Country Living Isn’t as Sweet as It Seems

Ontarians in rural communities are at a greater risk of stroke than their urban counterparts. But why, and what can be done about it?


For many city dwellers, life in the country sounds idyllic. The open spaces, fresh air and farmer’s markets sound like the perfect setting for a more leisurely pace of life. But with these perks come barriers that mean a rural life is not necessarily a healthy one.

In fact, Ontarians who live in rural communities are at greater risk of stroke than their urban counterparts. This in itself is not new, but thanks to new research from the Institute for Clinical Evaluative Sciences, we now have a better idea of why.

To get to the bottom of the discrepancy Moira Kapral, a Senior Scientist at the Toronto General Hospital Research Institute, and team examined health records from over six million Ontarians across urban and rural (<10,000) communities.

Using data from 2008 to 2012, the researchers found that the incidence of stroke-related death is 19% higher in those living in the country versus those living in cities.

This is in part due to lifestyle. Rural Ontarians have higher rates of smoking (24.9% vs. 18.5%), obesity (24.3% vs. 18.8%) and heavy alcohol consumption (16.0% vs. 11.6%) compared to their urban neighbours. But while these factors all increase stroke risk, they only partly explain the higher rates of stroke and stroke-related death in rural communities.

Compounding the problem is preventative care, or a lack of it. Despite higher risk factors, rural residents are significantly less likely to be screened for diabetes (70.9 % vs. 81.3%) and high cholesterol (66.2% vs. 78.4%), and also less likely to have their diabetes under control (51.3% vs. 54.3%).

Interestingly, these disparities disappear if you’ve already had a stroke. Co-author Dr. Albert Jin, medical director of the Stroke Network of South Eastern Ontario, sees this is a sign that stroke aftercare is reaching patients regardless of where they live.

Nevertheless, work is needed to ensure information and screening services reach all Canadians to prevent strokes in the first place.

“Our findings demonstrate the need to improve access to primary care in rural regions, and to raise awareness of risk factors such as smoking and obesity,” explains Kapral.

Until then, country life might not be as healthy as you’d think.

‹ Previous post
Next post ›

Amy Noise is a science communicator who is fascinated by how and why the world works. Always learning, she is passionate about science and sharing it with the world to improve and protect our health, society and environment. Amy earned her BSc (biology and science communication) at the University of Manchester, and MSc (nutrition science and policy) at King’s College London, UK. She tweets sporadically @any_noise