The Shifting Demographics of Congressional Briefing Rural America: - - PowerPoint PPT Presentation

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The Shifting Demographics of Congressional Briefing Rural America: - - PowerPoint PPT Presentation

Sep 17, 2022 331 likes •460 views

The Shifting Demographics of Congressional Briefing Rural America: Washington, D.C. Health and Mortality April 3, 2017 Dr. Wesley James Department of Sociology University of Memphis The Transition of United States Geographic Mortality

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The Shifting Demographics of Rural America: Health and Mortality

  • Dr. Wesley James

Department of Sociology University of Memphis

Congressional Briefing Washington, D.C. April 3, 2017

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Prior to 1900 Present 1940 1985

Urban Mortality Penalty

(Urban Mortality Exceeds Rural Mortality)

No Penalty

(Urban Mortality Equal To Rural Mortality)

Rural Mortality Penalty

The Transition of United States Geographic Mortality Disparities in Historical Context

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Trends in Rural-Urban Mortality Rates

National Center for Health Statistics. Compressed Mortality File, 1968-2012.

700 800 900 1000 1100 1200 1300 1400 1968 1973 1978 1983 1988 1993 1998 2003 2008 2013

Rural US Urban US

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Trends in Rural-Urban Mortality Rates by Race

National Center for Health Statistics. Compressed Mortality File, 1968-2012.

700 800 900 1000 1100 1200 1300 1400 1500 1600 1700 1968 1973 1978 1983 1988 1993 1998 2003 2008 2013 Rural US White Urban US White Rural US Black Urban US Black

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The Shifting Rate of Change in Mortality Rates

Excess Deaths and Rate of Change By Rural-Urban and Race Excess Deaths (1986-2012) Rate of Change (1968-1985) Rate of Change (1986-2012) Rural U.S. >700,000 1.57% 0.62% Urban U.S.

  • 1.56%

1.06% Rural White 693,300 1.62% 0.62% Urban White

  • 1.59%

1.10% Rural Black 53,657 1.52% 0.94% Urban Black

  • 1.37%

1.43%

  • High rates of rural mortality are due to a slow down in the

annual rate of improvement since the mid-1980s

  • Rural white mortality has seen the greatest decline in improvement
  • More than 700,000 rural deaths occurred due to unequal death rates

National Center for Health Statistics. Compressed Mortality File, 1968-2012.

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Declining Life Expectancy

  • Declining life

expectancy corresponds with increasing mortality

  • The first

decrease since 1999

National Center for Health Statistics. Compressed Mortality File, 1968-2015.

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Deaths of Despair

  • An important part of rural America’s problems is the recently

identified opioid epidemic

  • Accompanied by suicide and alcoholism
  • Alarming increase in deaths due to external causes for mid-life

white Americans with little education

  • This corresponds with declining reports of physical and mental

health, joblessness, joint pain, sciatica, distress, isolation

Case and Deaton, 2015, 2017

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Geographic Expansion of Deaths of Despair

http://bruegel.org/2017/03/the-american-opioid-epidemics/

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International Comparison of Deaths of Despair

Source: “Mortality and morbidity in the 21st century” by Anne Case and Angus Deaton, Brookings Papers on Economic Activity, Spring 2017

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Deaths of Despair by Sex and Education Level

Source: “Mortality and morbidity in the 21st century” by Anne Case and Angus Deaton, Brookings Papers on Economic Activity, Spring 2017

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Take Home Points

  • Deaths in America are not created equal
  • Rural Americans die at a higher rate than urban Americans,

and it’s getting worse every year

  • Who is hit the hardest?
  • Rural black Americans
  • Rural, middle-aged white women and men
  • < high school education
  • Unemployed
  • Those who accumulate disadvantages
  • The American Dream?