Rural areas in the United States, often referred to as rural America, consists of approximately 97% of the

United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territori ...

' land area. An estimated 60 million people, or one-in-five residents (17.9% of the total

U.S. population The United States had an official estimated resident population of 333,287,557 on July 1, 2022, according to the U.S. Census Bureau. This figure includes the 50 states and the District of Columbia but excludes the population of five unincorpor ...

), live in rural America. Definitions vary from different parts of the United States government as to what constitutes these areas. Rural areas tend to be poorer and their populations are older than in other parts of the United States, in part because of rural flight, declining infrastructure, and fewer economic prospects. This declining population also results in less access to services, such as high quality medical and education systems.

Definitions

The

United States Census Bureau The United States Census Bureau (USCB), officially the Bureau of the Census, is a principal agency of the U.S. Federal Statistical System, responsible for producing data about the American people and economy. The Census Bureau is part of t ...

defines these areas in the United State as sparsely populated and far from

urban centers An urban area, built-up area or urban agglomeration is a human settlement with a high population density and infrastructure of built environment. Urban areas are created through urbanization and are categorized by urban morphology as cities ...

, which make up an estimated 3% of the land area of the U.S., but is home to more than 80% of the total population. The

United States Office of Management and Budget The Office of Management and Budget (OMB) is the largest office within the Executive Office of the President of the United States (EOP). OMB's most prominent function is to produce the president's budget, but it also examines agency programs, pol ...

defines rural areas in the United States by county; some rural areas are classified into metropolitan counties. Others are spread throughout the numerous micropolitan statistical areas. The

U.S. Department of Agriculture The United States Department of Agriculture (USDA) is the federal executive department responsible for developing and executing federal laws related to farming, forestry, rural economic development, and food. It aims to meet the needs of comme ...

has four different systems for defining rural areas: Frontier and Remote (FAR) area codes, which define rural areas in four levels of increasing remoteness by ZIP code, Rural–Urban Commuting Areas (RUCA), Urban Influence Codes (UICs), and Rural-Urban Continuum Codes (RUCC). The

United States Department of Health and Human Services The United States Department of Health and Human Services (HHS) is a cabinet-level executive branch department of the U.S. federal government created to protect the health of all Americans and providing essential human services. Its motto is ...

has two agencies that define rural areas. The Health Resources and Services Administration addresses the shortcomings of the U.S. Census Bureau, the U.S. Office of Management and Budget, and RUCA definitions to produce a definition that is balanced between them. The

Centers for Medicare & Medicaid Services The Centers for Medicare & Medicaid Services (CMS), is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer M ...

uses its own definition for setting Medicare payment rates. CityLab defines rural areas by congressional district, based on census tracts and a machine-learning algorithm.

History

Rural America was the center of the

Populist movement Populism refers to a range of political stances that emphasize the idea of "the people" and often juxtapose this group against " the elite". It is frequently associated with anti-establishment and anti-political sentiment. The term developed ...

of the United States in the 1890s. Since the 1930s, the rural United States has largely been a stronghold for the Republican Party. A notable exception in recent times is

Vermont Vermont () is a state in the northeast New England region of the United States. Vermont is bordered by the states of Massachusetts to the south, New Hampshire to the east, and New York to the west, and the Canadian province of Quebec to ...

, a highly rural state which has elected numerous Democrats to office in the 21st century.

Demographics

Most rural counties are experiencing persistent population decline. Compared with households in urban areas, rural households had lower median household income ($52,386 compared with $54,296), lower median home values ($151,300 compared with $190,900), and lower monthly housing costs for households paying a mortgage ($1,271 compared with $1,561). A higher percentage owned their housing units “free and clear,” with no mortgage or loan (44.0 percent compared with 32.3 percent). Grants Chapel

States with the highest median household incomes in rural areas were Connecticut ($93,382) and New Jersey ($92,972) (not statistically different from each other). The state with the lowest rural median household income was Mississippi ($40,200). Among rural areas, poverty rates varied from a low in Connecticut (4.6 percent) to a high in New Mexico (21.9 percent). About 13.4 million children under the age of 18 live in rural areas of the nation. Children in rural areas had lower rates of poverty than those in urban areas (18.9 percent compared with 22.3 percent), but more of them were uninsured (7.3 percent compared with 6.3 percent). A higher percentage of "own children" in rural areas lived in married-couple households (76.3 percent compared with 67.4 percent). ("Own children" includes never-married biological, step and adopted children of the couple). As of 2016, about 7 percent of

homeless people in the United States Homelessness in the United States refers to the issue of homelessness in the United States, a condition wherein people lack a fixed, regular, and adequate residence. The number of homeless people varies from different federal government accoun ...

live in rural areas, although some believe that this is an underestimate.

Health

There are significant

health disparities Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequiti ...

between urban and

rural areas In general, a rural area or a countryside is a geographic area that is located outside towns and cities. Typical rural areas have a low population density and small settlements. Agricultural areas and areas with forestry typically are describ ...

of the United States. The per capita rate of

primary care physician A primary care physician (PCP) is a physician who provides both the first contact for a person with an undiagnosed health concern as well as continuing care of varied medical conditions, not limited by cause, organ system, or diagnosis. The term ...

s is lower in rural areas of the country (65 primary care physicians per 100,000 rural Americans, compared to 105 primary care physicians for urban and suburban Americans).Molly O'Toole
Healthcare access lagging in rural U.S.: report
Reuters (July 27, 2011). Rural Americans are also more likely than other Americans to suffer from chronic health conditions such as

diabetes Diabetes, also known as diabetes mellitus, is a group of metabolic disorders characterized by a high blood sugar level ( hyperglycemia) over a prolonged period of time. Symptoms often include frequent urination, increased thirst and increased ...

, heart disease, and

cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...

. A study published in the journal ''

JAMA Pediatrics ''JAMA Pediatrics'' is a monthly peer-reviewed medical journal published by the American Medical Association. It covers all aspects of pediatrics. The journal was established in 1911 as the ''American Journal of Diseases of Children'' and renamed i ...

'' in 2015 analyzed data on U.S.

youth suicide Youth suicide is when a young person, generally categorized as someone below the legal age of majority, deliberately ends their own life. Rates of youth suicide and attempted youth suicide in Western societies and other countries are high. You ...

rates from 1996 to 2010. It found that the rates of suicides for rural Americans aged 10 to 24 was almost double the rate among their urban counterparts. This was attributed to social isolation, greater availability of guns, and difficulty accessing healthcare. Notwithstanding the economic and health challenges, a 2018 survey of rural adults found a majority felt they were better off financially than their parents at the same age. They thought their children would also experience such improvement. Forty percent said their lives came out better than they expected.

Notes

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External links

* tp://ftp.hrsa.gov/ruralhealth/Eligibility2005.pdf List of Rural Counties and Designated Eligible Census Tracts in Metropolitan Countiesfrom the Office of Rural Health Policy Populated places in the United States Rural geography