Crucial factors which need to be addressed include broadband availability, transport and affordable housing.
The study was conducted by the regional development agency Advantage West Midlands.
The region's rural unemployment rate is declining as it exits recession, says the report.
Levels of home-working in the countryside are three times the level of urban areas.
High levels of entrepreneurship suggest rural residents are creative and resilient, it adds.
But rural areas are also suffering from local economic problems sometimes masked by standard national government statistics.
Some 25% of the region's rural jobs are in the public sector.
This is a major concern for some rural communities, especially when linked with poor access to alternative work, ther report says.
People working in urban areas tend to have higher salaries - commuters typically earn up to £8,000 a year more than someone working locally.
Rural areas contribute 33% to the region's economy.
Some 80% of West Midlands land is rural, with 35% of the population living in rural areas and 34% working in them.
Market towns are seen as key to rural employment but some of these have been hit by the closure of national companies such as Woolworths.
The full report, Rural Evidence Base 2010, can be downloded here.
It includes a Rural Disadvantage Indicator which builds on the national Index of Multiple Deprivation.
Together, they review the state of the rural economy, housing affordability and the level of acces to services.
Mark Pearce, the development agency's corporate director for economic regeneration, said the countryside faced an uncertain future.
"Rural areas face significant challenges of low wages, high levels of public sector employment, poor broadband availability and affordable housing.
"Future regeneration of rural areas will need to address these issues."
The findings had been shared with the agency's partners to influence their investment plans to benefit the rural economy using limited resources.
"This provides them with an invaluable resource, identifying key rural issues," said Mr Pearce.