Disparities between African American and White rural residents were found across multiple sociodemographic domains. Individually, rural African American residents were more likely to have low educational attainment, to be impoverished, to be disabled, and to lack home Internet access than their white peers. In addition, rural African American individuals were more likely than their White peers to live in counties where these problems are widespread, suggesting lower availability of community resources that could supplement individual family resources. As a likely consequence, residents of high African American counties were more likely to report fair to poor health and to experience a variety of adverse health conditions including HIV. In context, it is not surprising that mortality rates for rural African American populations exceeded those not only of White rural residents but of urban African American residents as well.

Changing the outlook for rural African American populations requires actions beyond the realm of health policy alone. State and local policymakers and philanthropic organizations should consider the promotion of cross-sectoral efforts. Focusing on improving high school graduation rates and promoting local economic development are two examples of ways to improve eventual health outcomes.