Rural-Urban Variation in COVID-19 Experiences and Impacts among U.S. Working-Age Adults

Abstract

This study investigates rural-urban continuum differences in COVID-19 experiences and impacts to physical and mental health, social relationships, employment, and financial hardship among U.S. working-age adults (18-64) from the National Wellbeing Survey collected in February and March 2021 (N=3,933). Most respondents (58%) reported that COVID-19 has had a negative impact on their lives. Residents of rural counties adjacent to metro areas reported the worst outcomes. They were more likely than residents of large urban counties to report testing positive for coronavirus, living with someone who tested positive, having a close friend or family member outside of the household test positive, having a close friend or family member hospitalized, seeking treatment for anxiety or depression, being late paying rent, mortgage, and other bills, not being able to afford groceries or other necessities, and getting a loan from family or friends. Recovery policies must consider geographic variation in COVID-19 vulnerability and impacts.