Steve August 3, 2020
racial-disparities-in-death-rates-widen-in-us.-rural-areas,-study-says

Aug. 3 (UPI) — Racial disparities in death rates are “widening” in rural areas of the United States — an indication of the growing burden of chronic disease among racial and ethnic minorities in these areas, according to authors of an analysis published Monday by JAMA Network Open.

While mortality rates declined by about 40% among older White and Black adults living in urban and “adjacent rural areas” — the suburbs — between 1968 and 2016, they dropped by less than 30% for Black men in rural areas farther away from cities, the researchers found.

This “considerable widening in mortality rate” started in the 1980s, building through the mid-2000s, researchers said.

Compared with White men, there were about 1,200 more deaths per 100,000 Black men in urban counties as of 2004 and 1,900 more deaths per 100,000 Black men in the suburbs as of 2007, they said.

“Chronic disease is a huge concern to rural healthcare systems, and its impact on mortality is profound in older Black rural residents,” analysis co-author Nasim B. Ferdows told UPI.

“Rural older Black Americans are a high-risk population who experience significant health disparities and bias in access to healthcare, along with high prevalence of multiple chronic conditions,” said Ferdows, assistant professor of health administration and policy at the University of Oklahoma Health Sciences Center.

The findings are based on analysis of death rates among adults age 65 and older for all U.S. counties — 3,076 as of 1968 and 3,087 as of 2016 — obtained from the Centers for Disease Control and Prevention, according to Ferdows and her colleagues.

Between 1968 and 2016, mortality for White older adults declined by 46% among men — from 9,063 to 4,896 deaths per 10,000 population — and by 39% for women — from 6,175 to 3,760 per 100,000 population — the researchers found.

Over the same period, death rates for Black adults decreased 38% — from 8,801 to 5,477 deaths per 100,000 population among men and from 6,380 to 3,960 deaths among women — they said.

However, while the mortality rate among White men decreased by 48% in urban counties, by 41% in suburban counties and by 42% in rural counties, it declined by 38%, 28%, and 27%, respectively, for Black men in each of these areas, researchers said.

“Residents of rural areas in the United States tend to be older and sicker than their urban counterparts,” Ferdows said.

“They have higher rates of cigarette smoking, high blood pressure and obesity, [and] there is some level of healthcare disparity and bias in healthcare delivery [that] restricts rural residents from optimizing their health outcomes,” she said.

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