Texas A&M: Urban Americans More Likely To Follow COVID-19 Guidelines Than Rural Residents

Americans who live in rural areas are significantly less likely to wear face coverings in public, sanitize their homes and workplaces, avoid dining at restaurants and bars, or work from home, according to the findings of a Texas A&M University-led study.

In the first national study of its kind, researchers found that rural residents were far less likely to participate in seven of eight analyzed COVID-19 prevention behaviors. The two most notable behavior differences between urban and rural Americans were in wearing face coverings in public and working from home.

The findings were based on a representative survey of 5,009 American adults between May 28 and June 8, 2020 that analyzed the influence of rural status, political ideology, demographic factors, and COVID-19 experiences on self-reported adoption of preventative health behaviors.

There were also smaller, but significant differences reported in behaviors like avoiding restaurants, changing travel plans, and disinfecting home and work areas, with rural residents again being less likely to follow these recommendations. No significant differences between rural and urban-dwelling Americans were reported for measures like physical distancing, handwashing and avoiding social engagements.

The research team included Timothy Callaghan and Alva Ferdinand from the Southwest Rural Health Research Center at the Texas A&M School of Public Health. They accounted for demographic factors like age, gender, race, education and income. In the survey, they asked respondents a series of yes/no questions about preventative behaviors to prevent the spread of COVID-19. The analysis also measured respondents’ political ideology, their experiences with the virus – which could influence individual behavior – and how trusting they are of experts.

The participants also reported their ZIP codes, which were linked with rural-urban commuting area codes.

When including political ideology and social factors in their analysis, the researchers found that some factors were associated with the likelihood of following recommendations. Older respondents and people who were more concerned about COVID-19 were more likely to follow at least some of the recommendations, as were those with greater educational attainment and higher income. People with a more conservative political ideology were less likely to follow prevention guidelines, and women were more likely to follow them than men. However, living in a rural area remained a strong influence on following public health recommendations.

Given the limited access to high quality medical care in rural areas, these behaviors could lead to negative, yet avoidable, health outcomes in rural America. Finding ways to improve the adoption of COVID-19 prevention behaviors in rural areas is critical, Callaghan said, which could be achieved through targeted messaging.

“Public health efforts that consider factors like trust of medical experts and political ideology when reaching out to different groups could be key,” Callaghan said.