Working-age rural residents are dying at 'wildly higher rates' than their urban counterparts; cause is undetermined

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U.S. mortality rates can fall into two very different camps -- rural working-age death rates and everyone else's death rate. "Rural Americans age 25 to 54 — considered the prime working-age population — are dying of natural causes such as chronic diseases and cancer at wildly higher rates than their age-group peers in urban areas, according to a new report from the Agriculture Department's Economic Research Service," reports Jazmin Orozco Rodriguez of KFF Health News.

To compare the two groups, "USDA researchers analyzed mortality data from the Centers for Disease Control and Prevention from two three-year periods — 1999 through 2001, and 2017 through 2019," Rodriguez explains. "In 1999, the natural-cause mortality rate for rural working-age adults was only 6 percent higher than that of their city-dwelling peers. By 2019, the gap had widened to 43 percent." 

In reviewing demographic differences, Native American women fared the worst, but overall, a link between younger rural deaths and a lack of Medicaid expansion could be part of the cause. "USDA researchers and other experts noted that states in the South that have declined to expand Medicaid under the Affordable Care Act had some of the highest natural-cause mortality rates for rural areas," Rodriguez reports. "But the researchers didn’t pinpoint the causes of the overall disparity."

Another possible connection could be the lack of rural health care options and rural hospital closures. "Alan Morgan, CEO of the National Rural Health Association, and other health experts have maintained for years that rural America needs more attention and investment in its health care systems by national leaders and lawmakers," Rodriguez adds. "It’s unlikely that things have improved for rural Americans since 2019, the last year in the periods the USDA researchers examined. The coronavirus pandemic was particularly devastating in rural parts of the country."