Physical Health Worse for Adults Living in Small Cities, Rural Areas

Self-rated physical health is more likely to be fair/poor for residents of medium/small urban, metro-adjacent rural, and remote rural counties compared with residents of large urban counties, according to research published in the Feb. 4 issue of the U.S. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report.

Danielle C. Rhubart, Ph.D., from The Pennsylvania State University in State College, and Shannon M. Monnat, Ph.D., from Syracuse University in New York, used data from the National Well-being Survey of approximately 4,000 U.S. working-aged adults conducted during February and March 2021 to examine differences in self-rated physical health along the rural-urban continuum.

The researchers found that the probabilities of reporting fair/poor self-rated physical health were significantly higher for residents of medium/small urban, metro-adjacent rural, and remote rural counties compared with their large urban-county peers. Self-rated physical health did not differ significantly by sex or race/ethnicity. Factors that contributed to the advantage among residents of large urban counties included individual-level socioeconomic resources, such as higher educational attainment, higher household income, and higher probability of employment.

“A large body of research demonstrates that multiple factors are responsible for the worse rural health profile in the United States, suggesting that multiple policy strategies will be needed to address these disparities,” the authors write. “Policies focused on reducing socioeconomic disparities, such as increasing the availability of livable wage jobs, especially for persons without a college degree, likely would address poor health outcomes in rural areas.”

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