Rural Alabama’s health:

Alabama Living Magazine

A major public health concern

Many people think that rural areas are not as important as more urban areas with larger numbers of people.  This is far from the truth.  Rural areas are the sources of the vast majority of materials, resources, and necessities, such as food, that everyone must have to survive.  Having healthy and vibrant rural areas is important to everyone.

Rural Alabama is plagued by numerous health status concerns combined with a lack of healthy population growth. This lack of healthy population growth creates difficulty in attracting and keeping health care providers. Twenty-four rural counties have smaller populations today than they had in 1910.  More disturbing, 41 counties are projected to have less population in 2040 than they had in 2010.  Alabama’s population growth is projected to be the lowest among all southern states, less than one half of Mississippi’s growth.

Major indicators of the serious health issues facing rural Alabama include the following:

  • Alabama has the 3rd highest death rate among all 50 states and the rate is 10 percent higher for rural residents than urban Alabamians.
  • Life expectancy is three years less for Alabamians than for the nation – 3 ½ years less for rural Alabamians.
  • In 1980, 45 rural counties had hospitals that provided obstetrical service.  Today only 16 rural counties still have such service available.  The loss of hospitals that deliver babies is greater in the 12 counties of the Black Belt Region.  In 1980, 10 of these 12 counties had hospitals providing obstetrical service.  Today only one county (Dallas) still has this service.
  • Only two rural counties (Coffee and Pike) are recognized by the Health Resources and Services Administration as providing the minimal primary care service that is needed. None provide minimal dental service that is needed for low-income (Medicaid) residents, and none provide minimal mental health service.

The Alabama Department of Public Health has a long history of recognizing the importance of rural health. This Department has housed Alabama’s official State Office of Rural Health for many years. In addition, ADPH officials, including State Health Officer Thomas Miller, M.D., were the founders of the Alabama Rural Health Association in 1991. This non-profit organization operates independently but closely shares rural health interests and concerns with the ADPH.

For additional information on rural health concerns and this association, please visit

Editor’s note: Alabama Living congratulates Jim McVay, Dr. P.A., former director of the Bureau of Health Promotion and Chronic Disease of the Alabama Department of Public Health, who wrote our “Healthy Living” column for the past few years. Dr. McVay retired Dec. 31 after 42 years with the state of Alabama.

Dale Quinney is executive director of the Alabama Rural Health Association, 1414 Elba Highway, Troy, 36081.


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