Americans are Healthier,
Except for Rural Dwellers

Americans are healthier than 25 years ago — as long as they don't live in the country or inner cities. A new study shows the split.

Americans are healthier than 25 years ago, but suburbanites are much better off than people in small towns and some urban dwellers, a new study finds.

A governmental report released today by the Health and Human Services department says Americans who live in the suburbs and better-off areas of cities have a longer life expectancy compared to 25 years ago, have better infant survival rates, smoke less, have less hypertension and lower cholesterol levels.

But rural areas and the poorer, more concentrated areas of cities, have relatively higher adult mortality and infant mortality rates and are less likely to have health insurance.

The 25th annual report on the nation's health is the first to look at levels of urbanization and how it relates to health.

Access to routine and emergency health care, racial and ethnic makeup, air quality and other factors of rural and urban areas may be the reasons for poorer health, researchers said.

"Clearly, prevention plays a role in the urban-rural patterns we've observed," said Dr. Jeffrey Koplan, director of the Centers for Disease Control and Prevention. "Those communities where citizens are able to lead healthier lifestyles and adopt the healthy habits that prevent illness and injury see the results in many tangible ways."

Long distances to hospitals, doctors and other health care providers sometimes account for some small-town residents waiting up to a half hour for an emergency vehicle, according to the study.

"We want all Americans, regardless of where they live, to have an equal chance for a healthy life," said Health and Human Services Secretary Tommy Thompson in a statement. "Geography alone does not determine health status, but this report performs a valuable service by helping us understand where the most rural and urban communities can target public health efforts to close the gaps."

Urban areas were considered to be counties with more than one million people. Suburban areas were counted as larger towns on the fringes of the largest cities. Rural areas were defined as counties having less than one million people, with the most rural areas defined as counties without cities attached to them. These areas counted less than 10,000 people.

Among the reports findings:

In 1999, overall life expectancy matched the record high set in 1998 of 76.7 years and reached a new high for black men of 67.6 years, and 74.5 for white men. Life expectancy for white women is 80 years, and for black women is 74.8.

Death rates for working-age adults were higher in the most rural and most urban areas. The highest death rates for children and young adults were in the most rural counties.

Residents of rural areas had the highest death rates for unintentional injuries generally and for motor-vehicle injuries specifically. Homicide rates were highest in the central counties of large metro areas.

Suburban residents were more likely to exercise during leisure time and more likely to have health insurance. Suburban women were the least likely to be obese.

Both the most rural and the most urban areas had a similarly high percent of residents without health insurance.

Teenagers and adults in rural counties were the most likely to smoke. Residents of the most rural communities also had the fewest visits to dental care.

The top three causes of death in 1999 — heart disease, cancer and stroke — declined. Death rates due to homicides also declined.

Reference Source 104

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