This chartbook presents variations in U.S. population health in rural areas across all Census regions and states. Where the data allow, the chartbook also presents rural population health findings stratified by sex, race, and ethnicity. This chartbook presents a full range of data across multiple geographic areas. When looking at data like these it is important to consider the full data range or distribution, not just the average, because the data points may cluster in one direction or another and interpretation may become difficult. Similarly, focusing exclusively on averages may cause readers to overlook sub-problems. For example, a national average can conceal rural, regional, and/or state issues; and likewise, a state average may conceal a problem in many of its counties. This is particularly important when making rural-urban comparisons due to the wide range of geographic variation across the U.S.

The goal of this chartbook is to provide data that are useful for State Offices of Rural Health, county health departments, local hospitals, and other local health leaders. While there are numerous data sources and chartbooks available, these sources are not usually designed to highlight rural-urban disparities in population health, nor do they provide an in-depth look at the data. Additionally, little research has been conducted comparing the health of individuals residing in rural areas by race and ethnicity. However, research has consistently documented that populations of different races and ethnicities face different health risks, access to health care, and realize different health outcomes, suggesting that additional and more rigorous analyses of racial disparities are urgently needed.

A range of indicators are used in this report to describe population health in rural America and document health disparities between rural and urban areas. This report includes 33 measures of population health, organized into five domains: Access to Care, Health Outcomes and Risks, Mortality, Social Determinants of Health, and Socioeconomics.