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The Role of Individual-Level Factors in Rural Mortality Disparities.

Erika Rees-Punia1, Emily Deubler1, Alpa V Patel1

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Summary
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Rural residence was linked to a small increased mortality risk, but this disparity disappeared after accounting for individual demographics and health behaviors like education and physical activity.

Keywords:
Rural healthalcoholhealth behaviorsphysical activity

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Area of Science:

  • Epidemiology
  • Public Health
  • Rural Health

Background:

  • The rural-urban mortality gap is a significant public health concern.
  • Individual risk factors contributing to this disparity are not well understood.

Purpose of the Study:

  • To investigate how individual demographics and health behaviors influence the association between rural living and mortality risk.

Main Methods:

  • Utilized data from the Cancer Prevention Study-II.
  • Assigned Rural-Urban Commuting Area codes as a time-varying exposure.
  • Employed Cox proportional hazards regression to analyze mortality risks.

Main Results:

  • Initially, rural residents showed a slightly elevated risk of all-cause mortality (HR=1.04).
  • This elevated risk was entirely eliminated after adjusting for individual-level factors.
  • Education, alcohol consumption, and physical activity levels explained the rural mortality disparity.

Conclusions:

  • The increased mortality risk associated with rural residence is largely attributable to individual demographics and health behaviors.
  • Modifiable factors may be key to reducing rural mortality disparities.