Rural Americans are dying younger, living less healthy lives, alarming report reveals

LOS ANGELES — For many Americans, moving to the country is a lifelong dream to finally escape the stress of busy city life. Unfortunately, a new study warns that people opting for “the simple life” of rural America are actually living shorter lives.

Researchers at the University of Southern California have discovered a growing divide in health between rural and urban Americans as they age. Specifically, rural residents face shorter lifespans and more years lived in poor health. The research paints a concerning picture of the health challenges facing older adults in these communities.

“Rural populations face a higher prevalence of chronic diseases, which has serious implications for healthy aging,” says lead author Jack Chapel, a postdoctoral scholar at the USC Schaeffer Center for Health Policy & Economics, in a media release. “With an aging population and fewer physicians available, the burden on rural communities is set to grow, leading to significant challenges in providing care for those who will face more health issues in the future.”

The study, published in The Journal of Rural Health, found that for men nearing retirement age, the gap in health-adjusted life expectancy between urban and rural areas has more than doubled over the past two decades. While urban men can expect to live about 17.5 quality years after age 60, their rural counterparts face only 15.7 years of healthy life – a difference of nearly two full years.

For women, the disparity is smaller but still significant. Urban women at age 60 can anticipate 19.3 quality-adjusted years of life, compared to 18.7 years for rural women. These figures represent not just the total lifespan but also years lived in good health.

To understand these differences, researchers examined a range of factors, including chronic diseases, disability rates, and health behaviors like smoking. The team found that rural Americans tend to have higher rates of smoking, obesity, and chronic conditions at age 60, setting the stage for poorer health outcomes in later years.

“While education matters, so does smoking, prevalent obesity, cardiovascular conditions – and simply living in a rural area – which leads not only to more deaths but more illness among rural American men,” notes co-author Elizabeth Currid-Halkett, the James Irvine Chair in Urban and Regional Planning and a senior scholar at the USC Schaeffer Institute for Public Policy & Government Service.

The study also revealed stark differences based on education and geography. Rural residents in the South fared worst, while the urban-rural gap was negligible in the Midwest. Education played a crucial role, with college graduates enjoying significantly better health outcomes regardless of location. However, even when comparing similarly educated groups, rural residents still lagged behind their urban peers in health-adjusted life expectancy.

Perhaps most alarming is the trend over time. While urban men have seen their health-adjusted life expectancy increase by a full year since the late 1990s, rural men have made no gains at all. This widening gap suggests that rural areas are being left behind as overall population health improves.

The researchers explored potential solutions through simulated scenarios. They found that addressing smoking and obesity could yield substantial benefits, particularly for rural residents. Managing chronic conditions like heart disease and high blood pressure also showed promise in improving health outcomes. However, the study suggests that interventions focused solely on older adults may not be enough to close the urban-rural health gap.

“Closing the gap in healthy life expectancy between urban and rural areas for older adults would require encouraging health behavior changes earlier in life and making broader social and economic improvements in rural areas,” contends co-author Bryan Tysinger, director of health policy simulation at the Schaeffer Center.