What is Healthier: City or Rural Living?

In one of Aesop’s more familiar fables, a proud town mouse visits a country mouse and scoffs at the simple food and housing. The town mouse brings his country mouse friend to experience the finer city living, but the country mouse is horrified to find that the fine life requires mortal danger. He eventually goes home, glad to escape the fear.

This tale has been retold and referenced for centuries because there will always be those who prefer one type of life over the other and those who don’t understand the alternate view. While it might not decide which lifestyle is “better,” there is some research on the health of those living in the city versus those living in rural areas. And after all, what is more valuable than health?

City Living

For almost 100 years, the suburban population was growing faster than the urban population. People moved to the city, but then moved to the suburbs. However, recent trends show that people aren’t leaving urban areas; in fact, many heavily urban areas are filling up and running out of space.

The last US Census found that the nation’s urban population grew by 12.1 percent from 2000 to 2010. As of 2012, more than 80 percent of the US population lived in an urban area. From 2010 to 2014, Austin, Texas gained 126,000 new migrants. Denver also gained more than 100,000.

When it comes to health, there are those who argue certain lifestyles are healthier than others. Some say country life is healthier, while others maintain excellent fitness in the city. What does the research say about health as it relates to living in the city?

Air Quality

Particulate matter (PM), is the name for a “mixture of solid particles and liquid droplets found in the air,” according to the EPA. These particles range in size, some being visible, others too small to be seen. PM can be made of hundreds of different chemicals from dust, smoke, power plants, cars, etc. the smallest particles are dangerous because they can find their way deep into a person’s lungs and even into the bloodstream. These particles are generally more highly concentrated in urban areas.

Research has connected PM exposure to heart problems, decreased lung function, and worsening of asthma. Children who grow up in crowded urban neighborhoods have higher rates of asthma.

Learn about your area on www.airnow.gov.

Green Space

Most cities in the United States have good park systems, which is important for mental and physical health. Research shows that nature can restore mental capacities. Trees also help clean the air, and parks cool down the cities. They also provide a place for physical activity.

Mental Health

Cities can be stressful. City dwellers live around and are seen by many people every day, meaning appearance and behavior must always consume mental energy. Add in the traffic, parking, noise and excessive stimuli, and you get a very mentally demanding life. Other writers point to the excess of choices in the city, meaning that people must always be deciding what they are going to do with their time. The constant need for awareness can be straining and may not be what the human mind was built for.

Research suggests that city dwellers tend to have higher stress levels and more mood disorders. There is also a higher rate of psychotic illness like schizophrenia.

Studies on the brains of city-dwellers show that they have a more sensitive response to situations of stress or threat (this brain activity occurs in the amygdala). Being raised in the city may cause permanent changes to the brain that make a person more alert to stressful situations.

How to Avoid City Mental Health Issues

Exposure to nature is a well-researched way to improve mental health and restore one’s capacity to be aware of surroundings. Go to parks or leave the city occasionally to restore your mental health.


Noise pollution is an increasingly talked-about phenomenon. A combination of car horns, sirens, traffic, and a host of voices can create a loud, constant noise. Researchers from the University of Michigan claim that more than 100 million people in the United States are at risk from noise-related health problems. Noise-induced hearing loss is the main risk.


There is a significant body of research showing that cancer incidence and mortality is higher in urban populations. However, study results often conflict, and certain cancers are more prevalent in rural areas.

Germs, Disease

Are there simply more germs, disease and spread of disease in cities? Certainly, this was the case centuries ago, but nowadays it’s difficult to pin down. Public restrooms are generally designed to inhibit bacteria growth. Exposure to a greater number of people, however, increases your chances of meeting someone who is sick and therefore becoming ill yourself.

Medical Access

Quicker and easier access to hospitals and medical specialists is a big health benefit of living in a city.


  • Lower smoking and obesity rates than rural areas.
  • High rates of violent crime.


  • Tend to have the best health outcomes.
  • Lowest rates of uninsured people.
  • Longest commutes to work.


  • Higher rates of depression.
  • More poverty.
  • Not as healthy (higher rates of smoking, obesity, child poverty, teen births).
  • High rates of premature death.
  • Highest rates of uninsured people.
  • High rates of preventable hospital stays.
  • Shorter commutes to work.

Source: www.countyhealthrankings.org

Rural Living

A big problem in discussing health differences of rural and urban populations is defining each of those groups. Is suburban more urban or more rural, for example? Most studies try to define each with some sort of measurement in population density.

While country or rural living is often depicted as healthier or more natural, rural populations actually aren’t very healthy. Researchers in Wisconsin examined things like premature death, low birth weight, disease, smoking, obesity, drinking, employment, crime and other factors, and determined that 48 percent of the healthiest counties were urban or suburban, and that 84 percent of the unhealthiest counties were rural.

Several studies show that suicide rates are actually higher in rural areas, as are rates of fatal overdoses, including overdoses related to opioids. Premature death in general is higher in rural America, in part because healthcare is more difficult to access.

In fact, a new study from the CDC shows that of the five leading causes of death, people living in rural areas are more likely to die from all of them than are their urban counterparts. This includes heart disease, cancer, unintentional injuries, respiratory disease and stroke.

Sources: University of Wisconsin Population Health Institute, scientificamerican.com, www.ncbi.nlm.nih.gov, healthland.time.com


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