After decades of lower or similar mortality rates in rural areas than in urban areas of the U.S., a rural mortality penalty emerged in the 1990s and has grown since the mid-2000s. Although the rural–urban mortality gap has widened across all major racial/ethnic groups over the past 30 years, it has widened the most among working-age non-Hispanic (NH) whites.

A research brief in the Population Research and Policy Review  summarizes the results of a study that examined rural-urban differences in mortality rates overall and from 15 specific causes among working-age (age 25-64) NH whites¹ from 1990 to 2018 and identified the causes of death that have contributed most to the widening of the rural mortality penalty.²

Results show that the rural mortality penalty is wide and growing and is pronounced across multiple causes of death. Growth in the rural disadvantage is due to smaller rural declines in deaths from cancers and cardiovascular diseases and larger rural increases in deaths from metabolic, respiratory, alcohol-related, and mental and behavioral diseases and suicides compared to urban areas. Mortality rate trends are particularly concerning for the younger working-age group (25-44) and for females overall. Ultimately, 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, failures across a variety of institutions and policies have contributed to rural America’s troubling mortality trends.

Learn more at https://lernercenter.syr.edu/2020/10/20/rb-35/