Recent reports have shed light on the concerning trend of higher percentages of preventable premature deaths in nonmetropolitan areas compared to metropolitan areas in the United States. This analysis aims to extend the understanding by examining data spanning from 2010 to 2022, providing insights into the urban-rural disparities in preventable premature deaths.
Methodology: Utilizing mortality data from the National Vital Statistics System, preventable premature deaths from the five leading causes of death among individuals under 80 years old were calculated. Urban-rural classification of counties was employed, and preventable premature deaths were defined as exceeding expected numbers based on benchmark states with the lowest rates.
Results: The analysis revealed notable trends over the study period. Preventable premature deaths increased for unintentional injury and stroke, decreased for cancer and chronic lower respiratory disease (CLRD), and remained stable for heart disease. Across all years, rural counties consistently exhibited higher percentages of preventable premature deaths compared to urban counties. Notably, the most rural counties consistently experienced the highest percentages of such deaths.
Key Findings:
- Preventable premature deaths from heart disease saw significant increases in noncore and micropolitan counties, while large central metropolitan counties witnessed a decrease.
- Cancer-related deaths decreased across all county categories, with the most substantial declines in large metropolitan areas.
- Unintentional injury-related deaths increased across all county types, with the largest spikes in large metropolitan areas.
- CLRD deaths decreased in large central metropolitan counties but slightly increased in noncore areas.
- Stroke-related deaths fluctuated over the years, with an initial decrease followed by stability and a subsequent increase in 2020, likely influenced by the COVID-19 pandemic.
Implications: These findings underscore the persistent disparities in preventable premature deaths between urban and rural areas. Monitoring such disparities based on urban-rural classifications can aid public health departments in identifying areas with higher prevalence, thus facilitating targeted interventions to address underlying factors such as access to healthcare and social determinants of health. Additionally, the observed increases in preventable premature deaths during the COVID-19 pandemic highlight the importance of addressing broader health system issues to mitigate future impacts.
