Death rates for rural whites, especially women in their 40s, continue to increase

The rural-urban gap in the death rate gap among white Americans—especially women—continues to widen, Joel Achenbach and Dan Keating report for The Washington Post. Since 1990, "Death rates for rural white women in midlife have risen by nearly 50 percent."

Among rural white women in their late 40s, the death rate has risen 30 percent, from 228 out of every 100,000 women in 2000 to 296/100,000 today. "White men are also dying in midlife at unexpectedly high rates. But the most extreme changes in mortality have occurred among white women, who are far more likely than their grandmothers to be smokers, suffer from obesity or drink themselves to death." Other factors are a rise in heroin and opioid addiction among rural whites and that more rural women today work, which increases stress and other poor health factors.

"Public-health experts say the rising white death rate reflects a broader health crisis, one that has made the U.S. the least healthy affluent nation in the world over the past 20 years," Achenbach and Keating write. "In affluent countries, people generally enjoy increasingly long lives, thanks to better cancer treatments; drugs that lower cholesterol and the risk of heart attacks; fewer fatal car accidents; and less violent crime. But progress for middle-aged white Americans is lagging in many places—and has stopped entirely in smaller cities and towns and the vast open reaches of the country."

In rural Victoria County, Texas (Best Places map), "deaths among women 45 to 54 have climbed by 169 percent, the sharpest increase in that age group of any U.S. county," Achenbach and Keating write. "The death rate climbed from 216 per 100,000 people to 583." Lisa Campbell, medical director for the Victoria County health department, "said a third of adults in the county are obese, roughly in line with the national average. Also, 1 in 5 smokes—well above the national average—and people can still light up in restaurants and other public places."

Opioid and heroin overdoses have "been particularly devastating in working-class and rural communities," Achenbach and Keating write. "Another killer is related to heavy drinking. Deaths of rural white women in their early 50s from cirrhosis of the liver have doubled since the end of the 20th century, The Post found. Suicides are also on the rise. The suicide rate is climbing for white women of all ages and has more than doubled for rural white women ages 50 to 54. Other trends may be contributing to the die-off, including obesity. Americans are the heaviest people in the world outside of a few Pacific Island nations; more than a third of adults in the U.S. are considered obese."

"The average American woman today weighs as much as an American man did in the early 1960s." Achenbach and Keating write. "Researchers point out that this generation of white women has experienced a revolutionary change in gender roles over the past half-century, surging into the workforce while typically retaining traditional duties as domestic caregivers—a dual role to which many women of color have long been accustomed. White women often find themselves harried in ways their grandmothers could never have imagined." (Read more)