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Demovictory9

(32,598 posts)
Mon Apr 15, 2024, 06:26 PM Apr 15

Rural America's working-age adults die at wildly higher rates than their counterparts in cities. Why?

Rural America’s working-age adults die at wildly higher rates than their counterparts in cities. Why?

Rural Americans ages 25 to 54 — considered the prime working-age population — are dying of natural causes such as chronic diseases and cancer at wildly higher rates than their age-group peers in urban areas, according to the report.

The USDA researchers analyzed mortality data from the Centers for Disease Control and Prevention from two three-year periods — 1999 through 2001, and 2017 through 2019. In 1999, the natural-cause mortality rate for rural working-age adults was only 6 percent higher than that of their city-dwelling peers. By 2019, the gap had widened to 43 percent.


The disparity was significantly worse for women — and for Native American women, in particular. The gap highlights how persistent difficulties accessing health care, and a dispassionate response from national leaders, can eat away at the fabric of rural communities.

A possible Medicaid link
USDA researchers and other experts noted that states in the South that have declined to expand Medicaid under the Affordable Care Act had some of the highest natural-cause mortality rates for rural areas. But the researchers didn’t pinpoint the causes of the overall disparity.


Seven of the 10 states that have not expanded Medicaid are in the South, though that could change soon because some lawmakers are rethinking their opposition, as KFF Health News previously reported.

https://www.msn.com/en-us/health/other/ar-BB1lEcWm

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Rural America's working-age adults die at wildly higher rates than their counterparts in cities. Why? (Original Post) Demovictory9 Apr 15 OP
Access to quality medical care may be a part Maeve Apr 15 #1
bingo. WarGamer Apr 15 #5
And, the city hospitals are now bamagal62 Apr 15 #6
You're right, especially about access to specialists. ShazzieB Apr 15 #22
Jeez !!!! Karadeniz Apr 15 #2
They die of jobs where OSHA is absent or barely present. no_hypocrisy Apr 15 #3
I think you're right. And the stats should be able to show this. erronis Apr 15 #11
I live in furniture making country in rural NC ms liberty Apr 15 #24
And I thought we were doing a good thing buying American. LT Barclay Apr 15 #27
It is a good thing. But it's not easy work, it's physically demanding ms liberty Apr 15 #37
The pieces are definitely quality and we are "bringing them home". We are working on a move to Anderson, SC by June. LT Barclay Apr 15 #38
Oh yes, you will be able to find someone I am sure. n/t ms liberty Apr 15 #40
Don't forget more pesticide exposure, higher reliance on hunting and fishing for sustenance LT Barclay Apr 15 #25
Good points. Everyday life harards/stresses, coping attempts. brush Apr 15 #28
"Stick it to the libs" idiocy is undoubtedly a factor. Aristus Apr 15 #4
It also encompasses males being against other practices that they perceive as "nanny state" or anti-macho. Sky Jewels Apr 15 #8
The only problem is when it ends up killing someone other than the toxics themselves. Aristus Apr 15 #10
Yeah, but men have always been that way. erronis Apr 15 #12
Yep. Anyone remember Sarah Palin drinking a "diabeetus in a cup" Big Gulp... keep_left Apr 15 #19
It worked. jimfields33 Apr 15 #36
People in cities are more active Buckeyeblue Apr 15 #7
And In so calif urban areas..gyms are packed!! Demovictory9 Apr 15 #9
IMNSHO, refusing to expand Medicaid is reprehensible. ShazzieB Apr 15 #13
Can we state it in the same moralistic terms as Fox News would? JadedButHopeful Apr 15 #14
I have a hospital literally a block away from my house. BlueTsunami2018 Apr 15 #15
We're On The Fringes Of Chicagoland ProfessorGAC Apr 15 #29
It's 41 miles to the nearest hospital for me Kaleva Apr 15 #34
At least they're voting for people who will put their kids to work after they're dead. Probatim Apr 15 #16
Opioids? In the US Appalachian & Ohio areas irisblue Apr 15 #17
All of the things others have said Tree Lady Apr 15 #18
I remember reading how badly fried fish impacted the heath of southerners BlueWaveNeverEnd Apr 15 #26
True, I try to stay away from fried food Tree Lady Apr 15 #41
Stubbornness Drum Apr 15 #20
Republicans, in their determination to be cruel, are killing off their voters dlk Apr 15 #21
Insecticides&herbicides OceanPete Apr 15 #23
Yep, all those toxic chemicals in the clime nearby are sure to kick butt, then bucket kicking. brush Apr 15 #33
It is likely a number of things. Manual jobs in all weather and poor working conditions are two I think. twodogsbarking Apr 15 #30
Medicaid expansion has not been implemented JustAnotherGen Apr 15 #31
+1 betsuni Apr 16 #45
Rates can be misleading when talking about small numbers Kaleva Apr 15 #32
I live 30 miles from the closest hospital equipped with a Cath Lab Cheezoholic Apr 15 #35
yikes. glad you made it. BlueWaveNeverEnd Apr 15 #43
They closed a few hospitals/clinics in rural area in my area. LiberalFighter Apr 15 #39
Because their employers choose profit over regulations? Initech Apr 15 #42
I notice the food first when I visit family in "rural America." hunter Apr 15 #44
I was a vegetarian traveling thru the south..it wasnt easy Demovictory9 Apr 17 #46

