Canadians living in rural communities are more likely to have poorer health outcomes than their urban counterparts, Canada’s chief public health officer says.

In her inaugural report on healthy living released Oct. 26, Dr. Theresa Tam said rural Canadians were more likely to report they were in poor or fair health and tended to have higher mortality rates, particularly from respiratory disease (linked to smoking).

Twenty percent of Canadians live in rural communities — a figure that has declined dramatically from the 50-50 population split of the 1940s. Canada’s rural communities are also likely to be older than their city counterparts.