Rural/urban differences in self-rated health: Examining the roles of county size and metropolitan adjacency

This research explored the roles of 'rurality' - nonmetropolitan county population size and adjacency to metropolitan areas - on self-rated health among a nationally representative sample of US adults. Using seven years of pooled individual level data from the Behavioral Risk Factor Surveillance System and county-level data from the County Characteristics survey, we found that residents of remote rural counties have the greatest odds of reporting bad health and that the significant differences in self-rated health between metropolitan residents and residents of rural areas can be entirely explained by rural structural disadvantage, including higher rates of unemployment and population loss and lower levels of educational attainment.