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COVID19 is Killing Rural Americans at Twice the Rate of People Living in Urban Areas

Rural Americans are dying of Covid-19 at more than twice the rate of their urban counterparts, a dichotomy that health experts say is likely to get even widen as access to medical care shrinks for a segment of the population that tends to be older, sicker, heavier, poorer, and less vaccinated.

While the earlier surges of Covid deaths bypassed much of the more rural parts of the country where roughly 15 percent of Americans live, nonmetropolitan mortality rates quickly started to outpace those of urban areas as the virus spread nationwide before vaccinations became available, according to data from the Rural Policy Research Institute.

Photo by Robert Nickelsberg/Getty Images

Since the pandemic began in early 2020, about 1 in 434 rural Americans have died from Covid, compared with roughly 1 in 513 urban Americans, the institute’s data shows. And though vaccines have reduced overall Covid death rates since the winter peak, rural mortality rates are now more than double that of urban ones, and those numbers are accelerating quickly thanks to the rapid spread of the highly contagious and deadlier Delta variant.

The high incidence of cases and low vaccination rates don’t fully capture why mortality rates are so much higher in rural areas than elsewhere. Academics and officials alike see rural Americans’ greater rates of poor health and their limited options for medical care as a deadly combination. The pressures of the pandemic have compounded the problem by deepening staffing shortages at hospitals, creating a cycle of worsening access to care.

In hard-hit southwestern Missouri, for example, 26 percent of Newton County’s residents were fully vaccinated as of September 27th. The health department has held raffles and vaccine clinics, advertised in the local newspaper, and even driven the vaccine to those lacking transportation in remote areas. But like everywhere else, vaccination rates typically increase only after someone dies or gets seriously ill within a hesitant person’s social circle.

Additionally, the overload of Covid patients in hospitals has undermined a basic tenet of rural health care infrastructure: the ability to transfer patients out of rural hospitals to higher levels of specialty care at regional or urban health centers.



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