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A Little Bit Country or Rhinestone Cowboy? Urban-Rural Life Expectancy

By Martha Michael

Like dueling divas, a health debate between rural residents and city folks could end with either of them in the spotlight. But there are more than banjos at stake when you’re collecting data about life expectancy, and sometimes evidence says it isn’t just a draw.

For about four decades, the life expectancy for people in urban areas has outpaced that of their counterparts in the country, says Health Behavior News Service writer Stephanie Stephens in an article printed in the American Journal of Preventive Medicine.

Rural Low Notes

Pastoral images typically carry with them a reputation for fresh air, organic foods and wholesome living. But the advantages of clean living aren't always the case, due to higher rates of chronic conditions and injury among residents in rural settings, according to Gopal K. Singh, Ph.D, of the U.S. Health Resources and Services Administration (HRSA). The gap in life expectancy between city and country populations has gotten larger, from a 0.4 year difference in 1970 to 2 years in 2009. Specifically, 70 percent of the gap between life expectancies in the two areas are the result of cardiovascular disease, COPD, lung cancer and accidents, according to Singh.

“When compared to urban areas, rural areas have higher rates of both smoking and lung cancer, along with obesity, yet reduced access to health care services,” Singh says. “Additionally, rural residents have a lower median family income, higher poverty rate and fewer have college degrees.”

Urban High Notes

Though a lot of the bad news, healthwise, seems to come from big cities, such as pandemics and rare diseases, city dwellers get more health care funding. Income levels of residents and access to health care are key factors in life expectancy. And because only 17 percent of Americans live in the country, money for public health purposes get steered toward the urban areas, Singh says.

Also of note, for many years, cities were thought to be dirty, polluted, rat-infested dens of disease. Not only is that hyperbole, the successful efforts to clean up urban environments have changed a lot of the facts. The country isn’t the only one bragging about fresh air or purified water.

Urban folks are also less likely to be obese and smoke tobacco, says an article in the Wall Street Journal. According to County Health Rankings, or CHR, urban residents have lower rates of:

  • Stroke
  • Diabetes
  • Heart attacks
  • High blood pressure

When it comes to life expectancy, the sparkle coming off Marie Osmond’s impeccable teeth are no match for the rhinestone studs on Glen Campbell’s chaps. Urban folks are singing a happy tune while country residents are playing second fiddle.


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