Rural and Urban Progress Toward Healthy People 2030 Benchmarks for Major Causes of Death in the U.S.

Rural Americans consistently experience higher mortality than urban residents across leading causes, and progress in narrowing this gap has been uneven. Building on prior work showing widening rural–urban disparities through 2017, this project will quantify rural–urban progress toward Healthy People 2030 targets for the seven leading causes of death (i.e. ischemic heart disease, cancer, diabetes, stroke, chronic obstructive pulmonary disease, unintentional injury, and suicide) and assess whether trends align with stakeholders' heightened focus on mental health and addiction. Using National Vital Statistics System mortality data from 2015–2024 and U.S. Census denominators, we will estimate age-adjusted death rates per 100,000, evaluate annual trends and rural–urban rate ratios, and classify progress relative to Healthy People 2030 benchmarks as met/exceeded versus not met, and as improving, stable, or worsening. Findings will provide the Federal Office of Rural Health Policy, State Offices of Rural Health, legislative staff, and other stakeholders with a current, decade-spanning evidence base to refine targets, prioritize investments in mental health and injury prevention, and direct resources to rural populations and places where gaps remain largest.