Rural and Urban Differences in COVID‐19 Prevention Behaviors

Abstract

Purpose To examine whether the adoption of COVID‐19‐related preventive health behaviors vary in rural versus urban communities of the United States while accounting for the influence of political ideology, demographic factors, and COVID‐19 experiences. Methods We rely on a representative survey of 5009 American adults collected from May 28 to June 8, 2020. We analyze the influence of rural status, political ideology, demographic factors, and COVID‐19 experiences on self‐reported adoption of 8 COVID‐19‐related preventive health behaviors. Findings Rural residents are significantly less likely to have worn a mask in public, sanitized their home or workplace with disinfectant, avoided dining at restaurants or bars, or worked from home. These findings, with the exception of dining out, are robust to the inclusion of measures accounting for political ideology, demographic factors, and COVID‐19 experiences. Conclusions Rural residents are significantly less likely to participate in several COVID‐19‐related preventive health behaviors. This reality could exacerbate existing disparities in health access and outcomes for rural Americans. Health messaging targeted at improving COVID‐19 preventive behavior adoption in rural America is warranted.

COVID‐19 risk mitigation behaviors among rural and urban community‐dwelling older adults in summer, 2020

“…With self-reported data, high rates of risk mitigation behaviors may represent a desire to appear to comply with public health directives. However, some of our results, such as lower reported risk mitigation behaviors by men versus women, correspond with observational work, 9 suggesting that respondents reported actual behavior. Second, the data set used do not allow us to examine the frequency of the risk mitigation behaviors.…”

“…While one online survey in late April 2020 found rural and urban residents equally concerned with COVID and willing to engage in social distancing and avoidance of public spaces, 7 lower use of risk mitigation behaviors in rural areas has been documented in both surveys [8][9][10] and observational studies. 11 Individuals aged 65 years and older are at higher risk for death due to COVID-19.…”

“…10,11 However, little research to date has explored potential rural disparities in risk mitigation within this vulnerable population. We extend the recent work of Callaghan and associates, 9 which used an online survey to explore rural-urban differences in COVID-19 risk mitigation among US adults. This analysis found that rural adults were less likely to report mask wearing and working from home, but otherwise did not differ from urban respondents.…”

Transmission Dynamics, Heterogeneity and Controllability of SARS-CoV-2: A Rural–Urban Comparison

“…Urban residents are more likely to participate in preventive behaviors than rural residents [ 36 ]. In addition, subways, office buildings, and residential garbage are positively connected with the virus transmission [ 37 ], which increases the probability of household and social transmission. However, in rural areas, community contacts lead to a large proportion of infections.…”

Rural-Urban and Within-Rural Differences in COVID-19 Mortality Rates

“…These factors may influence health care access and ability to physically isolate. Rural residents have also been more resistant to engaging in preventive behaviors, such as mask wearing (Callaghan et al 2021;Haischer et al 2020), avoiding dining out (Callaghan et al 2021), and getting vaccinated (Kaiser Family Foundation 2021). The Kaiser Family Foundation's Vaccine Monitor shows that 24% of rural residents report that they will definitely not get the COVID-19 vaccine compared to only 7% of urban residents (Kaiser Family Foundation 2021).…”