Rural Americans Are More Vulnerable to COVID-19

March 8, 2021, 5:10 p.m. ·

The Rural Policy Research Institute report says the highest case rates in late September's COVID-19 surge were in rural counties, particularly those that have no town larger than 2,499 residents (Photo by Melissa Rosales).

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Rural Americans are 13.4% more likely to be infected and die from COVID-19 than those who live in urban areas, according to a recent report from the Iowa-based Rural Policy Research Institute.

When the COVID-19 pandemic arrived, mostly urban areas were hit, but by fall rural areas had the highest case rates, more severe illnesses, and higher death rates. That’s according to the USDA’s Economic Research Service report.

Dean of the School of Public Health at UNMC Dr. Ali Khan said he’s not surprised by the report.

“We know that there are existing health and social inequities in rural areas," he said. "And so COVID-19 just exposes the ongoing inequities that we see in rural areas in Nebraska and nationwide.”

Rural Nebraskans were more likely to be infected because there were fewer mask mandates. Khan said rural residents are also typically older and some have underlying conditions that make them more vulnerable to COVID-19. Once infected, rural residents are more likely to have worse outcomes.

“Eighty percent of rural communities are considered to be medically underserved," he said. "So, for example, you're likely to be much farther away from a hospital with an ICU, if you live in a rural community."

Dr. Khan said issues around older age, underlying health conditions, and lack of healthcare access lead to worse outcomes. He said high infection rates also lead to high death rates.

“We must always be working to try to address these disparities in rural healthcare, especially here in Nebraska,” he said.

He urges everyone to practice social distancing and get vaccinated when they can.