September 10, 2001
Health and Human Services Issues Report on Community Health in Rural, Urban Areas
Statistics Show Suburban Residents Fare Better in Many Key
- HHS Secretary Tommy G. Thompson today released a new report that shows
Americans who live in the suburbs fare significantly better in many key
health measures than those who live in the most rural and most urban areas.
The 25th annual statistical report on the Nation’s health is the first to
look at health status relative to communities’ level of urbanization.
The report found that people who live in the most rural and most urban areas
have higher mortality rates for working age adults than suburban residents.
Those who live in the suburbs of large metropolitan areas have the lowest
infant mortality rates and are more likely to have health insurance and
healthy lifestyles. These variations also frequently track other demographic
factors, such as income and race.
"We want all Americans, regardless of where they live, to have an equal
chance for a healthy life," Secretary Thompson said. "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."
The report, "Health, United States, 2001, With Urban and Rural Health
Chartbook," documents differences in a wide-ranging set of health
characteristics for people residing in communities from the most rural to
the most urban. Among its specific findings:
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
Both the most rural and 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 for
The chartbook presents detailed analysis of population characteristics,
health risk factors, health status indicators, and health care access
measures for residents of counties grouped by five urbanization levels. It
also examines patterns by region of the country.
Communities at different urbanization levels differ in terms of age, race,
ethnicity, income, and other factors, which affect health status. For
example, residents of the most rural and the most urban areas are more
likely to be poor. Access to routine and emergency health care, racial and
ethnic makeup, air quality, and other factors also affect a community’s
"Clearly, prevention plays a role in the urban-rural patterns we’ve
observed," said Dr. Jeffrey P. Koplan, director of the Centers for Disease
Control and Prevention. "Those communities where citizens are able to lead
healthier life styles and adopt the healthy habits that prevent illness and
injury see the results in many tangible ways."
Overall, the annual report shows that Americans are healthier today than 25
years ago – with longer life expectancy, better infant survival, fewer
smokers, less hypertension, and lower cholesterol levels. Highlights of the
overall findings include: 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 67.8
years and 74.6 for white men. The top three causes of death in 1999--heart
disease, cancer, and stroke--declined.
Death rates for unintentional
injuries and homicides were also down. In the past decade, mothers receiving
early prenatal care – which can protect the health of mother and infant –
increased from 76 to 83 percent. In 1999, 78 percent of children ages 19-35
months had received the recommended combined series of vaccinations, up from
69 percent in 1994. Children below the poverty level were less likely to
have been vaccinated.
The chartbook’s focused look at
rural, urban, and suburban health will complement other efforts at HHS to
address the special health care needs of rural communities and other
underserved areas. In July, Secretary Thompson announced the creation of a
HHS Rural Task Force that will conduct a Department-wide examination of how
HHS programs can be strengthened to better serve rural communities.
This type of detailed analysis of
urban/rural patterns of health in America is virtually unprecedented," said
Dr. Edward J. Sondik, director of CDC's National Center for Health
Statistics, which prepares this annual report. "This is the information that
is needed to target efforts in prevention and health care access."