Rural residents are currently dying from Covid-19 at twice the rate of metropolitan residents, according to a Daily Yonder analysis.

And the rate of new infections in rural counties is 50% higher than the metropolitan rate.

This stark divergence between rural and urban areas comes as the summer surge appears to be abating. (See the report on Covid-19 in rural America last week.)

A Rural/Metropolitan Gap

Throughout most of the pandemic, the rural death rate has been equal to or slightly higher than the metropolitan death rate. (See graph above.) The parallel tracks began to diverge in early August. Since then, the weekly death rate in rural areas has grown six-fold. During the same period, the metropolitan weekly death rate increased three-fold.

Last week, the rural death rate was 4.8 per 100,000 in population, 109% higher than the metropolitan rate of 2.3 per 100,000.

There’s a similar story in rural infections. The week of August 7, the rural and metropolitan weekly infection rates were roughly equal. (See graph below.) Since August 7, the metropolitan rate climbed about 40% to its peak two weeks ago. Meanwhile, the rural infection rate grew 80% before peaking last week.

The most recent infection rates are 432 per 100,000 population for nonmetropolitan (rural) counties, and 293 per 100,000 for metropolitan counties.

The rural-urban infection gap is the most significant divergence since spring 2020, when Covid-19 infections and deaths in New York City drove up the nation’s metropolitan rates.

Health researchers have named a number of demographic and behavioral factors that could affect infection and death rates in rural areas.

Rural residents have lower vaccination rates compared to metropolitan areas. The most recent Daily Yonder analysis of vaccinations showed that 39.6% of the nation’s rural population is completely vaccinated for Covid-19. In metropolitan areas, 51.9% of the population is completely vaccinated.

Rural residents are more likely to have conditions such as respiratory or cardiovascular illness that can affect the prognosis for people who contract Covid-19. Rural residents tend to be older than urban residents.