Since 2000, 79 of 114 Missouri counties show a rise in white mortality rates among ages 25-59, according to a report recently released by the Missouri Foundation for Health and created in partnership with Virginia Commonwealth University’s Center on Society and Health, and the University of Pittsburgh.
The report, “Why Are Death Rates Increasing Among Whites in Missouri? Communities Facing New Social & Economic Realities” states death rates have generally been decreasing in the United States and other industrialized countries due to advances in public health and medicine. Nevertheless, and for the first time, a reverse pattern was observed among young and middle-aged white Missourians.
Ryan Barker, vice president of Health Policy for the Missouri Foundation for Health, said the report shows that rural whites and urban people of color in Missouri have more in common than many would suspect, including being hard-hit by the recession in 2007-2008, which caused a spike in unemployment.
“Jobs haven’t come back and unemployment hasn’t dropped for certain populations and we see that both in the African-American urban community and in some of the rural communities in Missouri,” Barker said.
This trend among Missouri whites is mainly in rural areas, where researchers cite an increase in what they refer to as “deaths of despair” – fatal drug overdoses, alcohol poisonings and suicides – which point to a feeling of hopelessness and a lack of opportunity. The report describes it as a “crisis of confidence in the American dream.” From 1995-2014, the 79 affected counties saw a 585 percent increase in drug overdoses, 763 percent increase in alcohol poisoning, and a 30 percent increase in suicides.
The report found that rural areas in Missouri reflect a rise of more than 50 deaths per 100,000 people aged 25-59. Thirty-three counties in particular are facing the brunt of this crisis. While they are scattered across the state, the Bootheel and Ozark areas have seen the largest increases. The 33 hardest-hit counties suffer from long-term poverty, unemployment, a lack of health care access, and few opportunities for the future.
“People living in the 33 most impacted counties had less education; lower household incomes; higher rates of unemployment, poverty, and food insecurity; and a larger proportion of foreign-born residents,” the report states. “Residents of these counties had less access to health insurance, health care providers (primary care and mental health), a vehicle, parks, or public transit. The 46 counties with more modest increases in mortality had more urban characteristics, including greater air pollution and violent crime.”
The MFH report also found dramatic increases in deaths from diseases, which account for a large proportion of excess deaths among middle-aged whites in Missouri.
“The medical disorders responsible for these deaths included chronic lung disease, viral hepatitis, liver cancer, heart disease, and other organ diseases, many having potential links to substance abuse and trauma (e.g., accidents),among other risk factors,” the report states.
“Whites in the affected counties also experienced significant increases in death rates from other causes, such as obesity, kidney failure, sepsis, neurologic disorders (including anoxic brain damage), and maternal deaths related to child birth. A variety of factors could be responsible for these trends, but common contributors could include increased smoking, overeating, drug and alcohol use, and catastrophic damage to vital organs.”
The 46 Missouri counties with more modest increases in mortality had more urban characteristics, including greater air pollution and violent crime.
During 1995-2014, mortality rates among blacks, American Indians and Alaskan Natives, and Asians in Missouri decreased by 23 percent, 24 percent, and 26 percent, respectively. Mortality rates among Hispanics in Missouri decreased by 53 percent.
“This generation within rural Missouri is really dealing with this economic downturn, combined with educational opportunity and the inequality of education is there – and it’s the first time,” Barker said. “As the report points out, a lot of our minority communities have been experiencing that type of stress for generations.”
Barker said the hypothesis is that this stress may be behind the increased white mortality rates, although it remains higher than certain groups.
“I do want to make clear that while we are happy to see the mortality rate dropping for African Americans, for Hispanics – it is still much higher than whites,” Barker said.
The report states black Missourians live shorter and less healthy lives than whites, Asians, and Latinos. During the years 2010–2014, the death rate among blacks remained 1.2 times that of whites.
As a state, lawmakers have an opportunity to create policy solutions that include health insurance coverage for all Missourians.
“We know there are still high rates of uninsured both in our urban racial and ethnic minority groups, but also in rural Missouri,” Barker said. “It’s one of those common threads of where can our state legislature come together – urban legislators, rural legislators – that really benefit the entire state of Missouri.”
If Missouri really wants to address health issues, Barker said it will have adopt a comprehensive approach.
“We have to be open to addressing economic, housing issues, employment and education,” Barker said. “You really need everybody working together towards common solutions.”
Read the complete report at https://tinyurl.com/WhiteMortalityMo.
