Rural Versus Urban Alabama Comparisons
Click on the following subjects to view or print brief reports comparing Rural versus Urban Alabama on these subjects. See the Technical Notes near the end of this page for a description of the Rural and Urban areas used in these comparisons or for explanations of other technical details presented in these reports.
Note that reports on new subjects will be added to this site periodically and existing subjects will be updated with more current information when this becomes available. Please CONTACT ARHA to suggest a subject or subjects which you would like to see added to this site.
Healthcare Subjects:
Mortality Subjects:
Motor Vehicle Accident Mortality
Natality Subjects:
Births Occurring Outside Mother's Resident County
Births With Less Than Adequate Prenatal Care
Other Subjects:
The following reports are a joint product of the Alabama Rural Health Association and the Office of Primary Care and Rural Health in the Alabama Department of Public Health. These reports, which are developed through partial funding by the National Organization of State Offices of Rural Health and the National Rural Health Association, present information on selected health-related factors for the U.S., Alabama, Alabama's rural counties, Alabama's urban counties, the eight regions of the Alabama Rural Action Commission, the Black Belt Action Commission, Alabama's Appalachian Region counties, and Alabama's Delta Region counties.
Indicators of Health Status in Alabama Reports:
Heart Disease Mortality (October 2007)
Cancer Mortality (October 2007)
Cerebrovascular Diseases (Stroke) Mortality (October 2007)
Accident Mortality (October 2007)
Motor Vehicle Accident Mortality (July 2008)
Diabetes Mortality (October 2007)
The following is a series of reports that have been developed to assist those seeking to improve health care in rural Alabama. Each report includes information on 68 different rural health status indicators, comparing the rural and urban counties in the Alabama Rural Action Commission regions and the Black Belt Action Commission region to the State of Alabama and the United States (where possible). Regional reports can be used in conjunction with the “County Specific Data” in identifying specific health related concerns at the county level. While this series of reports was primarily developed to assist those volunteering to work with the Alabama Rural Action Commission and Black Belt Action Commission, this information should be of value to anyone with an interest in Alabama’s rural health care.
Selected Health Status Indicators Reports:
Alabama Rural Action Commission Region Rororts:
North Alabama Action Commission (Region 1)
West Alabama Action Commission (Region 2)
Central Alabama Action Commission (Region 3)
East Alabama Action Commission (Region 4)
South Central Alabama Action Commission (Region 5)
Tombigbee Action Commission (Region 6)
Wiregrass Action Commission (Region 7)
Southwest Alabama Action Commission (Region 8)
Rural/Urban Areas:
For analytical purposes, a classification of areas as being "rural" or "urban" is desired at the county level. This is because most data is not available at sub-county levels, but is available at the county level. Prior to June 2003, the Alabama Rural Health Association used the White House's Office of Management and Budget (OMB) classification of counties as being in or not in Metropolitan Statistical Areas (MSAs) in identifying rural or urban status. Those counties which were included in MSAs were classified as "urban" and those which were not in MSAs were classified as "rural." A re-determination of counties included in MSAs was announced by OMB in June 2003 and several Alabama counties which must be regarded as being "rural" were included in MSAs in this re-determination. This made the development of a more acceptable method for classifying counties as "rural" or "urban" necessary.
The method developed and used by the Alabama Rural Health Association uses four variables which are generally accepted as being characteristic of "rural" areas in a formula with each variable accounting for 25 of a possible 100 points. The higher the overall score, the more "rural" a county is considered as being. The four variables are as follows:
|
1. |
The percentage of total employment in the county which is comprised by those employed by the public elementary and secondary school systems. Since the local school system is the largest single employer in many rural counties, the higher the percentage of employment in school system(s) in relation to total employment, the more rural a county is considered.
|
|
The dollar value of agricultural production per square mile of land. The greater the value of agricultural production per square acre, the more rural the county is considered.
|
|
|
3. |
The population per square mile of land. The fewer the number of persons per square mile, the more rural a county is considered.
