About Rural Health in America

General Statistics:

  • Approximately 62 million people – nearly one in five Americans – live in rural and frontier areas.
  • Rural Americans reside in 80 percent of the total U.S. land area but only comprise 20 percent of the U.S. population.
  • There are 4,118 primary care Health Professional Shortage Areas (HPSAs) in rural and frontier areas of all U.S. states and territories compared to 1,960 in metropolitan areas.
  • The average median income for rural U.S. residents is $40,615 compared to $51,831 for urban residents.
  • Approximately 15.4 percent of rural U.S. residents live in poverty compared to 11.9 percent of urban residents.

Rural Health Workforce:

  • There is a more holistic, patient-centered approach to health care in rural communities – providers have the opportunity to provide more comprehensive care to their patients.
  • Despite this opportunity, only nine percent of all physicians and 12 percent of all pharmacists practice in those settings.
  • There were 55 primary care physicians per 100,000 residents in rural areas in 2005, compared with 72 per 100,000 in urban areas – a figure which decreases to 36 per 100,000 in isolated, small rural areas.
  • There are only half as many specialists per 100,000 residents in rural areas compared to urban areas.
  • Rural areas average about 30 dentists per 100,000 residents; urban areas average approximately twice that number.
  • Only 10 percent of psychologists/psychiatrists and 20 percent of masters-level social workers work in rural areas.

Healthcare/Health Insurance Accessibility:

  • While nearly 85 percent of U.S. residents can reach a Level I or Level II trauma center within an hour, only 24 percent of residents living in rural areas can do so within that time frame – this despite the fact that 60 percent of all trauma deaths in the United States occur in rural areas,.
  • Approximately 21.9 percent of residents in remote rural counties are uninsured, compared to 17.5 percent in rural counties adjacent to urban counties and 14.3 percent in urban counties.
  • Rural residents spend more on health care out of pocket than their urban counterparts; on average, rural residents pay or 40% of their health care costs out of their own pocket compared with the urban share of one-third. One in five rural residents spends more than $1,000 out of pocket in a year.

Rural Hospitals:

  • Rural hospitals are sources of innovation and resourcefulness that reach beyond geographical boundaries to deliver quality care. They are also typically the economic foundation of their communities – every dollar spent on rural hospitals generates about $2.20 for the local economy.
  • Twelve percent of rural hospitals indicate they are not considering HIT investments because of cost concerns compared to 3 percent of urban hospitals.
  • Critical Access Hospitals care for a higher percentage of Medicare patients than other hospitals because rural populations are typically older than urban populations.

State Offices of Rural Health:

  • All 50 states maintain a State Office of Rural Health (SORH).
  • SORHs serve as a clearinghouse of information and innovative approaches to rural health services delivery; coordinate state activities related to rural health in order to avoid duplication of efforts and resources; and identify Federal, State and nongovernmental programs that can provide technical assistance to public/private nonprofit entities serving rural populations.
  • Collectively, SORHs provided technical assistance to more than 28,000 rural communities during the 2010-2011 fiscal year.