In the seven-state Great Plains region, heart disease accounted for over 45,000 deaths in 2020.  Relative to population size, the heart disease death rate per 100,000 population in the region was slightly better than the national average.  However, consistent with a pattern seen elsewhere, there was a very wide disparity in heart disease death rates between urban and rural populations, with death rates in smaller communities and rural areas being much higher.  Further study of data from the CDC's National Center for Health Statistics (NCHS) yield the following about urban vs. rural heart disease death rates in the Great Plains region:

Urban vs. Rural Heart Disease Death Rates in the Great Plains Region

County Classification	Deaths	Population	Death Rate*
Large Central Metro	4,441	2,819,881	157.5
Large Fringe Metro	8,951	5,016,579	178.4
Medium Metro	7,365	3,793,143	194.2
Small Metro	6,552	3,430,748	191.0
Micropolitan (Nonmetro)	7,739	3,140,344	246.4
NonCore (Nonmetro)	10,012	3,281,139	305.1
Region	45,060	21,481,834	209.8
Nationally	696,962	329,484,123	211.5

(*) number of heart disease deaths per 100,000 population

Report Period: 2020

States in region:  Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota

See the 2013 NCHS Urban-Rural Classification Scheme for additional information on population categories, including a map of which U.S. counties fall in which categories.

Source: CDC Wonder. Centers for Disease Control and Prevention, National Center for Health Statistics. Underlying Cause of Death 1999-2020 on CDC WONDER Online Database, released in 2021. Data are from the Multiple Cause of Death Files, 1999-2020, as compiled from data provided by the 57 vital statistics jurisdictions through the Vital Statistics Cooperative Program. Accessed on January 21, 2023