This is probably not a surprise to anyone here.

https://www.npr.org/sections/health-...s-to-health-ca

"After a major poll we did last fall found that a majority (55%) of rural Americans rate their local economy as only fair or poor, we undertook a second survey early this year to find out more about economic insecurity and health. The poll looked beyond the known factors of job loss and the decades-long flight of young people to more urban areas."