18 The gaps in many other measures of well-being have widened as well. In small towns and rural areas, college attainment rates have increased by less, disability rates have increased by more, divorce rates have risen by more, and mortality due to lung disease, cancer, or cardiovascular disease have either improved by less or worsened by more.
19 Opioid use is also most prevalent in less populous metro and rural areas. 20 I have seen many of these challenges first hand.