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What’s Causing The Rise in Rural Mortality?

The problem isn’t entirely health-related

9:19 AM CDT on July 15, 2026

People who live in rural parts of the United States have significantly shorter lifespans compared to those in urban areas. In fact, rural working age adults (aged 25 to 54) are 43 percent more likely to die from natural causes than those who live in cities, according to data from 2019. The gap has widened from a 9 percent difference in mortality when the trend first emerged three decades ago. Now a new study in the journal Economics & Human Biology is attempting to unravel the multifarious causes. 

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In the first-of-its-kind study, researchers from the University of Illinois Urbana-Champaign combined data from a variety of sources to get a more complete picture of the problem. Metrics like blood pressure, cholesterol, and obesity from the National Health and Nutrition Examination Survey allowed them to look at the worsening cardiometabolic indexes of rural Americans. They found that chronic stress, nicotine use, obesity, and diet stood out as major biological contributors to the trend.

Read more: “Why Living in a Poor Neighborhood Can Change Your Biology

“These metrics are a combination of factors we got from the survey, such as whether an individual is diabetic, has cotinine in their blood (evidence of nicotine use), high blood pressure, just a whole host of things,” study author Sarah Low said in a statement. “The more of those things you have, the higher the cardiometabolic index and the higher the overall stress on the body.”

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Meanwhile, place-based data like access to grocery stores, hospitals, and gyms offered insights into the infrastructure of rural towns. “It’s this wicked mess to untangle,” Low explained. “But the data told us we can’t blame rural-urban health disparities on rurality alone. By digging into the data, we found that it is the characteristics of rural communities rather than the fact that they are rural that is driving the place-based results.” 

In other words, there are plenty of health and lifestyle factors to blame for skyrocketing rural mortality, but shuttered hospitals, sparse healthy food options, and other non-biological factors are compounding the problem.

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