Healthy People 2020: Rural Areas Lag In Achieving Targets For Major Causes Of Death

Abstract

For the period 2007-17 rural death rates were higher than urban rates for the seven major causes of death analyzed, and disparities widened for five of the seven. In 2017 urban areas had met national targets for three of the seven causes, while rural areas had met none of the targets.

Keywords: Cancer; Chronic obstructive pulmonary disease; Health People 2020; Health Services; Health policy; Mortality; Rural health care; Stroke; access to care; health disparities; public health.

Figures

Exhibit 2.

Average annual percent changes from 2007 to 2017 in death rates for the major causes of death tracked by Healthy People 2020, by rurality. SOURCE Authors’ analysis of age-adjusted death rates for 2007–17 from the National Vital Statistics System, National Center for Health Statistics. NOTES Negative slope estimates indicate decreasing death rates, while positive slope estimates indicate increasing death rates. The error bars represent 95% confidence intervals. Appendix exhibit A3 contains the data for average annual percent changes in rural and urban area death rates for the major causes of death (see note 11 in text). CHD is coronary heart disease. COPD is chronic obstructive pulmonary disease among people ages forty-five and older.

Exhibit 3

Ratios of rural annual death rates to urban annual death rates for the major causes of death tracked by Healthy People 2020, 2007–17. SOURCE Authors’ analysis of age-adjusted death rates for 2007–17 from the National Vital Statistics System, National Center for Health Statistics. NOTESAppendix exhibit A4 contains the data for the ratios of rural to urban rates for the major causes of death (see note 11 in text). CHD is coronary heart disease. COPD is chronic obstructive pulmonary disease among people ages forty-five and older.

Exhibit 4.

Average annual percent changes from 2007 to 2017 in death rates in rural areas for the major causes of death tracked by Healthy People 2020, by census region. SOURCE Authors’ analysis of age-adjusted death rates for 2007–17 from the National Vital Statistics System, National Center for Health Statistics. NOTES Negative slope estimates indicate decreasing death rates, while positive slope estimates indicate increasing death rates. The error bars represent 95% confidence intervals. Appendix exhibit A5 contains the data for the average annual percent changes in rural areas for the major causes of death by census region (see note 11 in text). CHD is coronary heart disease. COPD is chronic obstructive pulmonary disease among people ages forty-five and older.