Straight, No Chaser: The Health Risks of Urban vs. Rural Living


What’s your flavor, city vs country living? Regardless as to wear you live your life, each decision comes with defined risks to your health, and yes, these effects go beyond the risks of different forms of trauma in each location. To extend the scenario globally, it is an amazing fact that for the first time in human history, it is estimated that more people worldwide live in urban areas than in rural ones. In today’s Straight, No Chaser, we evaluate a few health facts that speak to the relative value of city vs. country living.
It is important to understand that some considerations are more reflective of socioeconomic status than urban vs. rural dwelling. Notably, poverty is a cause of poor health and limits access to health prevention and medical care, regardless of the location of one’s home. There are strong correlations between lower income and higher death rates (mortality) across the board. Poverty, not urban living per se, increases the likelihood of encountering violence, increases the likelihood of experiencing violence and child abuse.


More specific to inner-city urban living, in 1997 the American College of Physicians identified specific health problems most commonly associated with US inner cities, labeling this disadvantage as an “urban health penalty.” They included the following:

  • Drug abuse
  • HIV infection
  • Teenage pregnancy
  • Violence

Simply put, addressing this set of issues requires addressing the root causes of poverty. It is also of note that access to care presents as significant problems in both urban and rural communities, but for different reasons. Rural communities are likely to have access considerations due to geographic and physician shortages, and urban communities are more likely to have barriers prevent accessing available resources.


There are defined differences in health and health risks, based on living in the city vs. a rural location. For example, those that live in cities:

  • Actually have less of a risk of becoming obese;
  • Are less likely to die of an accident;
  • Are more likely to be lactose tolerant.
  • Are more likely to develop asthma, have allergies and suffer from dry eyes;
  • Are more likely to have better TB resistance;
  • Have a much lower risk of suicide;
  • Have troubled circadian rhythms and disturbed sleep; and
  • Report a more pleasant and healthy old age.

Finally it is worth noting that inner city environments produce specific public health threats. These include the following:

  • Homelessness,
  • Increased availability of illicit drugs,
  • Increased spread of HIV infection and treatment-resistant tuberculosis
  • Presence of higher concentration of certain types of pollutants, such as carbon monoxide and molds.

At the end of the day, these risks may or may not result in health problems for you individually. It is important for you to be aware of the risks in order to limit your exposure. Be empowered, not crippled, by this information, and enjoy the rest of this wonderful time of the year, regardless of your environment.

Feel free to ask your SMA expert consultant any questions you may have on this topic.
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