MANKATO — A report released Tuesday shows persistent, and in some cases widening, disparities among rural and urban residents when it comes to the most common preventable early deaths.
The U.S. Centers for Disease Control and Prevention report analyzed data from 2010-2022 for cancer, chronic lower respiratory disease, heart disease, stroke and unintentional injury fatalities.
Rural Minnesotans were more likely to die early in four of the five leading causes, according to the report.
Minnesota counties in rural areas had a 4% early death rate from cancer in 2022, whereas urban counties had no more cancer deaths than would be expected based on benchmarks. Macarena Garcia, senior health scientist at the CDC’s Office of Rural Health, attributed the gap to screening, prevention and treatment being more accessible in urban areas.
“That means people go without preventive services (in rural areas),” she said during a presentation Monday ahead of Tuesday’s data release.
Among the various factors contributing to the gap, said local researcher Paul Force-Emery Mackie, workforce shortages in rural areas loom large.
“We talk about stigma, that’s important. Financial resources are important, but one unique deep challenge for decades has been around workforce,” he said. “Why do we have so much trouble getting people in rural communities?”
Mackie is a professor at Minnesota State University and serves as associate director of the The Blue Cross and Blue Shield of Minnesota Center for Rural Behavioral Health. His research includes studies looking into rural recruitment and retention challenges.
The most significant predictor of what led people to seek work in rural settings, he found, is whether the worker was from a rural area.
“Not many said I grew up in a very urban area and now they live in a rural area,” he said.
This connection between home areas and preferred career settings could be valuable to academic programs and workplaces. Identifying students and workers who are interested in behavioral health or other health fields and have a rural background could steer them toward those settings.
Another predictor of careers spent in rural settings was whether the worker had an internship, residency or training program set in a rural area. The idea behind some health care residency programs, for example, is to introduce an aspiring practitioner to a rural setting in the hopes they’ll stick around long term.
Finding solutions to these workforce challenges in rural areas is very much a topic of interest for the Center for Rural Behavioral Health and other organizations, Mackie said. As a past president and current board member at the National Association for Rural Mental Health, he pointed out it was hosting a webinar Tuesday to discuss recruitment and retention strategies at rural behavioral health employers.
“We do know what the problems are, but what we need to keep working on are the solutions,” Mackey said.
Among the five leading causes of premature death, the biggest gap in rates between Minnesota’s urban and rural areas in 2022 was chronic lower respiratory disease. Rural areas had a 24% premature death rate, compared to just 2% in urban areas.
Urban areas had no more premature heart disease deaths above the expected threshold, while rural areas had 7% more. Unintentional injuries, mainly driven by drug overdoses, were about even between the two settings. Rural areas had a 59% rate and urban areas a 56% rate — fentanyl has been driving an uptick in overdoses in Minnesota.
The only leading premature death rate in which rural areas had lower rates than urban areas was strokes, a 10% to 19% difference.