Public Health in the Rockies 2026

Background: Rural populations experience a wide range of health disparities, including higher rates of cancer and heart disease death. Persistent inequities in the social determinants of health, such as lower access to quality public services, underlie many rural health disparities. Yet, rural contexts vary both across and within states, and the particular needs and resilience capacity of Colorado’s rural populations have been insufficiently characterized. This research showcase will report on a two-year project led by the Colorado Department of Public Health and Environment to assess rural health equity statewide and inform policy responses.

Methods: The presentation will compare rural, rural resort, and urban geographies on 40 health and social determinant indicators, drawing on a novel dataset that combines vital statistics and survey data for all 64 counties in Colorado. The presentation will also report on a qualitative analysis of interviews and focus groups and a review of Colorado public policy.

Results: Rural populations fared worse than urban populations on 75% of health indicators, including premature mortality and deaths from chronic disease. Rural areas also fared worse on 55% of social determinant indicators tested, such as uninsured rates and food insecurity, but fared better on 30%, including the violent crime rate. Rural resort populations, by contrast, actually fared better than urban ones on 87% of health indicators. They also fared better on 50% of social determinant indicators, while faring worse on just 20%. Social connections are core strengths of both rural and rural resort communities, with participants routinely reporting a strong sense of belonging and interdependence.

Implications: Colorado’s rural populations face interlocking disadvantages across most health and social determinant indicators, but they also hold strengths that can be reinforced through strategic investments and expanded support. The presentation concludes with a discussion of promising approaches and lessons for advancing rural health equity.