title: Rural-urban disparities in the prevalence of diabetes and coronary heart disease.
abstract: OBJECTIVE
  To examine the rural-urban differences in the prevalence of diabetes and coronary heart disease, and the extent to which they are explained by the presence of established risk factors including poverty.
  
  
  METHODS
  Cross-sectional study of more than 214,000 respondents using data from the US Centers for Disease Control and Prevention's (CDC's) 2008 Behavioral Risk Factor Surveillance System.
  
  
  METHODS
  Logistic regression models were utilized; prevalence odds ratios with corresponding confidence intervals and P-values are provided.
  
  
  RESULTS
  The crude prevalence rates of diabetes and coronary heart disease were 8.6% (P = 0.001) and 38.8% (P < 0.001) higher among respondents living in rural areas compared with urban areas, respectively. The higher prevalence in rural areas of many of the common risk factors for these conditions, including poverty (P < 0.001), obesity (P < 0.001) and tobacco use (P < 0.001), may contribute to these findings. After controlling for these and other risk factors, the prevalence of diabetes was lower among respondents living in rural areas [prevalence odds ratio (POR) = 0.94, P = 0.032], but the prevalence of coronary heart disease was higher (POR = 1.09, P = 0.011).
  
  
  CONCLUSIONS
  The higher prevalence of diabetes and coronary heart disease in rural populations in the USA presents a formidable public health challenge. It exacerbates many of the pre-existing rural health disparities, including a lack of access to financial resources and primary care providers.
authors.affiliation: Department of Community and Family Medicine, Dartmouth Medical School, Maine Dartmouth Family Medicine Residency, 4 Sheridan Drive, Fairfield, ME 04937, USA. aoconnor@mainegeneral.org
authors.forename: A
authors.initials: A
authors.lastname: O'Connor
authors.forename: G
authors.initials: G
authors.lastname: Wellenius
mesh_terms: D000293:Adolescent; D000328:Adult; D003327:Coronary Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011203:Poverty; D015995:Prevalence; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data*; D055815:Young Adult