Rural Americans – particularly men – are expected to live significantly shorter, less healthy lives than their urban counterparts, according to our research, recently published in the Journal of Rural Health.

We found that a 60-year-old man living in a rural area is expected on average to live two fewer years than an urban man. For women, the rural-urban gap is six months.

A key reason is worse rates among rural people for smoking, obesity and chronic conditions such as high blood pressure and heart disease. These conditions are condemning millions to disability and shortened lives.

What’s more, these same people live in areas where medical care is evaporating. Living in rural areas, with their relatively sparse populations, often means a shortage of doctors, longer travel distances for medical care and inadequate investments in public health, driven partly by declines in economic opportunities.

Our team arrived at these findings by using a simulation called the

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