Potentially Excess Deaths from the Five Leading Causes of Death in Metropolitan and Nonmetropolitan Counties — United States, 2010–2017

Abstract

Problem/Condition: A 2017 report quantified the higher percentage of potentially excess (or preventable) deaths in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas. In that report, CDC compared national, regional, and state estimates of potentially excess deaths among the five leading causes of death in nonmetropolitan and metropolitan counties for 2010 and 2014. This report enhances the geographic detail by using the six levels of the 2013 National Center for Health Statistics (NCHS) urban-rural classification scheme for counties and extending estimates of potentially excess deaths by annual percent change (APC) and for additional years (2010)(2011)(2012)(2013)(2014)(2015)(2016)(2017). Trends were tested both with linear and quadratic terms.

Society of behavioral medicine statement on COVID-19 and rural health

“…Rural populations are uniquely at risk for COVID-19-related inequities for a variety of reasons. First, rural populations are on average, older, poorer, and have higher age-adjusted rates of underlying chronic conditions (e.g., obesity, diabetes, cancer, and respiratory illnesses) and disabilities than non-rural populations in the U.S. [ 20–24 ].…”

Bridging the Gap in Potentially Excess Deaths Between Rural and Urban Counties in the United States

“…In 2017, the number of potentially excess deaths from cancer was approximately 39 000 in the United States. 7 Cancer had the lowest (9.2%) percentage of potentially excess deaths among the 5 leading causes of death, ranging from 3.2% in large central metropolitan counties (urban classification) to 21.7% in noncore counties (rural classification). These numbers mirror lower incidence and higher death rates found in nonmetropolitan counties compared with metropolitan counties.…”

“…6 In November 2019, CDC reported that, in both rural and urban counties, the 5 leading causes of death in the United States during 2010-2017 were heart disease, cancer, unintentional injury, chronic lower respiratory disease, and stroke, which together accounted for 1.72 million deaths (approximately 61% of all deaths) in 2017. 7 Furthermore, the number of potentially excess deaths-defined as deaths among persons aged <80 in excess of the number that would be expected-differed among and within public health regions and among US states. In addition, the percentage of potentially excess deaths from the 5 leading causes of death, nationally, across public health regions, and in most states is greater in rural counties than in urban counties.…”

“…In addition, the percentage of potentially excess deaths from the 5 leading causes of death, nationally, across public health regions, and in most states is greater in rural counties than in urban counties. 7 Several factors may influence the rural-urban gap in potentially excess deaths, many of which are associated with sociodemographic differences. The rural-urban disparity was most striking for potentially excess deaths from unintentional injury, whereby increases in potentially excess deaths from unintentional injury in urban and suburban counties accelerated at a much faster pace than in all other county categories.…”

“…22 A comprehensive approach to cancer control and prevention (eg, prevention, early detection, treatment, and survivorship) has helped address cancer disparities during the past 20 years in the United States, 23 and a more focused approach for reducing rural-urban disparities could be developed in the future. For prevention and early detection, several evidence-based interventions 7 focus on reducing tobacco use and overweight, both of which are risk factors for some types of cancers. In 2016, data from the National Survey on Drug Use and Health showed that the prevalence of cigarette smoking for persons aged 12 years was 37.8% in a completely rural county compared with 27.1% in a large metropolitan county.…”