Mortality rates of working people living in rural areas compared to urban areas is widening, according to a recent study from Syracuse University.

The study — Trends in U.S. Working-Age non-Hispanic White Mortality: Rural-Urban and Within-Rural Differences — examined “all-cause” and “cause specific” trends in deaths among non-metro and metro working-age adults ages 25-64 years old from 1990-2018.

The report was written by Syracuse University sociology professor Shannon Monnat, who said the rural disadvantage is not limited to just one or two specific causes of death, but persists across multiple diseases and injury categories.

"Smaller rural declines in cancers and ischemic and circulatory system diseases and larger increases in suicide, alcohol-induced causes, mental and behavioral disorders, metabolic diseases (related to diabetes and obesity), infectious diseases, and respiratory diseases are major culprits," Monnat told Agri-Pulse in an email. 

The study also suggested figures on mortality rate increases over the last three decades shifted depending on where people live and what they do for a living. There were poor trends in New England, South Atlantic, East South Central, West South Central, and Appalachia, but more favorable ones in the mid-Atlantic, Mountain, and Pacific.

“Mining-dependent counties have very high mortality rates and have diverged from other economies since the mid-2000s due to multiple causes of death, whereas farming counties have comparatively lower mortality rates,” the study says.

Monnat said farming counties have a comparative mortality advantage, due in large part to much smaller increases in drug poisoning and infectious disease mortality than the other economic types. "However, large increases in suicide and alcohol-induced mortality in farming-dependent counties are concerning, as they risk driving up overall mortality in these counties, and they signal that there is a major mental health problem in farming communities," she said.

In the 25-44 age group, suicide rates rose in most farm-dependent counties for men and women.

Alana Knudson, director of the NORC Walsh Center for Rural Health Analysis said the report reaffirms what they’ve been researching the last several years.

“We are seeing a decline in longevity among our rural populations,” Knudson told Agri-Pulse. She said the report points out there is great concern with the working age 25 to 64-year-olds across the country and that rural life expectancy is decreasing. Knudson feels the decrease is being driven by economic stability.

"If you do not have a foundation of economic stability, you are not able to necessarily access health services and afford the different types of social determinants that contribute to health and well-being," Knudson said. 

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Death rate trends among women were particularly concerning. The study noted the mortality rate has increased 70% among rural females ages 25-44 and 16% among rural females ages 45-64 since 1990. 

"These women are dying in the prime of their lives, during the period when people form families, start moving ahead in their careers, and contribute to their communities," Monnat said. She stated given that these women are still very young and these trends forebode troubling outcomes in the decades to come.

For years people have been told to change routines related to smoking, diet, and exercise, but Monnat argued more needs to be done.

She recommends a more “cost-effective and humane approach would be to apply upstream interventions that target the structural (economic, social, environmental), corporate, and policy determinants of health to prevent future generations from exacerbating these already problematic mortality trends.”

Monnat said Congress can also improve health care access and quality has the potential to reduce disparities in certain types of death that are amenable to screening and known-effective treatments (e.g., cancer; infectious diseases).

Knudson agreed access to better health care and improved economic policies will be critical for slowing the rate. She also said another solution is for neighbors in rural communities is to simply check on neighbors who may be under financial stress.

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