The objective of the study was to examine and compare health status between rural and urban adults. The data are from a 1993 statewide probability-based telephone survey of adult Kentuckians (n = 662). Metropolitan Statistical Area (MSA) residents (n = 264) and nonMSA residents (n = 398) were compared using the Medical Outcomes Study, Short Form Health Survey (SF-20). Self-perceived urban (n = 406) and rural (n = 256) residents were also compared. Additional analyses were stratified by the age categories of 18-44, 45-64, and > or = 65 years of age. Few differences in health status existed between rural and urban adults. However, rural elders (> or = 65 years) had significantly poorer health status than urban elders. After controlling for demographic variables in multiple regressions, rural elders had significantly poorer functioning (all p < .05) than urban elders as measured by the SF-20 subscales of a) physical functioning, b) role functioning, c) social functioning, d) general mental health, and e) general health perceptions. No differences between rural and urban residents were noted for the pain subscale. Although the health status of rural and urban adults is generally similar, the rural elderly have significantly worse health status than their urban counterparts.