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Trends in U.S. Working-Age non-Hispanic White Mortality: Rural–Urban and Within-Rural Differences

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  • Shannon M. Monnat

    (Syracuse University)

Abstract

After decades of lower or comparable mortality rates in rural than in urban areas of the U.S., numerous studies have documented a rural mortality penalty that started in the 1990s and has grown since the mid-2000s. The widening of the gap appears to be especially pronounced among non-Hispanic (NH) whites. However, the rural U.S. is not monolithic, and some rural places have experienced much larger mortality rate increases than others over the past 30 years. Drawing on restricted mortality files from the National Vital Statistics System (NVSS), I examine metro versus nonmetro and intra-nonmetro (divisional and economic dependency) all-cause and cause-specific mortality trends among working-age (25–64) NH white males and females, 1990–2018. Results show that the nonmetro mortality penalty is wide and growing and is pervasive across multiple disease and injury categories. Trends for females are particularly concerning. Smaller nonmetro declines in mortality from cancers and cardiovascular disease (throughout the 1990s and 2000s) and larger increases in metabolic and respiratory diseases, suicide, alcohol-related, and mental/behavioral disorders (throughout the 2010s) collectively drove the growth in the nonmetro disadvantage. There are also large divisional disparities (which are growing for females), with particularly poor trends in New England, South Atlantic, ES Central, WS Central, and Appalachia and more favorable trends in the Mid-Atlantic, Mountain, and Pacific. Mining-dependent counties have diverged from the other economic dependency types since the mid-2000s due to multiple causes of death, whereas farming counties have comparatively lower mortality rates. High and rising mortality rates across a variety of causes and rural places, some of which have been occurring since the 1990s and others that emerged more recently, suggest that there is not one underlying explanation. Instead, systemic failures across a variety of institutions and policies have contributed to rural America’s troubling mortality trends generally and within-rural disparities more specifically.

Suggested Citation

  • Shannon M. Monnat, 2020. "Trends in U.S. Working-Age non-Hispanic White Mortality: Rural–Urban and Within-Rural Differences," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 39(5), pages 805-834, October.
    • Handle: RePEc:kap:poprpr:v:39:y:2020:i:5:d:10.1007_s11113-020-09607-6
    DOI: 10.1007/s11113-020-09607-6
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    1. Stein, E.M. & Gennuso, K.P. & Ugboaja, D.C. & Remington, P.L., 2017. "The epidemic of despair among white americans: Trends in the leading causes of premature death, 1999-2015," American Journal of Public Health, American Public Health Association, vol. 107(10), pages 1541-1547.
    2. Anne Case & Angus Deaton, 2017. "Mortality and Morbidity in the 21st Century," Brookings Papers on Economic Activity, Economic Studies Program, The Brookings Institution, vol. 48(1 (Spring), pages 397-476.
    3. James, W.L., 2014. "All rural places are not created equal: Revisiting the rural mortality penalty in the United States," American Journal of Public Health, American Public Health Association, vol. 104(11), pages 2122-2129.
    4. Montez, J.K. & Zajacova, A., 2014. "Why is life expectancy declining among low-educated women in the United States?," American Journal of Public Health, American Public Health Association, vol. 104(10), pages 5-7.
    5. Montez, J.K. & Zajacova, A., 2013. "Trends in mortality risk by education level and cause of death among US White Women from 1986 to 2006," American Journal of Public Health, American Public Health Association, vol. 103(3), pages 473-479.
    6. Isaac Sasson, 2016. "Trends in Life Expectancy and Lifespan Variation by Educational Attainment: United States, 1990–2010," Demography, Springer;Population Association of America (PAA), vol. 53(2), pages 269-293, April.
    7. Brian Thiede & Shannon Monnat, 2016. "The Great Recession and America’s geography of unemployment," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 35(30), pages 891-928.
    8. Wesley James & Jeralynn Cossman & Julia Wolf, 2018. "Persistence of death in the United States: The remarkably different mortality patterns between America’s Heartland and Dixieland," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 39(33), pages 897-910.
    9. Hayward, Mark D. & Hummer, Robert A. & Sasson, Isaac, 2015. "Trends and group differences in the association between educational attainment and U.S. adult mortality: Implications for understanding education's causal influence," Social Science & Medicine, Elsevier, vol. 127(C), pages 8-18.
    10. Cosby, A.G. & Neaves, T.T. & Cossman, R.E. & Cossman, J.S. & James, W.L. & Feierabend, N. & Mirvis, D.M. & Jones, C.A. & Farrigan, T., 2008. "Preliminary evidence for an emerging nonmetropolitan mortality penalty in the United States," American Journal of Public Health, American Public Health Association, vol. 98(8), pages 1470-1472.
    11. Anne Case & Angua Deaton, 2015. "Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century," Working Papers 15078.full.pdf, Princeton University, Woodrow Wilson School of Public and International Affairs, Research Program in Development Studies..
    12. repec:aph:ajpbhl:10.2105/ajph.2017.303941_0 is not listed on IDEAS
    13. Christopher J L Murray & Sandeep C Kulkarni & Catherine Michaud & Niels Tomijima & Maria T Bulzacchelli & Terrell J Iandiorio & Majid Ezzati, 2006. "Eight Americas: Investigating Mortality Disparities across Races, Counties, and Race-Counties in the United States," PLOS Medicine, Public Library of Science, vol. 3(9), pages 1-12, September.
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    1. Shannon M. Monnat, 2022. "Demographic and Geographic Variation in Fatal Drug Overdoses in the United States, 1999–2020," The ANNALS of the American Academy of Political and Social Science, , vol. 703(1), pages 50-78, September.
    2. Thomas, Kelsey L. & Dobis, Elizabeth A. & McGranahan, David A., 2024. "The Nature of the Rural-Urban Mortality Gap," Economic Information Bulletin 341639, United States Department of Agriculture, Economic Research Service.
    3. Eric Jonathon Osborne‐Christenson, 2022. "Saving light, losing lives: How daylight saving time impacts deaths from suicide and substance abuse," Health Economics, John Wiley & Sons, Ltd., vol. 31(S2), pages 40-68, October.

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