University of Wisconsin–Madison Medical College of Wisconsin

Rural Residence Predicts Lower Cardiac Mortality and Better Mental Health Outcomes

Danyon Anderson, BA; Paul Beinhoff; BS; Leslie Ruffalo, PhD

WMJ. 2021;120(3):183-187.

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Introduction: Previous studies have found higher rates of heart disease and worse mental health outcomes among individuals residing in rural areas. To our knowledge, no research has used county-level data to measure the effect of “ruralness” (the degree to which a county is rural) on heart disease and mentally unhealthy days while controlling for other sociodemographic factors. This study analyzes the effect of ruralness on heart disease death rates and the average number of mentally unhealthy days on a county-level.

Methods: Linear regressions were performed using county-level data to analyze the effect of “Ruralness” on heart disease death rates and mental unhealthiness while controlling for confounding variables. Geographic analysis was also used.

Results: Higher rural-urban continuum codes predict lower rates of cardiac mortality (β = -.075 deaths per 100,000 people/continuum code, t = -4.36, P  < .001) and fewer mentally unhealthy days (β = -.265 monthly mentally unhealthy days/continuum code, t = -16.45, P < .001).

Conclusion: Being from a rural area correlates with lower rates of heart disease death and mental unhealthiness after controlling for sociodemographic confounders. This adds nuance to the previously reported trend of heart disease being more prevalent in rural areas.

Author Affiliations: Department of Family and Community Medicine, Medical College of Wisconsin, Wauwatosa, Wisconsin (Anderson, Beinhoff, Ruffalo).
Corresponding Author: Danyon Anderson, 7900 Harwood Ave, Wauwatosa, WI 53213; phone 719.310.2831; email; ORCID ID 0000-0002-9784-4271.
Financial Disclosures: None declared.
Funding/Support: None declared.
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