Rural Population in New Hampshire

New Hampshire

Rural areas are often under-resourced and face unique challenges, especially regarding the social determinants of health. Compared with those living in urban areas, rural populations have a 40% higher rate of preventable hospitalizations and a 23% higher mortality rate. People living in rural areas are more likely to die from cancer, chronic lower respiratory disease, heart disease, stroke and unintentional injury than those living in urban areas. Motor vehicle accidents and drug deaths from opioids are also higher in rural areas, contributing to an unintentional injury death rate that is approximately 50% higher than in urban areas. Rural areas are also home to a higher proportion of older adults — more than 20% of rural residents in the United States are 65 and older. This population is at especially high risk for poor health outcomes such as dementia, heart disease and cancer.

The health of rural populations is affected by a complex mix of economic, social, racial, ethnic, geographic and health workforce factors. Financial insecurity, remote location, lower socioeconomic status and higher rates of unhealthy behaviors contribute to the significant health disparities between rural and urban populations. Furthermore, geographic isolation and shortages in the health care workforce make access to care a very serious challenge for rural populations.

Addressing rural health disparities requires special policy considerations at all levels of the government and community.

In order to reduce health disparities in rural areas, the Centers for Disease Control and Prevention (CDC) recommends that health care providers:

• Participate in state-level comprehensive cancer control programs that address prevention, education, screening, access to care, support for cancer survivors and healthy living.
• Improve screening for high blood pressure and encourage blood pressure control to reduce heart disease and stroke.
• Encourage people to be more active and eat healthier to reduce the risk of obesity.
• Connect families of children with mental, behavioral or developmental disorders with support networks and resources. 
• Educate patients about motor vehicle safety. 
• Encourage smoking cessation, regular physical activity and other healthy behaviors.
• Follow the CDC Clinical Practice Guideline for Prescribing Opioids for Chronic Pain.

Davis, James C., Anil Rupasingha, John Cromartie, and Austin Sanders. “Rural America at a Glance: 2022 Edition.” Economic Information Bulletin. U.S. Department of Agriculture, November 2022. https://www.ers.usda.gov/webdocs/publications/105155/eib-246.pdf.

Dowell, Deborah, Kathleen R. Ragan, Christopher M. Jones, Grant T. Baldwin, and Roger Chou. “CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022.” MMWR. Recommendations and Reports 71, no. 3 (November 4, 2022): 1–95. https://doi.org/10.15585/mmwr.rr7103a1.

Johnston, Kenton J., Hefei Wen, and Karen E. Joynt Maddox. “Lack Of Access To Specialists Associated With Mortality And Preventable Hospitalizations Of Rural Medicare Beneficiaries.” Health Affairs 38, no. 12 (December 1, 2019): 1993–2002. https://doi.org/10.1377/hlthaff.2019.00838.