Understanding Rural-Urban Mortality Differences

Research center:
Lead researcher:
Project funded:
September 2015
Project completed:
May 2020

Growing evidence indicates that rural residents face a significant disparity in achieving longevity compared to their urban counterparts. While this rural-urban mortality gap has been well-documented, the reasons behind it are unclear. This study will address these gaps in our understanding of rural mortality disparities using the 1985-2009 National Health Interview Survey (NHIS), linked to national death certificate data, to explore the individual-level characteristics and health behaviors of rural and urban adults and their association with mortality. These analyses will provide greater understanding of the potential socioeconomic, health behavior and health resource reasons behind rural disparities in mortality. This information is a critical step for identifying potential policy and practice interventions that may ameliorate the rural-urban mortality gap and lead to longer, healthier lives for rural populations.


  • Rural-Urban Residence and Mortality Among Three Cohorts of U.S. Adults
    Policy Brief
    Maine Rural Health Research Center
    Date: 05/2020
    Rural residents have a shorter life expectancy than urban residents. We analyzed national linked survey and death certificate data and found risk of death was 10% higher for rural than urban residents and has increased over time. Findings suggest the overall mortality penalty in rural areas may be partly driven by social determinants of health.