As the rural-urban mortality gap continues to expand, researchers have been exploring the reasons why the gap exists and how some of the deaths might be prevented. The notion of what is a preventable or avoidable death is difficult to capture, and subject to multiple definitions and thus empirical approaches. In this study, the North Carolina Rural Health Research Program used variation in three risk factors – smoking, obesity, and excessive alcohol use – to identify their relative contribution to common causes of mortality. The goals of the study are to use our new approach to compare (1) the rates of potentially avoidable deaths between rural and urban communities in the U.S.; (2) how rates of potentially avoidable deaths vary by census region; and (3) the relative contribution of the selected modifiable risk factors to rates of potentially avoidable deaths (e.g., the effect of smoking relative to the effect of excessive alcohol use). As expected, we found that rural counties had a higher proportion of deaths attributable to health risk factors than urban counties, and there was significant variation across common conditions, and the South has the highest percent of deaths that are potentially avoidable.