A Comparison of the Rural‐Urban Mortality Differential for Deaths From All Causes, Cardiovascular Disease and Cancer*

ABSTRACT Using a nine category continuum of residence ranging from major metropolitan counties of one million or more to isolated rural counties with las than 2,500 residents, the data presented indicate that although ruralurban differentials in mortality narrowed over the decade of the 1970s, by 1980 non‐metropolitan counties continuedto have crude death rates that were significantly higher than metropolitan counties for deaths from all causes, cardiovascular disease, and cancer. A detailed examination of directly standardized rates reveals that virtually all of the rural‐urban mortality differential is due not to residence per se , but to differences in demographic structure, particularly age composition. Rural areas have an age distribution more heavily skewed toward the older ages where the probability of death is higher. The implications of the findings for broad‐based rural health care policy are discussed with an emphasis on the need to consider the special health and service needs ofan aging population.