Rural America and COVID-19 in 6 Charts

Posted by Sarah Hubbart on September 27, 2021

Rural America and COVID-19

The COVID-19 pandemic continues to loom large, in nearly every aspect of our lives.

Back in March 2020, we outlined a few key sources of uncertainty about the pandemic. The ongoing recovery efforts also landed at the top of our spring 2021 ag policy watchlist.

The development and distribution of the COVID-19 vaccination marked a significant step in that recovery process. The number of COVID-19 cases and the vaccination rate in rural areas continue to be important numbers to watch as we consider the outlook for the farm (and macro) economy.

As of September 21, 55% of the U.S. population is fully vaccinated against COVID-19 and 65% have received at least one dose. The vaccination rate in rural America is a complicated situation. But it is also one that has provided a lot of data to consider.

About 60 million people (19.3% of the country’s total population) live in rural counties. This significant segment of the population is comprised of a diverse array of ethnicities, education levels, employment, political beliefs, and other factors.

Below are six charts that capture some of the ongoing effects of the COVID-19 pandemic and vaccination rates in rural America.

Chart 1: Cumulative COVID-19 Cases

Source: USDA Economic Research Service 

chart, cumulative covid-19 cases in metro and nonmetro areas. March 1, 2020 - June 7, 2021.

The virus initially spread most rapidly in cities. However, beginning in October 2020, the prevalence of cumulative COVID-19 cases was greater in nonmetro areas, eventually evening out in April 2021.

Chart 2: Rural vs Urban Death Rates

Source: USDA Economic Research Service 

chart, urban and rural weekly death rates from covid-19, 2021-2021
Large urban areas recorded the highest weekly death rates during the first COVID-19 surge between March – June 2020. But that started to shift during the second surge from July to August 2020. In September 2020, the COVID-19 death rate of rural areas surpassed those in urban areas. As of February 2021, death rates in rural areas began decreasing, possibly correlated with more widespread vaccinations.

USDA outlined how rural America’s especially at-risk population includes older adults with underlying health issues who have to travel further to reach medical care and are less likely to have health insurance.

Chart 3: Completed Vaccination Rate By County

Source: The Daily Yonder 

daily yonder chart, covid-19vaccination rate by county

The rural vaccination rate reached 40.4% of the total rural population as of September 16. This map shows which counties were at, above, or below the average vaccination rate of 50.5% of the population at that time. (Green means “rural, average or better” and red means “rural, very low.”)

Chart 4: New Rural Vaccinations By Week

Source: The Daily Yonder 

daily yonder chart, newly competed vaccinations in rural counties per week
Nearly 2/3 of the nation’s 1,976 nonmetro (rural) counties completed more vaccinations during the week ending September 16 than they did during the two weeks before. The number of vaccine shots has trended upward since August 12.

Chart 5: Distance Traveled to Get Vaccine

Source: CDC 

FIGURE 1. Percentage of vaccinated persons who traveled outside their county of residence* for their first dose of COVID-19 vaccine,† by jurisdiction and urban-rural classification§ — United States, December 14, 2020–April 10, 2021

CDC chart, states that traveled outside county for covid-19 vaccine

Between December 14, 2020, and April 10, 2021, 67.1% of vaccinated people were vaccinated in their county of residence and 98.3% in their state of residence.

A larger proportion of persons in large suburban areas and rural areas traveled beyond their county of residence to receive a vaccination, compared with people living in urban areas. Having to travel to find a vaccine can represent a hurdle to becoming vaccinated.

Chart 6: “Waiting and Seeing”

Source: Kaiser Family Foundation 

KFF chart- demographics that lag in vaccine uptake
As of July 2021, three in ten adults overall remained unvaccinated, including one in ten who said they wanted to “wait and see” how the vaccine works for other people before getting vaccinated. Younger adults (18-29 years old), Republicans, rural residents, and the uninsured reported lower vaccination rates than other demographic groups.

Drilling down further, 15% of rural residents said they were taking a “wait and see” approach to the vaccine. Rural residents were more likely to say that getting vaccinated is a personal choice and less likely to say they were worried about themselves or family members getting sick from COVID-19.

Wrapping It Up

Obviously, the pandemic is not yet behind us, so it’s impossible to know what the long-term effect will be on rural communities. In some places, COVID-19 has highlighted the disparity in healthcare availability across the country. There will also undoubtedly be lessons learned from the rollout of the vaccine. When considering the current situation in rural America, it appears that vaccine rates are now less a problem of access and more an issue of trust.


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