Research Finds Emerging 'Rural' Mortality Penalty

Newswise — National trends in recent decades reveal an "emerging mortality penalty" for people living outside of metropolitan areas, Mississippi State researchers are reporting in American Journal of Public Health.

For the first time in recent years, university scientists have identified data showing that more than 40,000 more people living in rural counties die annually than those in metropolitan areas. Research also shows the historical metropolitan mortality rate--more people dying in cities than in rural areas--has reversed since the mid-1980s, leading researchers to explore reasons why.

In the article to be published in August but available online now, a team from MSU's nationally recognized Social Science Research Center point out that non-metropolitan areas have higher rates of deaths overall. Heart disease, cancer and stroke are cited as the top three causes.

Team members include Jeralynn S. Cossman, an associate professor; Wesley L. James, a postdoctoral associate; Arthur G. Cosby, SSRC director; and Ronald E. Cossman, research professor. They analyzed mortality data covering the years 1968-2005 obtained from the National Center for Health Statistics Compressed Mortality File.

"This is a reversal of a century-long trend that may have long-term ramifications for rural health care policy," lead researcher Jeralynn Cossman said. "In fact, if this disparity continues on its current trajectory, it will grow larger than our racial disparity in mortality."

She noted that, while non-metropolitan mortality rates for stroke have been higher than metropolitan rates for years, their study found them to be higher for heart attacks, cancer and overall causes of death for the first time. Mortality rate projections for 2010-15 show the trend continuing, she added.

The researchers applied standard U.S. Department of Agriculture criteria to define non-metropolitan and metropolitan counties in their report.

While the MSU study is the first to show an emerging non-metropolitan mortality penalty, exact causes for the shift from metropolitan to more rural areas remain elusive.

According to the MSU team, possible causes could be changes:

--In standards of health care that have not been implemented in rural areas,

--In rates of people without insurance coverage,

--In rates of disease occurrences, and

--Changes in health behaviors.

Jeralynn Cossman said additional research should examine potential reasons that may have caused the shifts. Some possibilities include changes in medical treatments for heart attacks and cancer, and the growth of Hispanic populations in rural areas, she said.