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Rural Population - Ages 65+
Rural Population - Ages 65+ in United States
United States

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United States Value:


Percentage of adults ages 65 and older who live in a rural area

Rural Population - Ages 65+ in depth:

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Rural Population - Ages 65+ by State

Percentage of adults ages 65 and older who live in a rural area

Rural Population - Ages 65+ Trends

Percentage of adults ages 65 and older who live in a rural area

Trend: Rural Population - Ages 65+ in United States, 2023 Senior Report

Percentage of adults ages 65 and older who live in a rural area

United States

 U.S. Census Bureau, American Community Survey

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About Rural Population - Ages 65+

US Value: 23.3%

Top State(s): Vermont: 66.7%

Bottom State(s): New Jersey: 6.1%

Definition: Percentage of adults ages 65 and older who live in a rural area

Data Source and Years: U.S. Census Bureau, American Community Survey, 2021

Suggested Citation: America's Health Rankings analysis of U.S. Census Bureau, American Community Survey, United Health Foundation,, accessed 2023.

Residents of rural areas tend to be older than their urban counterparts — 19% of the rural population is 65 years or older — and are at greater risk for poor health outcomes. Rural areas are often under-resourced and face unique challenges with respect to the social determinants of health. These challenges are associated with a preventable hospitalization rate 40% higher than that of urban populations and a mortality rate 23% higher. Rural residents also tend to have higher rates of cigarette smoking, high blood pressure and obesity. 

The demographics of the older adult population are shifting. Historically, women have lived longer than men; at last count, 52% of the older rural population was female. While this trend will likely continue, the age gap between men and women is expected to shrink. Rural areas are less ethnically diverse, with the white population accounting for 92.7% of adults ages 65 and older. Older Black and Hispanic adults make up less than half the proportion they do in urban populations, accounting for 4.5% and 2.3% of rural demographics, respectively. 

Older adults living in rural areas face unique challenges in staying healthy. The health of rural populations is impacted by a complex mix of economic, social, racial, ethnic and geographic factors. Financial insecurity, remote location, lower socioeconomic status and higher rates of unhealthy behaviors contribute to the significant health disparities between rural and urban populations. Furthermore, geographic isolation and health care workforce shortages make lack of access to care a very serious issue for rural populations. As rural residents age, their health needs increase, and their already-limited access to necessary services may decrease if they have mobility impairments or rely on caregivers for transportation. In 2020, there were an estimated 53 million caregivers in the United States, about half of whom were taking care of a parent or a parent-in-law. Most caregivers of older adults are spouses or adult children, but decreasing fertility and marriage rates and increasing divorce rates mean that many baby boomers will not have partners or children who can help them age independently. This will put new and unique stresses on the health care system and challenge how our society currently cares for older adults.

Addressing rural health disparities requires special policy considerations at all levels of the government and community.  

To reduce health disparities in rural areas, the Centers for Disease Control and Prevention (CDC) recommends that health care providers focus on the following areas for improvement: 

Older adults can use the National Council on Aging’s BenefitsCheckUp tool to find out more about what kind of assistance they may be eligible for and the Administration on Aging’s Eldercare Locator to find programs near them.

AARP and National Alliance for Caregiving. “Caregiving in the United States 2020.” Washington, D.C.: AARP, May 14, 2020.

Dowell, Deborah, Kathleen R. Ragan, Christopher M. Jones, Grant T. Baldwin, and Roger Chou. “CDC Clinical Practice Guideline for Prescribing Opioids for Pain — United States, 2022.” MMWR. Recommendations and Reports 71, no. 3 (November 4, 2022): 1–95.

Johnston, Kenton J., Hefei Wen, and Karen E. Joynt Maddox. “Lack Of Access To Specialists Associated With Mortality And Preventable Hospitalizations Of Rural Medicare Beneficiaries.” Health Affairs 38, no. 12 (December 1, 2019): 1993–2002.

Smith, Amy Symens, and Edward Trevelyan. “The Older Population in Rural America: 2012–2016.” American Community Survey Reports. Washington, D.C.: U.S. Census Bureau, 2018.

U.S. Department of Housing and Urban Development, Office of Housing, Office of Multifamily Housing Programs. “Great Places to Call Home: A Representative Portfolio of HUD’s Section 202 Program.” Washington, D.C., 2009.

Vespa, Jonathan, Lauren Medina, and David M. Armstrong. “Demographic Turning Points for the United States: Population Projections for 2020 to 2060.” Current Population Reports. Washington, D.C.: U.S. Census Bureau, February 2020.

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