Decrease in death rates has been less in rural U.S.

Death rates across the country have been decreasing since 1990, but urban rates are improving twice as fast as rural ones. "As a consequence of the changing rates of mortality, hundreds of thousands of rural residents have died since 1990 who would have been expected to live had the gap not appeared," Bill Bishop of the Daily Yonder reports. If the rate of decrease in urban and rural communities had remained the same after 1990, 389,000 fewer rural Americans would have been expected to die between 1990 and 2004, a phenomenon researchers have coined the “nonmetropolitan mortality penalty.”

This news comes on the heels of reports from Harvard University that life expectancy of women in 1,000 mostly rural counties had declined from 1983 to 1999, and a report that found California rural residents were more likely to commit suicide. “These excess deaths are equivalent to approximately 9 percent of the total mortality in the nonmetropolitan United States,” Arthur Cosby, a sociologist at Mississippi State University, and other researchers write in the August 2008 issue of the American Journal of Public Health. (USDA Economic Research Service graphic)
“A possible explanation for the emergence of the nonmetropolitan mortality penalty is based on the observation that access to health care is the most pervasive health disparity in the nonmetropolitan United States,” Cosby wrote in 2008. “If healthcare is becoming significantly more effective in prolonging life, then limited access to healthcare is becoming profoundly harmful to the nonmetropolitan U.S. population; hence, the nonmetropolitan mortality penalty.” The gap between rural and metro death rates in the South is the greatest, Bishop reports, while almost no gap is observed in the Midwest, and rural death rates in the West remain relatively low. (Read more)