Jacob Ingram

ORCID Identifier(s)


Document Type

Honors Thesis


There is limited information about how social determinants of health relate to mortality rates in rural and urban areas. The purpose of this study was to determine ruralurban differences in, and correlations between, county-level mortality and social determinants of health variables (i.e., income, number of hospitals, being with or without insurance). The design was secondary, cross-sectional, descriptive, and correlational. There are 82 urban and 172 rural Texas counties. Mean county-level mortality rate was significantly higher in rural counties (M=108, SD=36.4 per 10,000 population) compared to urban (M=90.9, SD=25.6). In rural counties, uninsured rates were higher, insured rates were lower, and median income was lower. For urban counties, there was a moderate, negative, statistically significant correlation between health insurance and mortality rates. There were not significant correlations between social determinants of health and mortality in the expected direction for rural counties. Future studies are needed to establish what may explain rural-urban mortality disparity.

Publication Date




Faculty Mentor of Honors Project

Jessica Smith



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.