According to our recent study published in the Journal of Rural Health, rural Americans (especially men) are expected to live shorter and less healthy than urban people.

We found that a 60-year-old man lives in rural areas on average two years less than a city man. For women, the rural urban gap is six months.

A key reason is that rural populations have lower rates in smoking, obesity and chronic diseases such as hypertension and heart disease. These conditions condemn millions of disabilities and shorten lives.

More importantly, these people live in areas where medical treatment evaporates. Living in rural areas, relatively sparse populations usually means a shortage of doctors, a long distance to medical services, and insufficient investment in public health, partly due to a decline in economic opportunities.

Our team made these findings by using simulations called the “Future Older People” model. Therefore, we were able to simulate the future life lessons of Americans who are currently living in urban or rural areas.

The model is based on the relationship observed in 20 years of data from the Health and Retirement Study, a ongoing survey that tracks people at 51 years of age for the rest of their lives. Specifically, the model shows how long these Americans may live, the expected quality over the next few years, and how certain changes in lifestyle affect the outcome.

We describe the conditions that bring the results as “desperate disease,” which is built on the landmark work of groundbreaking researchers who coined the term “desperate death” that is now widely used. They recorded rising mortality rates among Americans without college degrees and linked these deaths to a decline in social and economic outlook.

The main causes of desperate death - overdoses, liver disease and suicide - are also known as "desperate disease". However, the conditions we study, such as heart disease, may be affected by social and economic prospects. They can profoundly reduce the quality of life.

We also found that if rural education levels are as high as urban areas, this would eliminate almost half of the gap in urban life. Our data show that 65% of urban 60-year-olds receive education outside high school, while 53% of rural residents of the same age are.

The possible reason for this difference is that getting a bachelor’s degree may make a person more capable or willing to follow scientific advice – more likely to exercise 150 minutes a week or follow the doctor’s advice to them eat vegetables.

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Why it matters

In recent decades, the gap between urban and rural health outcomes has widened. However, this problem goes beyond the difference between urban health and rural health: it also splits some of the partisan and social divides that separate American citizens, such as education and lifestyle.

Scholarships on the decline of rural areas in the United States show that people living outside larger cities are dissatisfied with the economic power that could erode their economic power. The interaction between these forces and the health conditions we studied was less recognized.

Economic conditions can promote healthy outcomes. For example, increased stress due to unemployment and a sedentary lifestyle can lead to chronic health problems such as cardiovascular disease. The decline in economic outlook due to automation and trade liberalization is associated with an increase in mortality.

But health can also have a strong impact on economic outcomes. Hospitalization leads to high medical expenses, job losses and incomes, and increased bankruptcy. The onset of chronic illness and disability may lead to a long-term decline in income. Even health events experienced in early childhood can have financial consequences decades later.

At the same time, these health and economic trends may strengthen each other and contribute to inequality between rural and urban areas, resulting in very different quality of life.

Don't know yet

It should be noted that our results, like many studies, describe the results on average. The rural population is not a giant. In fact, some of the most active and healthy people we know live in rural areas.

How much impact your location has on your health is an ongoing field of research. But as researchers begin to learn more, we can propose strategies to promote the health of all Americans, regardless of where they live.

A brief introduction to the research is a brief view of interesting academic work.