Top 5 Takeaways

1. Rural-Urban Health Disparities: Working-aged adults in small/medium urban and rural counties reported worse physical health compared to those in large urban counties.
2. Socioeconomic Factors: Differences in socioeconomic status, such as education, income, and employment, largely explain the health disparities observed.
3. Persistent Rural Disadvantage: Despite adjustments for socioeconomic factors, residents of metro-adjacent rural counties still reported significantly worse health.
4. Impact of COVID-19: Data collection occurred during the COVID-19 pandemic, which may have influenced self-rated health perceptions.
5. Policy Implications: Addressing socioeconomic disparities, such as increasing access to livable wage jobs, could reduce rural-urban health disparities.

Original Article Author and Citation

Corresponding Author

Danielle C. Rhubart, dcr185@psu.edu, 814-863-7256

Suggested Citation

Rhubart DC, Monnat SM. Self-Rated Physical Health Among Working-Aged Adults Along the Rural-Urban Continuum — United States, 2021. MMWR Morb Mortal Wkly Rep 2022;71:161–166. DOI: http://dx.doi.org/10.15585/mmwr.mm7105a1

Summary

This study examined self-rated physical health among working-aged adults across the rural-urban continuum in the United States during 2021. The findings reveal that adults in small/medium urban and rural counties report worse physical health compared to those in large urban counties. Socioeconomic factors, including education, income, and employment, largely explain these disparities. Despite adjustments, residents of metro-adjacent rural counties still reported worse health, highlighting persistent rural disadvantages.

Methods

The study utilized data from the National Well-being Survey (NWS), a cross-sectional, web-based survey conducted in February and March 2021. The survey included approximately 4,000 U.S. working-aged adults, with an oversample of rural residents. Data were weighted to generalize to the broader U.S. working-aged population. Logistic regression analyses were used to predict self-reported fair/poor physical health based on rural-urban status and individual-level characteristics.

Discussion

The analysis highlights significant rural-urban disparities in self-rated physical health among working-aged adults. Socioeconomic factors play a crucial role in these disparities, with lower education, income, and employment rates contributing to worse health outcomes in rural areas. The persistent disadvantage in metro-adjacent rural counties may be influenced by regional factors such as lower access to care and higher poverty rates.

Conclusion

Addressing socioeconomic disparities is essential to reducing rural-urban health disparities. Policies that increase access to livable wage jobs, especially for those without a college degree, could improve health outcomes in rural areas.

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