Maeve

(42,392 posts)
1. Access to quality medical care may be a part
Mon Apr 15, 2024, 06:35 PM
Apr 15

Grew up in the country and the hospital was...limited. Go-getter doctors can make better money in the cities and medicine has become a for-profit enterprise. Still have to go 40 miles for some specialties (at least my Mom did, one reason she moved to the city). Not everyone can do that

bamagal62

(3,310 posts)
6. And, the city hospitals are now
Mon Apr 15, 2024, 06:51 PM
Apr 15

busting at the seams because they've closed so many of the county and rural hospitals.

ShazzieB

(16,938 posts)
22. You're right, especially about access to specialists.
Mon Apr 15, 2024, 08:41 PM
Apr 15

My sister (now deceased) lived in a rural town. There's a hospital there, but it can only do so much. This past January, she got covid (not an antivaxxer, but had been living in a nursing home). She was admitted to the local hospital, but when a nephrolology consult was needed, they had to put her in an ambulance and send her to a bigger hospital in a city that was 50 miles away. In her case, Medicaid paid for everything, but without that, she would have have been up the proverbial creek without a paddle.

(Before anyone asks, she was diabetic and her kidneys had been gradually failing. That bout of covid pushed her over the edge into what is called end-stage kidney failure, treatable only by dialysis or by a transplant. She wasn't a good candidate for either, for reasons that would take too long to go into here. She was past being able to make any decisions, so as the person who held her medical power of attorney, I had to make the call to change her code status to dnr (do not resuscitate) and call in hospice services. She was transported 50 miles back to the nursing home in her little town, where she died about a week later. The hospice folks were fantastic, and I am fine now.)

I mention this just as an example of the extra hassles that can occur in a small rural town with a lack of local access to specialized medical care, even when payment is not a barrier.

no_hypocrisy

(46,642 posts)
3. They die of jobs where OSHA is absent or barely present.
Mon Apr 15, 2024, 06:42 PM
Apr 15

Black lung disease from coal mining.

Driving 18-wheel rigs with 4 hours of sleep.

Alcoholism and cigarettes from job stress and financial stress.

Local hospitals bought and shut down.

Supermarkets that push more snacks than vegetables and fruit.

erronis

(15,776 posts)
11. I think you're right. And the stats should be able to show this.
Mon Apr 15, 2024, 08:11 PM
Apr 15

So many good research projects, dissertations, theses in these numbers. Come on , people!

ms liberty

(8,692 posts)
24. I live in furniture making country in rural NC
Mon Apr 15, 2024, 08:44 PM
Apr 15

A lot of America's furniture is made here, within a 75 mile radius of my house. It's really difficult physical labor, and people end up wore out and old before their time. Upholsterers by about age 50 have knarled hands with swollen joints, same with any of the spring up and frame assembly people. Finishing work on the exposed woods has the problem of lung and breathing issues due to the stains, paints, and the inevitable sanding. Sewers aren't left out either, the repetitive motion of sewing is terrible for the hands and arms, as well as the pulling and tugging needed to feed heavy upholstery fabrics through the machines.
We have other manufacturing here too ( most all the duct tape sold during the COVID craze was manufactured not 20 miles from my house), and all of the industries have their own issues, but the bottom line is that a lot of the work, probably most, is factory and physical. It can be decent money - if you're good at your job - but it requires hard work on production pay...meaning you get paid per piece. Much of the rural south lives in those kind of jobs.
Then add to that the fact of being 20 miles or more from a hospital in an area where it might take an ambulance 15 minutes to get to your house, and take them another 25 to get you to the hospital and you end up with what we've got now.

