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Rural-Urban and Within-Rural Differences in COVID-19 Mortality Rates

Jun 23, 2022

Rural-Urban and Within-Rural Differences in COVID-19 Mortality Rates

Yue Sun, Kent Jason G. Cheng, Shannon Monnat

Journal of Rural Social Sciences, June 2022

Shannon Monnat

Shannon Monnat


Yue Sun

Yue Sun


Kent Cheng

Kent Cheng


Since late-2020, COVID-19 mortality rates have been higher in rural than in urban America, but there has also been substantial within-rural heterogeneity. Using CDC data, we compare COVID-19 mortality rates across the rural-urban continuum as well as within rural counties across different types of labor markets and by metropolitan adjacency. As of October 1, 2021, the cumulative COVID-19 mortality rate was 247.0 per 100,000 population in rural counties compared to 200.7 in urban counties. Higher COVID-19 mortality rates in rural counties are explained by lower average educational attainment and lower median household income. Within rural counties, mortality rates have been highest in farming-dependent counties and lowest in recreation-dependent counties. Those differences are similarly explained by differences in educational attainment and median household income. Our findings have implications for ongoing COVID-19 prevention and vaccination efforts as well as for informing preparation efforts for future infectious disease outbreaks.

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