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Preventable deaths higher in rural areas

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News from the CDC

Potentially preventable deaths from the five leading causes of death occurred more often among people in the most rural counties than in the most urban counties during 2010–2017, according to a new study released in CDC’s Morbidity and Mortality Weekly Report.

The gap in the percentages of preventable deaths between rural and urban counties widened over the eight-year study period for deaths from cancer, heart disease, and chronic lower respiratory disease. This rural/urban gap remained relatively stable for stroke and decreased for unintentional injuries; however, the decrease in the gap for preventable deaths from unintentional injuries wasn’t due to improvements in rural counties but to the sharp rise in urban areas, due in large part to the opioid crisis.

The study also found that while potentially preventable cancer deaths fell to less than 10 percent of all cancer deaths in 2017, more than half of deaths due to unintentional injury were potentially preventable. Percentages of preventable deaths were generally higher in the southeastern United States for most causes than in other regions.

“We are encouraged to find that preventable deaths from cancer have gone down overall, yet there is a persistent and striking gap between rural and urban Americans for this and other leading causes of death,” said CDC Director Robert R. Redfield, M.D. “There are proven strategies for reducing health risks like cigarette smoking and obesity and we need to redouble our prevention efforts to reach those living in rural areas, where risks tend to be higher.”

CDC researchers used mortality data from the National Vital Statistics System to calculate potentially preventable deaths for the five leading causes of death among people under 80 years old.

Previous studies placed counties into two categories — urban or rural — but this new study breaks counties down further into six categories: large central metropolitan (the most urban), large fringe metropolitan, medium metropolitan, small metropolitan, micropolitan and noncore (the most rural). This gave the researchers a more detailed look at health differences among these communities.

Main findings

In 2010, 28.7 percent of deaths from cancer in the most rural counties were potentially preventable, compared with 17.9 percent in the most urban counties. By 2017, 21.7 percent of cancer deaths in the most rural counties were potentially preventable, compared with 3.2 percent in the most urban counties.

In 2010, 45.1 percent of deaths from heart disease in the most rural counties were potentially preventable, compared with 24.1 percent in large fringe metropolitan areas. By 2017, 44.9 percent of deaths from heart disease in the most rural counties were potentially preventable, compared with 18.5 percent in large fringe metropolitan areas.

In 2010, 60.9 percent of deaths from unintentional injury in the most rural counties were potentially preventable, compared with 25.4 percent in the most urban counties. By 2017, 64.1 percent of deaths from unintentional injury in the most rural counties were potentially preventable, compared with 47.8 percent in the most urban counties.

In 2010, 54.3 percent of deaths from chronic lower respiratory disease (such as COPD) in the most rural counties were potentially preventable, compared with 23.4 percent in the most urban counties. By 2017, 57.1 percent of deaths from chronic lower respiratory disease in the most rural counties were potentially preventable, compared with 13 percent in the most urban counties.

In 2010, 41.6 percent of deaths from stroke in the most rural counties were potentially preventable, compared with 22.7 percent in large fringe metropolitan areas. By 2017, 37.8 percent of deaths from stroke in the most rural counties were potentially preventable, compared with 17 percent large fringe metropolitan areas.

How to reduce deadly health risks in rural America

More than 46 million Americans live in rural areas, and these residents tend to be older and sicker than those living in urban areas. Rural Americans tend to have higher rates of cigarette smoking, high blood pressure, and obesity, and to report less leisure-time physical activity and lower seatbelt use than their urban counterparts. They also have higher rates of poverty, less access to healthcare and are less likely to have health insurance.

 

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