At a glance
People who live in rural areas of the United States are more likely than urban residents to die prematurely from chronic diseases. CDC works to improve rural health through funding, research, surveillance, and telehealth.
Overview
One in five people in the U.S. live in rural areas. These rural residents are more likely than urban residents to die prematurely from five of the leading causes of death: heart disease, cancer, stroke, unintentional injuries, and chronic lower respiratory disease. Several factors contribute to these health disparities:
- Health behaviors: Rural residents often have poor nutrition and low levels of physical activity compared to their urban counterparts, which can lead to conditions such as obesity and high blood pressure. Rural residents also have higher rates of smoking, which increases the risk of many chronic diseases.
- Health care access: Rural counties have fewer health care workers, specialists (such as cancer doctors), critical care units, emergency facilities, and transportation options. Residents are also more likely to be uninsured and to live farther from health services.
- Healthy food access: National and local studies suggest that residents of low-income, minority, and rural neighborhoods often have less access to supermarkets and healthy foods.
- Demographic characteristics: Rural residents tend to be older, with lower incomes and less education than their urban counterparts. These factors are linked to poorer health.
The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) works to improve the health of rural communities through funding, research, surveillance, and telehealth.
Funding
NCCDPHP funds and guides states, universities, territories, and tribes to reach rural populations with proven interventions and innovative projects.
For example, CDC's High Obesity Program (HOP) funds universities to work with community extension services to increase access to healthier foods and safe places for physical activity. These efforts focus on counties with an adult obesity rate of 40% or more, and mostly rural communities across 15 states in the South and Midwest. During 2018–2023, HOP reached:
- Over 338,000 people with more places to be physically active.
- Over 340,000 people with better access to healthier foods.
- Over 116,000 people with healthy nutrition standards where food is sold, served, or distributed.
Learn more about NCCDPHP's funded programs on health equity.
Research
Studying and reporting on rural health disparities can lead to new approaches to address those disparities. CDC publications on rural and urban health differences have covered topics such as arthritis symptoms, chronic pain, and oral health.
Learn about chronic disease research on advancing health equity and eliminating disparities, which covers issues that affect rural area.
Surveillance
NCCDPHP's surveillance systems measure how many Americans have chronic diseases or chronic disease risk factors. Some of these systems report data down to the county level, which helps rural communities understand and respond to their health needs. For example:
- The Interactive Atlas of Heart Disease and Stroke allows users to create customized, county-level maps that show the rates of heart disease and stroke, risk factors, health care availability and costs, and demographic, social, and environmental factors, including rural residence.
- The U.S. Diabetes Surveillance System provides county-level estimates of diabetes, obesity, and physical inactivity in the context of important social factors.
See the full list of CDC's chronic disease surveillance systems.
Telehealth
Telehealth—the delivery of health care through technology such as mobile phones or computers—can help reduce barriers to care for people who live far away from health care services and specialists, who have time or access restrictions, or who have transportation or mobility issues.
Telehealth can be an effective approach for communication and counseling. It's also a good way for doctors to monitor their patients' chronic conditions, like heart or lung disease. Better monitoring can improve patients' quality of life and reduce hospital admissions and deaths from chronic diseases.
CDC is supporting telehealth projects across the country to give rural residents better access to chronic disease prevention and management programs, as well as to specialist care.
For example, the Vision Health Initiative's Glaucoma Detection Program funds three academic institutions to help reach populations with high rates of vision loss. The University of Alabama at Birmingham, Columbia University, and the University of Michigan developed the Screening and Intervention for Glaucoma and eye Health through Telemedicine (SIGHT) studies. These studies work to improve glaucoma screening and management among populations at high risk for glaucoma. The SIGHT studies address barriers such as lack of health insurance, poverty, inadequate transportation, and trouble finding eye care specialists.
Read more about telehealth interventions to improve chronic disease.