Rural health in behavioral medicine: introduction to the special series

Approximately 60 million people—or one in five individuals—reside in rural areas throughout the United States (US Census Bureau, 2017). Rural is much more than just a geographical designation but encompasses a host of interrelated social, cultural, and behavioral factors which bear on the health and well-being of its residents. Research consistently indicates that those living in rural areas experience worse health outcomes across numerous diseases and conditions including cancer, depression, diabetes, heart disease, stroke, and suicide (Bolin et al., 2015; Coughlin et al., 2019; Yaemsiri et al., 2019). The reasons for these negative outcomes are many and may include greater travel burden, lack of health insurance, provider shortages, fewer educational resources, limited occupational opportunities, greater poverty, poor infrastructure, social isolation, and sociocultural norms and beliefs that may de-emphasize health-related actions and behaviors in certain contexts such as quitting smoking, obtaining vaccinations, or seeking mental health treatment. Collectively, many of these overlapping risks represent what is often referred to as the rural disadvantage. While these disparities and associated explanations have been articulated many times over, researchers and public health practitioners still struggle to understand and resolve these issues. …