Mortality rate higher for US rural residents

October 20, 2020

Syracuse, N.Y. - A recent study by Syracuse University sociology professor Shannon Monnat shows that mortality rates are higher for U.S. working-age residents who live in rural areas instead of metro areas, and the gap is getting wider.

The study "Trends in U.S. Working-Age non-Hispanic White Mortality: Rural-Urban and Within-Rural Differences" was published recently by Population Research and Policy Review. Monnat, an associate professor of sociology at Syracuse University's Maxwell School of Citizenship and Public Affairs, said no single cause of death is to blame for the growing disparity.

"Smaller nonmetro declines in cancers and ischemic/circulatory system diseases and larger increases in suicide, alcohol-induced cause, mental/behavioral disorders, cardiometabolic diseases, infectious diseases, and respiratory diseases are major culprits," Monnat said. "Mortality rate trends have been particularly problematic for females."

Monnat is director of the Lerner Center for Public Health Promotion and co-director of the Policy, Place and Population Lab in the Aging Studies Institute at Syracuse University. Here are the key findings from the study:Despite these findings, Monnat said "not all of rural America is in dire straits."

"While there is much to be concerned about in Appalachia, the South, and increasingly New England, some groups have seen improvement in the Mid-Atlantic, East North Central, and Mountain divisions," Monnat said. "My analysis of specific causes of death begins to offer insight into what's driving these disparities, but research is needed that identifies the specific upstream causal explanations for these trends, particularly those that are amenable to policy change."

In terms of policy recommendations, Monnat said, "Behavioral interventions targeting smoking, diet, and exercise have been widely advocated and have been attempted for decades, but they appear to have had little impact on reducing rural-urban or within-rural disparities. Far too often, the public health approach has been to apply health care and behavioral intervention to places with the worst health profiles.

"This approach has been costly and ineffective because it treats problems after they arise rather than preventing their onset," she continued. "Instead, the 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."

Syracuse University

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