along with obesity, yet reduced access
to health care services. Additionally, rural residents have a lower
median family income, higher poverty rate and fewer have college
Seventeen percent of the U.S. population lives in
rural areas, compared with 83 percent in urban areas, Singh noted.
“There’s always a temptation to take public health
resources away from rural areas and focus on where people actively live,
which would reduce the national disease burden but cause even greater
rural–urban disparities in health and life expectancy,” he says.
“In public health, we tend to focus on overall life
expectancy and it does move forward a little bit each year,” said Steven
P. Wallace, Ph.D., associate director of the UCLA Center for Health
Policy Research and chair and professor in the Department of Community
Health Sciences at the university’s Fielding School of Public Health.
“We have spent a lot of time looking at health disparities over the last
20 years and yet rural and urban disparities haven’t been front and
People who live in rural areas have a lot of the
same challenges as inner city people, Wallace said. “These include
safety, getting enough physical activity and even getting good
nutrition—in spite of all the food growing around many of them—the more
rural the location, the more difficult it often is. Additionally, young
adults have migrated from rural farming areas, leaving people with the
lowest incomes and the least opportunity—both factors correlate strongly
with life expectancy.”