Background: The overall mortality rate has been reported to be higher in rural vs. urban areas in several states in the United States. This study is to determine the rates of the top ten causes of death in rural vs. urban areas in East Texas, West Texas and South Texas in 2010, which also serve as the baseline for future studies. Methods: The top ten causes of death in the state and the nation were identified by Texas Department of State Health Services (DSHS) and the National Vital Statistics Report, respectively. Nine are leading causes of death for both Texas and the nation. Thus, eleven causes of death plus the all-cause mortality were studied. Death counts by age, race/ethnicity and county in 2010 were obtained from DSHS. The corresponding population sizes as the denominators for calculating age-adjusted mortality rates were obtained from the U.S. Census Bureau which conducts a once-a-decade full count census of the population by age, gender, ethnicity and county. Results: The age-adjusted mortality rate for each cause was significantly higher in rural vs. urban Texas with few exceptions. When analyzed by region, causes of death with the highest rates were all in rural areas: heart diseases, cancer, cerebrovascular diseases, accidents, suicide and allcause mortality in rural East Texas; chronic lower respiratory disease, Alzheimer's disease, and pneumonia-influenza in rural West Texas; and diabetes, kidney diseases and septicemia in rural South Texas. The rates of death by most causes in each ethnic group were higher in rural vs. urban areas in East, West and South Texas, respectively. Conclusions: These results show clear disparities in mortality from common causes of death in rural areas vs. urban areas in Texas. Rates presented establish a baseline against which to judge the progress of future public health policies aimed at reducing these disparities. [ABSTRACT FROM AUTHOR]