How Well are We Doing Meeting Healthy People 2020 Mortality Objectives at Midterm? Rural v. Urban Differences

Rural Americans have historically faced significant challenges in accessing healthcare and preventive healthcare services, including ambulatory care, dental care, emergency services, and pharmaceutical services. Rural Americans are more likely to die from conditions generally considered self-manageable or preventable such as diabetes, congestive heart failure, cardiovascular disease, ischemic heart disease, as well as certain types of cancer. Additionally, mortality associated with accidental injuries and intentional self-harm (e.g., suicide), is thought to be more prevalent for rural residents.

This national study examined rural versus urban differences and disparities in how the United States is meeting the Healthy People 2020 mortality objectives for the top 10 leading causes of death. The data for this study came from two sources, 1) national vital statistics mortality data available through the Centers for Disease Control and Prevention's Wonder website; and 2) national HCUP-NIS hospital data to examine reported deaths while hospitalized. We employed basic quantitative methods, including simple bivariate comparisons and multivariate comparisons, (logistic regression), to carry out our analyses.

Publications

• Healthy People 2020: Rural Areas Lag in Achieving Targets for Major Causes of Death
  Journal Article
  Southwest Rural Health Research Center
  Date: 12/2019
  For the period 2007-2017 rural death rates were higher than urban rates for the seven major causes of death analyzed, and disparities widened for five of the seven. In 2017 urban areas had met national targets for three of the seven causes, while rural areas had met none of the targets.