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Age-adjusted death rates per 100,000 population (with 95% confidence intervals) in group IV were lower than in group I for heart disease: 209 (193.9–224.1) vs. 227.4 (216.3–238.5); cancer: 135.9 (123.7–148.1) vs. 176.3 (166.6–186.0); cerebrovascular disease: 39.9 (33.3–46.5) vs. 44.6 (39.7–49.5); pneumonia: 19.6 (15.0–24.2) vs. 23.4 (19.8–27.0); and intentional injury deaths: 13.3 (9.5–17.0) vs. 15.1 (12.2–18.0). However, age-adjusted unintentional injury death rates were 54.2% higher in group IV than in group I: 42.7 (35.9–49.5) vs. 27.7 (23.8–31.6). Motor vehicle-related death rates were 93% higher: 23.3 (18.2–28.4) vs. 12.1 (9.5–14.7); and farm machinery-related deaths were 1250% higher: 2.7 (1.0–4.4) vs. 0.2 (-0.1–0.5). Conclusion: Age-adjusted unintentional injury death rates are higher in the rural counties of Nebraska, even though death rates for the four other leading causes of death (heart disease, cancer, cerebral vascular disease, and pneumonia) and intentional injury are lower. Although farm machinery-related deaths have the largest percentage difference between rural and urban counties, motor vehicle-related deaths are the major contributor to the unintentional injury death rate discrepancy in rural Nebraska.

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