Rural and Urban Differences in COVID-19 Prevention Behaviors.

Purpose: To examine whether the adoption of COVID-19-related preventive health behaviors vary in rural versus urban communities of the United States while accounting for the influence of political ideology, demographic factors, and COVID-19 experiences.

Methods: We rely on a representative survey of 5009 American adults collected from May 28 to June 8, 2020. We analyze the influence of rural status, political ideology, demographic factors, and COVID-19 experiences on self-reported adoption of 8 COVID-19-related preventive health behaviors.

Findings: Rural residents are significantly less likely to have worn a mask in public, sanitized their home or workplace with disinfectant, avoided dining at restaurants or bars, or worked from home. These findings, with the exception of dining out, are robust to the inclusion of measures accounting for political ideology, demographic factors, and COVID-19 experiences.

Conclusions: Rural residents are significantly less likely to participate in several COVID-19-related preventive health behaviors. This reality could exacerbate existing disparities in health access and outcomes for rural Americans. Health messaging targeted at improving COVID-19 preventive behavior adoption in rural America is warranted.