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Rurality was associated with significantly higher in-hospital mortality rates (1.44% vs 1.89%, OR 1.32, P less then .001). This association strengthened after adjusting for medical comorbidities and hospital characteristics. Further, disparities between urban and rural mortality were found to be growing, with the gap almost doubling between 2012 and 2016. Conclusions Rural and urban uninsured patients differed significantly, specifically in terms of race and median income. Among the uninsured, rurality was associated with higher in-hosp