With an increasing older population and a decreasing number of doctors, rural communities are facing a growing challenge.
According to new research from the USC Schaeffer Center for Health Policy & Economics, men in rural areas are passing away earlier than those in cities and are spending less of their later years in good health.
The study, published in this week’s Journal of Rural Health, highlights that higher rates of smoking, obesity, and heart-related issues among rural men contribute to a growing health gap between rural and urban populations. This disparity has intensified over the years, and the research suggests that by the time rural men hit 60, there are limited chances to adequately address these issues, indicating that earlier interventions are essential to prevent further expansion of this gap.
The research also indicates a growing need for healthcare services in rural areas, which is likely to strain these communities. Rural regions typically experience a shortage of healthcare providers and are aging at a quicker pace, as younger individuals tend to relocate to urban areas, further dwindling the availability of potential healthcare workers.
“Rural communities are experiencing a higher rate of chronic diseases, creating serious challenges for healthy aging,” explained lead author Jack Chapel, a postdoctoral scholar at the Schaeffer Center. “As the population ages and the number of doctors decreases, rural areas will face increasing burdens, resulting in significant difficulties in managing the health of those who are likely to encounter more health problems in the future.”
Researchers utilized data from the Health and Retirement Survey alongside a microsimulation model called the Future Elderly Model to project future life expectancy for both rural and urban Americans over the age of 60. They also evaluated the anticipated quality of health during those years, known as health-quality-adjusted life expectancy (QALE). The study compared health trends for Americans aged 60 between 2014-2020 with a similar cohort from 1994-2000.
The study concluded that 60-year-old men from rural areas can expect to live two years less than their urban peers, a gap that has nearly tripled over the last twenty years. Additionally, rural men are expected to live 1.8 fewer years in good health compared to urban men, with this difference more than doubling over the same time period. In contrast, the gap in life expectancy and health quality for women is much smaller and has increased at a slower rate.
An important insight from the study is that, while education plays a significant role in health quality, it doesn’t fully explain the urban-rural health disparity. Adjusting for education to align rural levels with urban areas reduced the gap in healthy life expectancy by nearly half, yet differences persisted even within each educational level, suggesting that geographic factors beyond education also affect health outcomes.
The researchers found that strategies to decrease smoking, manage obesity, and treat widespread heart disease would particularly benefit older individuals in rural regions compared to their urban counterparts. However, most interventions tested were unable to completely eliminate the urban-rural gap in healthy life expectancy.
“While education is crucial, factors like smoking, high obesity rates, and cardiovascular issues, combined with living in a rural environment, result in more deaths and illnesses among rural American men,” noted co-author Elizabeth Currid-Halkett, the James Irvine Chair in Urban and Regional Planning and a senior researcher at the USC Schaeffer Institute for Public Policy & Government Service.
“To bridge the healthy life expectancy gap between urban and rural areas for older adults, it’s vital to promote healthier behaviors earlier in life and implement broader social and economic enhancements in rural settings,” added co-author Bryan Tysinger, director of health policy simulation at the Schaeffer Center.
This research was supported by funding from the National Institute on Aging of the National Institutes of Health, under award P30AG024968.
