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To understand the role of county characteristics in the growing divide between rural and urban mortality from 1980 to 2010.

Age‐adjusted mortality rates for all U.S. counties from 1980 to 2010 were obtained from the CDC Compressed Mortality File and combined with county characteristics from the U.S. Census Bureau, the Area Health Resources File, and the Inter‐University Consortium for Political and Social research.

We used Oaxaca–Blinder decomposition to assess the extent to which rural–urban mortality disparities are explained by observed county characteristics at each decade.

Decomposition shows that, at each decade, differences in rural/urban characteristics are sufficient to explain differences in mortality. Furthermore, starting in 1990, rural counties have significantly lower predicted mortality than urban counties when given identical county …