|
|
4. |
An index is used to assign a score to counties which considers the population of the largest city in the county, the populations of other cities in the county, and the population of cities which are in more than one county. Counties where the largest incorporated place has a population of under 2,500 are assigned the highest index score of 25. Counties where the largest incorporated place has a population of 50,000 or more are assigned the lowest index score of 0. |
Using this methodology, 55 Alabama counties are classified as "rural" and 12 are classified as "urban." The "rural" counties are separated into two groupings for more specific analysis. One grouping is based upon the degree to which the counties were considered to be rural. These groupings are referred to as "Highly Rural" and "Moderately Rural." The second grouping divides the "rural" counties by geographic region. Those in the Appalachian Region of North Alabama are referred to as "Rural North" and those in South Alabama are referred to as "Rural South." The population demographics within these two regions vary significantly which makes analysis of the separate regions informative. Counties included in the groupings are as follows:
|
Rural counties |
Autauga, Baldwin, Barbour, Bibb, Blount, Bullock, Butler, Chambers, Cherokee, Chilton, Choctaw, Clarke, Clay, Cleburne, Coffee, Colbert, Conecuh, Coosa, Covington, Crenshaw, Cullman, Dale, Dallas, DeKalb, Elmore, Escambia, Fayette, Franklin, Geneva, Greene, Hale, Henry, Jackson, Lamar, Lawrence, Limestone, Lowndes, Macon, Marengo, Marion, Marshall, Monroe, Perry, Pickens, Pike, Randolph, Russell, St. Clair, Sumter, Talladega, Tallapoosa, Walker, Washington, Wilcox, and Winston.
|
|
Highly Rural counties |
Barbour, Bibb, Blount, Bullock, Butler, Cherokee, Choctaw, Clarke, Clay, Cleburne, Coffee, Conecuh, Coosa, Covington, Crenshaw, Cullman, Dallas, DeKalb, Escambia, Fayette, Franklin, Geneva, Greene, Hale, Henry, Jackson, Lamar, Lawrence, Lowndes, Macon, Marengo, Marion, Marshall, Monroe, Perry, Pickens, Pike, Randolph, Sumter, Washington, Wilcox, and Winston.
|
|
Moderately Rural counties |
Autauga, Baldwin, Chambers, Chilton, Colbert, Dale, Elmore, Limestone, Russell, St. Clair, Talladega, Tallapoosa and Walker.
|
|
Rural North counties |
Bibb, Blount, Chambers, Cherokee, Chilton, Clay, Cleburne, Colbert, Coosa, Cullman, DeKalb, Elmore, Fayette, Franklin, Hale, Jackson, Lamar, Lawrence, Limestone, Macon, Marion, Marshall, Pickens, Randolph, St. Clair, Talladega, Tallapoosa, Walker, and Winston.
|
|
Rural South counties |
Autauga, Baldwin, Barbour, Bullock, Butler, Choctaw, Clarke, Coffee, Conecuh, Covington, Crenshaw, Dale, Dallas, Escambia, Geneva, Greene, Henry, Lowndes, Marengo, Monroe, Perry, Pike, Russell, Sumter, Washington, and Wilcox.
|
|
Urban counties |
Calhoun, Etowah, Houston, Jefferson, Lauderdale, Lee, Madison, Mobile, Montgomery, Morgan, Shelby, and Tuscaloosa.
|
|
Age-Adjusted Mortality Rate |
Age-adjusting is a method of calculating mortality rates which remove differences between the ages of the populations in different geographical areas or in the same geographical area for different time periods. It is possible that a mortality rate for a geographical area may be higher than that for another area simply because the area has a greater proportion of elderly in its population and mortality naturally occurs at a higher rate as people get older. This can also be responsible for different mortality rates for the same geographical area during different time periods. In age-adjusting, mortality rates for specific age groups (age-specific mortality rates) are calculated using the actual population of the geographical area. These age-specific rates are then applied to a standardized population (The 2000 U.S. Standard Population is used in these reports.) to estimate the number of deaths that would have occurred in that standard population and the mortality rate using this expected number of deaths is calculated. This is the age-adjusted mortality rate. Age-adjusted rates remove age difference as a factor in comparing the rates, but is only relative in usage. The rate does not represent the actual number of deaths occurring in the geographical area. It can only be used to compare the rates of different geographical areas or the same area for different time periods to determine which is greater when age difference is removed as a factor.
|
|
Crude Mortality Rate |
The "Crude Mortality Rate" is usually simply referred to as the "Mortality Rate." This rate, as used in these comparison reports, will apply to selected causes of death. When used in reference to causes of death, this rate is specified as the number of deaths per 100,000 persons in the population of interest.
|
Return to the Top of This Page
Home Members, Only Mission/History Join ARHA Officers/Committees
Publications/Studies Statistics Rural Health Grants Announcements Legislation
ARHA Calendar What is Rural? NRHA Alerts Awards/Success Stories Links
Rural Health Classifieds Contact ARHA