Approximately 97% of United States' land area is within rural counties, and 60 million people reside in these areas.
Demographics
Most rural counties are experiencing persistent population decline. Compared with households in urban areas, rural households had lower median household income, lower median home values, and lower monthly housing costs for households paying a mortgage. A higher percentage owned their housing units “free and clear,” with no mortgage or loan. States with the highest median household incomes in rural areas were Connecticut and New Jersey . The state with the lowest rural median household income was Mississippi. Among rural areas, poverty rates varied from a low in Connecticut to a high in New Mexico. 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, but more of them were uninsured. A higher percentage of "own children" in rural areas lived in married-couple households.. As of 2016, about 7 percent of homeless people in the United States live in rural areas, although some believe that this is an underestimate.
There are significant health disparities between urban and rural areas of the United States. The per capita rate of primary care physicians is lower in rural areas of the country. Rural Americans are also more likely than other Americans to suffer from chronic health conditions such as diabetes, heart disease, and cancer. A study published in the journal JAMA Pediatrics in 2015 analyzed data on U.S. youth suicide rates from 1996 to 2010. It found that the rates of suicides for rural Americans age 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. Not withstanding 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.
Definitions
Two major official definitions are produced by the Census Bureau and the Office of Management and Budget. The Census Bureau definition is by census block, and policy experts note that it classifies much suburban area as rural. The OMB definition is by county and classifies some rural areas into metropolitan counties. The USDA has three different systems for defining rural areas: Urban Influence Codes, Rural-Urban Continuum Codes, and Rural–Urban Commuting Areas. The Centers for Medicare & Medicaid Services has its own definition used for setting Medicare payment rates. The Health Resources and Services Administration addresses the shortcomings of the Census Bureau, OMB, and RUCA definitions to produce a definition that is balanced between them. Another official definition is the USDA's Frontier and Remote Area Codes, which define rural areas in four levels of increasing remoteness by ZIP Code. CityLab defines rural areas by congressional district, based on census tracts and a machine-learning algorithm.
