Do Rural Communities Have a Higher Rate of Avoidable Deaths?
The rural-urban gap in mortality has been growing steadily over the last three decades, and a growing body of work has looked into the reasons for this growing disparity, specifically the causes of deaths. Another approach is to build on the seminal work that mapped lifestyle and behavior factors into death rates from specific causes; that is, to make predictions of future death rates due to current behavior. We hypothesize that the generally poorer health behaviors in rural areas lead to higher rates of avoidable death rural communities than in urban communities.
A deeper understanding of the relationship between behaviors and mortality may influence policy priorities. It may be the case that the most efficient strategies for targeting the overall rural-urban mortality rate are based in factors more "upstream" than previously thought. For example, while deaths from trauma (especially for those who had poor access to timely high-quality trauma care) may grab headlines, the less visible deaths from lung cancer (as a result of higher smoking rates) and heart disease (as a result of obesity) may disproportionately be more responsible for the rural-urban disparity.
The goals of the study are (1) to determine whether the rate of avoidable deaths is equal in rural and urban communities in the United States; (2) examine whether and how this pattern varies by region (e.g., in the South) and rural definition (e.g., micropolitan vs noncore); and (3) characterize the relative contribution of the key behaviors (e.g., the effect of smoothing relative to the effect of excessive alcohol use).