Living Alone: Rural-Urban Differences in Prevalence, Socio-Demographic Correlates, and Health Needs Across the Lifespan

Research center:
Project funded:
September 2019
Project completed:
June 2022

There has been a steady increase in the prevalence of living alone across the U.S. during the past century, with more people living alone today than ever before. Today, more than 32 million people live alone in the U.S., making up more than 27% of all households.

Living alone is a primary risk factor for social isolation and has been associated with poorer health. However, little is known about the prevalence and correlates of living alone for rural residents and how those differ from urban residents. More work is needed to understand the demographic and health characteristics of people living alone across the lifespan in order to offer a better lens into current and future needs of this rapidly-growing population.

For many people, living alone is an intentional choice and is associated with good health, but for others, it puts them at risk of greater isolation and of unmet need for necessary care and assistance. Middle-aged individuals (35-64 years old) living alone (the same group most impacted by "deaths of despair") are in worse health than their counterparts who are living with others; the same is not true of younger (<35 years old) or older (65+ years old) adults. Younger adults have relatively good health, regardless of living arrangement; older adults living alone tend to have better health than those living with others. Yet, among older adults, individuals living alone with limited economic resources face increased risks of worsening health and disability. Given the fact that rural areas tend to be poorer, rural residents living alone may have more difficultly than urban residents in affording the resources they need to navigate life on their own.

Finally, while urban areas are often well-situated to accommodate individuals living alone, with greater availability of small apartments and resources catering to single people, living alone may be significantly more difficult in rural areas, where there are fewer resources and housing units to appropriately and affordably accommodate such households. This may lead to poorer health outcomes for rural residents living alone, although more research is needed to demonstrate whether that is the case.

We used U.S. census data from 1980-2010 to identify trends in the prevalence of living alone by rural and urban location, and we merged in County Health Rankings data to identify county-level correlates of living alone. We also used restricted National Health Interview Survey data to identify individual-level correlates of living alone, including health status and socio-demographic characteristics. And we conducted an environmental scan of academic and gray literature, as well as printed and online resources, and key informant interviews to understand how individuals living alone are being supported or could be better supported in rural areas.