Mapping Health Disparities in 11 High-Income Nations

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Abstract
Geographic health disparities are well recognized in public health and health care delivery. The health of people in rural areas in particular is a recognized concern in the US and globally.1-3 In the US, the death rate is higher for rural vs urban areas (831 per 100 000 vs 704 per 100 000).4 Rural residents in the US have higher rates of chronic diseases5,6 (diabetes, obesity, chronic obstructive pulmonary disease), stroke,5,6 unintentional injury,5,6 tobacco use,7 opioid overdose,8 cancers associated with modifiable risks,9 suicide,10 worse maternal health,11 decreased confidence in the health care system,12 and limited access to care.13-17 In 2019, mortality rates were higher for the 10 leading causes of death in rural areas.18 Geographic health disparities also occur in other high-income countries, with evidence of overall worse rural health in Australia19 and Canada.20-22 In France and the Netherlands, there is evidence of worse perinatal health outcomes for women who live farther from hospitals, indicating that living in a rural area is a risk factor.23

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