In East Texas the further one is away from Houston the less their life expectancy. We all eat the same stuff, I think. The difference maxes out to 5 years average less per person, near Louisiana, but if you look at the actuary stats it’s a straight line correlation between medical center distance and how long we live, on average
This honestly is repeated for many states in the USA. The metro areas have same life expectancies as Europe and Japan, but it’s balanced out by rural lack of access and fewer preventative cares.
It is a lot easier to survive a heart attack and stroke if you can reach a hospital or comparable medical service in a reasonable amount of time.
Look up food deserts and reconsider whether urban and rural citizens in America have the same diet.
Food deserts do exist in many places, but majority of people in my area need vehicle access to get any groceries, or work. One usually does not walk down to the local dollar general.
And with vehicles come access to real grocery stores
Food deserts in the south are worse than just “need to drive to a grocery store.” Often the only nearby (short drive) is a store akin to Dollar General with very little or no fresh produce. If the closest place you can get decent quality fruit and veggies is an hour drive, you’re going to end up on a diet of corn syrup.