A life out in the countryside away from congested cities is often viewed as a safe, wholesome, and healthy way to exist. But a recent study indicates otherwise, by finding that over the last 40 years the life expectancy of city folk has grown more than those who live out in the boonies — and this unrecognized gap is only going to widen.

This disparity between rural and urban longevity was such that the further out in the countryside a person lived the less their life expectancy increased, reported lead author, Gopal Singh of the U.S. Health Resources and Services Administration, in the American Journal of Preventive Medicine. “We’ve had information about life expectancy by gender, racial or ethnic, and socioeconomic groups, but to our knowledge, nobody has looked at how disparities in life expectancy have changed over time — whether they’re widening or narrowing,” Singh explained in a press release. “In fact, disparities have been increasing over the past two decades as opposed to the last four.”

Singh and co-author, Mohammad Siahpush of the University of Nebraska, discovered that in 2005 to 2009, people who resided in large metropolitan areas had a life expectancy of 79.1 years in comparison to 76.9 and 76.7 years, which were the respective average life spans of people in small urban towns and rural areas during the same period. Back in 1969 to 1971, city life expectancy was less than half a year longer than nonmetropolitan areas. This gap increased to two years between 2005 and 2009. To put it in perspective, the authors pointed that rural poor and rural blacks currently experience “survival probabilities” that urban rich and urban whites benefited from four decades ago.

The U.S. has enjoyed a general increase in life expectancy from 70.8 years in 1970 to 78.7 years in 2010, according to the study. While numerous factors, such as racial discrepancy, play into some benefitting from this increase more than others, Singh noted that rural residents “remain at a higher risk of mortality from major chronic conditions and injuries.” Accidents, cardiovascular disease, chronic lung disease, and lung cancer explained 70 percent of the rural-urban difference in life expectancy in 2005 to 2009. These illnesses also accounted for a 54 percent discrepancy between the urban rich and rural poor during the same period.

“When compared to urban areas, rural areas have higher rates of both smoking and lung cancer, along with obesity, yet reduced access to health care services. Additionally, rural residents have a lower median family income, higher poverty rate and fewer have college degrees,” Singh explained. The disproportionate number of people living in urban areas — 83 percent — creates a shift in priority as far as geography goes, he added. “There’s always a temptation to take public health resources away from rural areas and focus on where people actively live, which would reduce the national disease burden but cause even greater rural–urban disparities in health and life expectancy.”

One example of this unequal allocation of resources is a report last year released by the Patient-Centered Outcomes Research Institute, which found that the 62 million Americans who live in rural areas lack adequate access to trauma care — as evidenced by a higher death rate from unintentional injuries. Another study in the International Journal of Epidemiology posed that differences in access to health services and factors that are conducive to living a healthy lifestyle might explain the higher risk of Alzheimer’s disease they found in affluent countries when people lived in a rural setting early in life.

Source: Singh G K, Siahpush M. Widening Rural–Urban Disparities in Life Expectancy, U.S., 1969–2009. American Journal of Preventative Medicine. 2014.