New Growth

Defining "rural"

Depending on who you're talking to, it can be difficult to define exactly what we mean when we use the word "rural". When thinking of a "rural" setting, we may picture farms, ranches, villages, small towns, and open spaces. However, when it comes to establishing a definitive difference between rural and urban places, researchers and policymakers are at the mercy of a dizzying array of definitions from various entities. This usually leads to unnecessary confusion and unwanted mismatches in program eligibility.

Rural health professionals share their insights

Providers truly know their patients & vise-versa. This helps foster a relationship with trust (both ways). Often times, providers have followed and/or treated their patients from birth to old age.

— Training Attendee (Florence, SC)

The fact that there are so many different definitions shows the reality that rural and urban are multidimensional concepts. In simple terms: it's not easy to make clear-cut distinctions between the two. Is population density the defining concern, or is it geographic isolation? Is it small population size that makes it necessary to distinguish rural from urban? If so, how small is rural? Because so many people in the U.S. live in areas that are not clearly rural or urban, seemingly small changes in the way rural areas are defined can have large impacts on who and what are considered rural. As many agencies, researchers, and policymakers have discovered, the key is to use a rural-urban definition that best fits the needs of a specific activity, initiative, or effort. 

Check out the resources below for more information on the meaning of "rural"!

SC Census places map.PNG

Census Bureau

The Census Bureau defines “rural” as any population, housing or territory not in an urban area. The Census Bureau focuses on defining urban areas through the use of population density and census block groupings, rather than defining rural areas. “Urban areas” consist of areas with a population of 50,000 or more people OR a core census block group with at least 1,000 people per mile with the surrounding census blocks containing an overall density of at least 500 per square mile. In 2000, the Census added “urban clusters”, defined as having a population of at least 2,500 but less than 50,000. Therefore, rural populations are everything outside of “urban areas” and “urban clusters”.

OMB rural SC map.PNG

Office of Management & Budget

The Office of Management and Budget (OMB) classifies statistical areas as metropolitan (metro), micropolitan, or neither based on high population concentrations and degree of social and economic integration (measured by commute to work). According to the OMB, a Metro area contains a core urban area of 50,000 or more population and a Micro area contains an urban core of at least 10,000 (but less than 50,000) population. All counties that are not part of a Metropolitan Statistical Area (MSA) are considered rural. Micropolitan counties are considered non-Metropolitan or rural along with all counties that are not classified as either Metro or Micro

ERS RUCA rural SC map.PNG

USDA Economic Resource Service

The Rural-Urban Commuting Area codes (RUCAs), used by the USDA’s Economic Resource Service (ERS), classify U.S. census tracts using measures of population density, urbanization, and daily commuting. The most recent RUCA codes are based on data from the 2010 decennial census and the 2006-10 American Community Survey. The classification contains two levels. Whole numbers (1-10) delineate metropolitan, micropolitan, small town, and rural commuting areas based on the size and direction of the primary (largest) commuting flows. These 10 codes are further subdivided based on secondary commuting flows, providing flexibility in combining levels to meet varying definitional needs and preferences.  

What makes rural settings unique and different?

What is Rural? Challenges and implications of definitions that inadequately encompass rural people and places

Bennett, Borders, Holmes, Kozhimannil, & Ziller, 2019

Monitoring and improving rural health is challenging because of varied and conflicting concepts of just what rural means. Federal, state, and local agencies and data resources use different definitions, which may lead to confusion and inequity in the distribution of resources depending on the definition used. This article highlights how inconsistent definitions of rural may lead to measurement bias in research, the interpretation of research outcomes, and differential eligibility for rural-focused grants and other funding. The authors make specific recommendations on how policy makers and researchers could use these definitions more appropriately, along with new definitions, to better serve rural residents. The authors also also describe concepts that may improve the definition of and frame the concept of rurality.

Life in Rural America - Part II

This "Life in Rural America-Part II" report is based on a survey conducted for NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health. The survey is the second in the series Life in Rural America, and it covers rural Americans’ personal experiences with health, social, civic, and economic issues in their local communities. It was conducted January 31-March 2, 2019, among a nationally representative, probability-based telephone (cell and landline) sample of 1,405 adults ages 18 or older living in the rural United States.

Life in Rural America - Part I

This “Life in Rural America” report is based on a survey conducted for National Public Radio, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health. The survey was conducted June 6 – August 4, 2018, among a nationally representative, probability- based telephone (cell and landline) sample of 1,300 adults ages 18 or older living in the rural United States. The purpose of this survey was to understand the current views and experiences of rural Americans on economic and health issues.

Find out more on SC rural health needs below!

Rural Health information hub

Introduction to SC Rural Health (2018)

SC Office of rural health

Presentation on the Rural Health Action Plan (2018)

University of south Carolina school of medicine

Presentation on Rural Health Initiatives (2017)