U.S. is suffering from a chronic disease endemic, but its prevalence and challenges are more extreme for rural folks

Chronic illness are prevalent across the U.S.
(Adobe Stock photo)

A lack of health care access, poverty and limited fresh food options means many rural Americans face a more intense battle combating chronic illnesses, many of which have become alarmingly common in the U.S. Eli Saslow of The New York Times reports, "Americans now spend more years living with chronic disease than people in 183 other countries in the World Health Organization — a reality that Robert F. Kennedy Jr. framed as a 'national crisis' in his first weeks as health secretary."

The daily work life of Sam Runyon, a traveling home health nurse in West Virginia, highlights how prevalent chronic health issues are in some rural communities. "All 31 patients in her caseload were under 65 years old, and yet each had at least one of the chronic diseases that had become endemic in the United States," Saslow writes. Runyon treats patients throughout Mingo County, "where the average life expectancy has been dropping steadily for a decade to 67 years old."

The prevalence of chronic disease deaths isn't unique to rural residents. "Death rates are up 25% nationally from diabetes, 40% from liver disease, 60% from kidney disease, 80% from hypertension and more than 95% from obesity," Saslow explains. However, rural residents can lack treatment options and financial resources that help counter chronic disease progression.

Joe Miller, 48, is one of Runyon's patients fighting chronic illness, poverty and a poor lifestyle history that can be common in many rural communities. Saslow writes, "Joe was lying shirtless on his bed, immobilized from hip pain as his pit bull chewed his socks. On his night stand was a bowl of macaroni and cheese, a box of salt. . . . [His wife] was dead of a heart attack in her 40s, and he was struggling with depression and closing in on 300 pounds with dangerously high cholesterol. . ."

Like many small towns, there is only one grocery store in Mingo County and produce is expensive, but ultra-processed foods such as soda and frozen pizza are plentiful. Health problems like Joe's have become more common among working-class Americans who are "dying at higher rates than they were 20 years earlier," Saslow adds. "People in the country’s poorest places were now almost twice as likely to develop chronic disease as those who lived in wealthy, urban centers on the coasts. . ."