Background: Rural health describes a set of health issues, health care challenges and research priorities driven by a single geo-demographic factor: low population density. Rural areas compared to urbanized areas have fewer providers per capita, longer distance to care, lower socioeconomic status, higher rates of untreated illness, greater exposure to agricultural chemicals, and higher rates of alcohol use, fatal motor vehicle crashes, and suicide. Accessing clinical data for large numbers of rural residents can be challenging. To meet this challenge, seven sites formed the HMORN Rural Health Scientific Interest Group (SIG). Methods: VDW data from seven HMORN sites were analyzed. Rural-Urban Commuting Area (RUCA) codes describe commuting flow but include data on urban, town, and rural tracts; RUCA codes were used to categorize areas as urban, large rural town, small rural town, or isolated rural area. We determined prevalence of chronic conditions by rural status and age group (child, adult, seniors). Results: Common diseases were hypertension, obesity, dyslipidemia, diabetes, alcohol/drug use, depression, and cancers. Most sites saw stable rates of rural vs. urban patients over the years. Rates of pediatric obesity increased at all sites. Adult obesity increased markedly among seniors while dyslipidemia and diabetes increased in all age groups. Cancer among adults also trended upward over time and exceeded national averages. Hypertension among adults appeared lower than US national average in 2010 (32%). Conclusions: Economic challenges and other factors may further accentuate existing health and health care disparities experienced by many Americans living in rural areas. The Rural Health SIG of the HMORN is poised to conduct meaningful, multi-site research addressing health care issues, health care delivery and care follow-up for this special patient population. Future analyses will explore variation in chronic disease by rural status and the influence of economic factors within geographies.