Coronavirus, Graphic of the Week, Rural America

GRAPHIC: COVID-19 death rates in rural communities surpassed urban ones in September

by Sky Chadde, Midwest Center for Investigative Reporting April 1, 2021April 21, 2021 Why you can trust Investigate Midwest

The Thompson River sits next-door to the permitted CAFO cite on Friday, March, 19, 2021, in Chillicothe, Mo. Friends of Poosey fear that pollution will spread from the pond on the property into the nearby creek, which feeds into the Thompson and the Missouri Rivers. "A third of the damage from the dead zone in the gulf is from Iowa's runoff of hog manure and commercial fertilizer," Doug Doughty said. He said Iowa's water issues are an example of where Missouri is headed without safety regulations. Credit: Danielle Pycior, for the Midwest Center for Investigative Reporting

When it started, the COVID-19 pandemic hit cities the hardest. In April 2020, metros with more than a million people had rate of about eight deaths a week per 100,000 adults, according to an analysis by the U.S. Department of Agriculture.

But the situation flipped as the pandemic progressed. In September, rural areas — those with a population less than 10,000 — started to have higher death rates than urban areas.

In December, small towns had a rate of about 10 deaths a week per 100,000 adults, according to the USDA analysis.

The USDA attributed the increase to three factors: 1) rural America’s aging population; 2) the prevalence of underlying health conditions among rural residents; and 3) the long distances many have to drive to hospitals with intensive care units.