skip to main content
skip to newscasts

Saturday, June 15, 2024

Public News Service Logo
facebook instagram linkedin reddit youtube twitter
view newscast page
play newscast audioPlay

The Supreme Court throws out a Trump-era ban on gun bump stocks; a look at how social media algorithms and Shakespearian villains have in common; and states receive federal funding to clean up legacy mine pollution.

view newscast page
play newscast audioPlay

The Supreme Court for now protects access to abortion drug mifepristone, while Senate Republicans block a bill protecting access to in-vitro fertilization. Wisconsin's Supreme Court bans mobile voting sites, and colleges deal with funding cuts as legislatures target diversity programs.

view newscast page
play newscast audioPlay

As summer nears, America's newest and largest international dark sky sanctuary beckons, rural job growth is up, but full recovery remains elusive, rural Americans living in prison towns support a transition, while birth control is more readily available in rural areas.

Mortality rates in rural Arizona have experts concerned

play audio
Play

Monday, May 20, 2024   

By Jazmin Orozco Rodriguez for KFF Health News.
Broadcast version by Alex Gonzalez for Arizona News Connection reporting for the KFF Health News-Public News Service Collaboration


In Matthew Roach’s two years as vital statistics manager for the Arizona Department of Health Services, and 10 years previously in its epidemiology program, he has witnessed a trend in mortality rates that has rural health experts worried.

As Roach tracked the health of Arizona residents, the gap between mortality rates of people living in rural areas and those of their urban peers was widening.

The health disparities between rural and urban Americans have long been documented, but a recent report from the Department of Agriculture’s Economic Research Service found the chasm has grown in recent decades. In their examination, USDA researchers found rural Americans from the ages of 25 to 54 die from natural causes, like chronic diseases and cancer, at wildly higher rates than the same age group living in urban areas. The analysis did not include external causes of death, such as suicide or accidental overdose.

The research analyzed Centers for Disease Control and Prevention death data from two three-year periods — 1999 through 2001 and 2017 through 2019. In 1999, the natural-cause mortality rate for people ages 25 to 54 in rural areas was only 6% higher than for city dwellers in the same age bracket. By 2019, the gap widened to 43%.

The researchers found the expanding gap was driven by rapid growth in the number of women living in rural places who succumb young to treatable or preventable diseases. In the most rural places, counties without an urban core population of 10,000 or more, women in this age group saw an 18% increase in natural-cause mortality rates during the study period, while their male peers experienced a 3% increase.

Within the prime working-age group, cancer and heart disease were the leading natural causes of death for both men and women in both rural and urban areas. Among women, the incidence of lung disease in remote parts of the nation grew the most when compared with rates in urban areas, followed by hepatitis. Pregnancy-related deaths also played a role, accounting for the highest rate of natural-cause mortality growth for women ages 25 to 54 in rural areas.

The negative trends for rural non-Hispanic American Indian and Alaska Native people were especially pronounced. The analysis shows Native Americans 25 to 54 years old had a 46% natural-cause mortality rate increase over those two decades. Native women had an even greater mortality rate jump, 55%, between the two studied time periods, while the rate for non-Hispanic White women went up 23%.

The rural-urban gap grew in all regions across the nation but was widest in the South.

The increased mortality rates are an indicator of worsening population health, the study authors noted, which can harm local economies and employment.

As access to and quality of health services in rural areas continue to erode, rural health experts said, the USDA findings should spur stronger policies focused on rural health.

Alan Morgan, CEO of the National Rural Health Association, said he found the report “shocking,” though, “unfortunately, not surprising.”

The disparity warrants greater attention from state and national leaders, Morgan said.

The study does not address causes for the increase in mortality rates, but the authors note that differences in health care resources could compromise the accessibility, quality, and affordability of care in rural areas. Hospitals in small and remote communities have long struggled, and continued closures or conversions limit health care services in many places. The authors note that persistently higher rates of poverty, disability, and chronic disease in rural areas, compounded by fewer physicians per capita and the closure of hospitals, affect community health.

Roach said his past job as an epidemiologist included working with social vulnerability indexes, which factor in income, race, education, and access to resources like housing to get a sense of a community’s resilience against adverse health outcomes. A map of Arizona shows that rural counties and reservations have some of the highest vulnerability rankings.

Janice C. Probst, a retired professor at the University of South Carolina whose work focused on rural health, said many current rural health efforts are focused on sustaining hospitals, which she noted are essential sources of health care. But she said that may not be the best way to address the inequities.

“We may have to take a community approach,” said Probst, who reviewed the report before its release. “Not how do we keep the hospital in the community, but how do we keep the community alive at all?”

The disparities among demographics stood out to Probst, along with something else. She said the states with the highest rates of natural-cause mortality in rural areas included South Carolina, Mississippi, Georgia, Alabama, and others that have not expanded Medicaid, the joint federal and state health insurance program for low-income people, though there are efforts to expand it in some states, particularly Mississippi.

It’s an observation the USDA researchers make as well.

“Regionally, differences in State implementation of Medicaid expansion under the 2010 Affordable Care Act could have increased implications for uninsured rural residents in States without expansions by potentially influencing the frequency of medical care for those at risk,” they wrote.

Wesley James, founding executive director of the Center for Community Research and Evaluation, at the University of Memphis, said state lawmakers could address part of the problem by advocating for Medicaid expansion in their states, which would increase access to health care in rural areas. A large group of people want it, but politicians aren’t listening to their needs, he said. James also reviewed the report before it was published.

According to KFF polling, two-thirds of people living in nonexpansion states want their state to expand the health insurance program.

Morgan added the study focused on deaths that occurred prior to the covid-19 pandemic, which had a devastating effect in rural areas.

“Covid really changed the nature of public health in rural America,” he said. “I hope that this prompts Congress to direct the CDC to look at rural-urban life expectancies during covid and since covid to get a handle on what we’re actually seeing nationwide.”

In Arizona, the leading cause of death for people 45 to 64 in 2021 in both rural and urban areas was covid, according to Roach.


Jazmin Orozco Rodriguez wrote this story for KFF Health News.


get more stories like this via email

more stories
The wells providing water on Santee Tribal lands had manganese levels more than 50 times greater than what is considered safe for adults. Excessively high manganese can cause problems with memory, attention and motor skills. (Adobe Stock)

Social Issues

play sound

Members of the Nebraska Santee Sioux Tribe hope a solution to their five-year water ordeal may be on the way. Their tap water has been unusable for …


play sound

Hurricane season is here, and conservationists are shining a light on the role salt marshes play in protecting coastal North Carolina communities…

Social Issues

play sound

This weekend, Father's Day will be tough for children with a dad in jail or prison. More than 200,000 kids in Michigan have had an incarcerated …


Social Issues

play sound

Local election administrators have new guidance from Wisconsin's highest court on alternative early voting sites. A political expert says the timing …

Between 2017 and 2022, Minnesota saw a more than 30% increase in farm acres planted with cover crops. (Adobe Stock)

Environment

play sound

When Minnesota farmers watch their crops grow this summer, some will monitor land that has better soil health. It's because of a fairly popular …

Environment

play sound

West Virginia will receive $140 million to clean up legacy pollution in regions decimated by decades of coal mining. The money is part of $725 …

Environment

play sound

Close to 200 events are planned now through Sunday at California state parks for the third annual State Parks Week. The events advance Gov. Gavin …

 

Phone: 303.448.9105 Toll Free: 888.891.9416 Fax: 208.247.1830 Your trusted member- and audience-supported news source since 1996 Copyright 2021