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Health lags in rural areas, says report

There are obvious differences between rural and urban areas of Minnesota - population, traffic - but there's one element that's strikingly different - health.

The health status of rural Minnesotans has been detailed in a report from the Minnesota Department of Health (MDH) and Office of Rural Health and Primary Care.

The report is a summary of information from 2009 statistics. It's a snapshot of key health indicators like behaviors, social and environmental health determinants.


The report starts with a list of clear disparities between rural and urban regions.

In Minnesota's rural population it was reported there are:

• Fewer people with at least some college.

• More people reported being current smokers.

• More people were uninsured.

• Lower homicide rates.

• Higher suicide rates.

• Higher mortality rates due to motor vehicle injury.

• Higher mortality rates due to pneumonia and influenza, especially in the older population.

• Higher diabetes, stroke and heart disease mortality rates.


Douglas County was grouped in the Northwest Region of the state. The area covers Kittson and Lake of the Woods counties to the north, Cass and Crow Wing counties to the east, Pope and Stevens counties to the south, and Polk and Clay counties to the west.

• Health insurance: The Northwest Region had the highest percentage of people with no health insurance in 2009, approximately 14 percent.

• Obesity: In 2004 and 2009, a higher percentage of greater Minnesotans were identified as obese - 57 percent in rural areas and 43 percent in the metro.

• Cancer: Incidence rates of all cancers were approximately equal across all regions. Statewide there were 125,539 new cases of cancer diagnosed between 2004 and 2008. In the Northwest Region, 960 cases were diagnosed.

During that same period, 45,584 deaths resulted from malignant cancer statewide; there were 348 cases in the Northwest Region.

• Population: The Northwest Region is a large area geographically and includes a population of about 544,000 people; the 2009 report reflects that 94 percent are white, 4 percent American Indian, 2 percent Hispanic/Latino, 1 percent two or more races, 1 percent Asian and 1 percent black/African American. Forty-five percent of the Northwest Region is age 45-years and older.

• Education: A lower percentage of the rural population has at least some college. In the Northwest Region, 55 percent of the population has some college, as reported in 2009.

According to the report, education is frequently used as a measure of socio-economic status (SES), which is associated with health outcomes, health behaviors, and access to health care.

• Mortality: From 2004-2008, the Northwest Region had overall mortality rates of 697 deaths per 100,000 person-years, compared to the metro (670).

• Smoking: In 2009, a higher percentage of adults in greater Minnesota reported they were currently smokers - 21 percent of men and 16 percent of women, compared to 16 percent men and 13 percent women in the metro.

• Driving While Intoxicated: The rate of DWI violations was highest in the Northwest Region, 779 cases per 100,000 people. The Northeast Region reported 755 cases from 2006-2009.

• Homicide: The metro had the highest homicide rate at 3 deaths per 100,000 people from 2006-2009; the Northwest Region reported 1.

• Motor vehicle deaths: The more rural regions had higher rates of motor vehicle injury deaths. The Northwest Region reported 16 deaths per 100,000 people from 2006-2009. Six deaths were reported in the metro during the same time frame.

• Age 65 and older: In 2009, the largest populations of 65-year-olds and older were in the Northwest, Southwest and Northeast regions. The Northwest Region reported the highest population - 14.9 percent of its population was 65 and older.


The following summary was reported about the Northwest Region:

• Mostly small rural or isolated rural population.

• Highest percentage of American Indian/Alaskan Native population.

• Fewer people with at least some college than the state average.

• High percent of population over 65.

• Highest infant mortality rate in state, but still lower than national average.

• Highest percentage of people without health insurance.

• High unintentional injury mortality rate.

• High rate of mortality due to motor vehicle injuries

• Lowest traumatic brain injury rate.

• Low unintentional injury mortality in 85 and older populations.

• High Alzheimer's disease mortality rate.



Authors noted the report is intended to generate awareness among policymakers, primary and rural health care providers, public health officials and concerned community members about the importance of examining rural and regional disparities.

"Minnesota is frequently ranked as one of the healthiest states in the nation, despite considerable differences in the health of Minnesotans in distinct regions of the state. These disparities may exist for a variety of reasons, including the rurality of the region," authors wrote.

"Regardless of their causes, the first step in eliminating disparities and improving population health is identifying where they exist."

Douglas County Public Health declined comment on the local impact of the report.

Follow Amy Chaffins on Twitter at @theosakisreview.

Amy Chaffins

Amy Chaffins is a journalist working for the Echo Press newspaper in Alexandria, Minnesota.

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