Premature Deaths on the Rise in Rural Areas

Where you live should not determine how long you live. New research shows it does.

Americans have enjoyed increasingly longer lives over time. Advances in medicine, a decline in fatal car accidents, and falling violent crime rates mean we are living longer.

But new research shows a reversal of this trend for some. If you are rich, geography doesn’t matter. Your expected lifespan is still increasing. But if you are poor, geography matters. In parts of the country we see an actual reversal of the trend.

geography of life expectancy map

As the map from The Health Inequality Project shows, life expectancy is lowest in a large swath that cuts through the rural Midwest and south. Blacks experience the highest rural mortality penalty. If you are black, where you live is more highly correlated with how long you will live.

For rural whites, and middle-aged white women in particular, the trend toward longer life expectancy has actually reversed course. In 21 hard-hit counties in the rural South and Midwest, the death rate for middle-aged white women has more than doubled. While white women remain an advantaged group, their advantage is eroding.

The impact is significant. Considering just the reversal of improving lifespans for white Americans over the last decade, half a million people are dead who should not be dead.

Each untimely death results in a family without a mother, a company without a worker, and a community without a leader.

While researchers are not yet certain of the cause of the trend, we know that it is correlated with fewer economic opportunities in rural areas, lower rates of education, higher than average rates of smoking, obesity, and drug and alcohol abuse.

The trend is also correlated with increasingly fractious politics. The Washington Post found that the places where middle-aged whites are dying fastest are the same places where presidential candidate Donald Trump is performing best.

This is an election outcome driven by individuals who feel left behind. Negative health outcomes and diminished economic opportunity have led this group to become disenfranchised. The resulting population is less likely to be engaged at the community, state, and national level.

In considering the challenge, we must remember that declining economic opportunity and rising health challenges are not inevitable facts of our nation. Rather, increasing challenges for the working poor are the result of policy decisions we have made.

We can make different decisions.

Trade agreements that hollowed out American manufacturing, a stagnant minimum wage, unfair tax policy, and a failure of states to expand health coverage to the working poor. These all contribute to factors now correlated with rising death rates.

We can chose to make different decisions about these policies, and we should.

Our goal should be that all Americans continue to enjoy increasingly longer and higher quality lives, regardless of who they are or where they live.