Wednesday, April 04, 2018

Infectious-disease deaths drop; not as much in rural areas

Though fewer Americans are dying from infectious diseases than three decades ago, mortality rates among rural Americans have improved less than overall, and one factor is the steady decline in access to health-care services in many rural areas, according to a study recently published in the Journal of the American Medical Association. "As a country we are doing much better, but certain counties are still lagging behind and are in fact getting worse," co-author Ali Mokdad, professor at the University of Washington, told Steven Ross Johnson of Modern Healthcare.

Deaths from lower-respiratory infections showed the largest difference between rural and urban areas, but "a 2017 Centers for Diseases Control and Prevention report found death rates for heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke were all higher in rural areas compared to urban environments," Johnson reports. "Like Tuesday's study, the CDC report suggested a combination of limited health-care access and a higher frequency of health-risk behaviors were major contributors to those outcomes."

Infectious-disease deaths dropped 18 percent between 1980 and 2014, from 43 per 100,000 to 34, based on death records from the National Center for Health Statistics, population counts from NCHS, the U.S. Census Bureau and the Human Mortality Database. Mortality rates for almost all categories of infectious disease declined, except for diarrheal diseases, which increased.

Mokdad said factors such as income, education, obesity, access to care, and frequency of risky behaviors like smoking and substance use usually predict health outcomes in a community, Johnson reports: "He said people living in medically under-served areas often go through a vicious cycle of engaging in unhealthy behaviors when they can't access health-care services consistently or take advantage of preventive services. Such individuals often delay seeking treatment until their condition has become more advanced, reducing their chances of recovery."

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