The urban-rural health divide

Differences in health outcomes between urban and rural areas have long been observed. In England and Wales the pattern is one of better health and mortality outcomes in rural than in urban areas. This study explores these patterns in more depth, recognising an urban to rural health ‘gradient’ disrupted by a ‘capital city effect’.

Moving beyond a simple two-fold divide between rural and urban areas, we have found that, after controlling for socio-demographic differences in population composition, the greater the level of urbanisation, the poorer the observed health and mortality outcomes. The one exception to this is the ‘capital city’ effect experienced in London, where mortality and health outcomes are better than would be expected given the degree of urbanisation. These findings have been found to be resilient to the precise urban-rural classification used and to the spatial scale at which the analysis is undertaken. We have also found differences in the way that the urban-rural health gradient operates for men and for women. 

Allan, R., Williamson, P., & Kulu, H. (2017). Unravelling urban-rural health disparities in England. POPULATION SPACE AND PLACE, 23(8). doi:10.1002/psp.2073