LT Barclay

(2,636 posts)
27. And I thought we were doing a good thing buying American.
Mon Apr 15, 2024, 08:48 PM
Apr 15

We have a living room set from NC and one of my kids had a bicycle from the remnants of the Schwinn company

ms liberty

(8,692 posts)
37. It is a good thing. But it's not easy work, it's physically demanding
Mon Apr 15, 2024, 09:38 PM
Apr 15

And that is what is necessary to make the furniture look good.. You don't get a tight back on your chair without an upholsterer physically pulling the fabric into place and then stapling it to the frame for instance. It's just what it takes to make a nice, well built piece of furniture. It's not that it's slave labor without safety regulations, but it's just as physical as working as a farmer, which is pretty much what many of these folks grandparents were.

LT Barclay

(2,636 posts)
38. The pieces are definitely quality and we are "bringing them home". We are working on a move to Anderson, SC by June.
Mon Apr 15, 2024, 09:42 PM
Apr 15

I remember many shops that rebuilt or reupholstered furniture, even on remote roadsides. Are those still a thing?
We have a few items that I'd like to have fixed for my wife. I'm also counting on finally being able to get some canvas work done for the boat.
But I definitely won't grumble about costs now.

LT Barclay

(2,636 posts)
25. Don't forget more pesticide exposure, higher reliance on hunting and fishing for sustenance
Mon Apr 15, 2024, 08:45 PM
Apr 15

Freshwater fish have up to 300 times the concentration of PFASs than is currently considered “safe”. I don’t know about other game animals but I would think they are contaminated also.
I read somewhere a few years back that the meat source with the fastest growth in sales was raccoon meat because a whole animal was only $5.

Aristus

(66,790 posts)
4. "Stick it to the libs" idiocy is undoubtedly a factor.
Mon Apr 15, 2024, 06:47 PM
Apr 15

Their frenzied hatred for anything that might possibly contribute to the greater good created anti-maskers and anti-vaxxers. Dying in order to make an idiotic ideological point is attention-getting, to be sure, but if one is not around to savor the attention, it's a little harebrained.

Sky Jewels

(7,302 posts)
8. It also encompasses males being against other practices that they perceive as "nanny state" or anti-macho.
Mon Apr 15, 2024, 07:14 PM
Apr 15

"Nobody's gonna tell me what to do! I have the freedom to smoke and blow it libs faces!"

"I ain't gonna eat that arugula and rabbit food! Vegetables and salads are for f*****s and soy boys! Gimme a big slab of red meat and a heap of fried potatoes!"

"I can drive my ATV over boulders and up steep slopes at top speeds and not wear a helmet! I ain't gonna be a lib pussy and worry about flipping!"

And so on...

Toxic masculinity kills.

Aristus

(66,790 posts)
10. The only problem is when it ends up killing someone other than the toxics themselves.
Mon Apr 15, 2024, 07:50 PM
Apr 15

What a prosecutor might call depraved indifference.

erronis

(15,776 posts)
12. Yeah, but men have always been that way.
Mon Apr 15, 2024, 08:13 PM
Apr 15

It's not really a factor of rural/urban......

Oh, wait. Men generally can't drive on mountains in downtown environments. But they still cause most of the vehicular deaths and injuries while downtown.

keep_left

(1,861 posts)
19. Yep. Anyone remember Sarah Palin drinking a "diabeetus in a cup" Big Gulp...
Mon Apr 15, 2024, 08:24 PM
Apr 15

...during her 2013 speech at CPAC? She was ridiculing the health initiatives of Michael Bloomberg and Michelle Obama.

[edit: it turns out I got some details wrong...Palin was drinking from a Super Big Gulp.]

https://archive.thinkprogress.org/sarah-palin-drinks-big-gulp-during-cpac-speech-shoot-its-just-pop-5ae8c4d8a0f7/

?si=DaIGtVLw_BRU2kgX

Buckeyeblue

(5,520 posts)
7. People in cities are more active
Mon Apr 15, 2024, 06:58 PM
Apr 15

They tend to walk more and seek out activities that keep them moving. In rural areas people drive everywhere, including down the driveway to the mailbox.

Demovictory9

(32,598 posts)
9. And In so calif urban areas..gyms are packed!!
Mon Apr 15, 2024, 07:20 PM
Apr 15

Hard to find parking around planet.fitness, 24 hr fitness, golds gym and others after work

ShazzieB

(16,938 posts)
13. IMNSHO, refusing to expand Medicaid is reprehensible.
Mon Apr 15, 2024, 08:13 PM
Apr 15

Reprehensible, and juet plain mean-spirited.

I believe a few red states have hopped on board belatedly. Any state still refusing to do so is the definition of a sh!thole state, afaic.

JadedButHopeful

(13 posts)
14. Can we state it in the same moralistic terms as Fox News would?
Mon Apr 15, 2024, 08:16 PM
Apr 15

We urbanites:

-Make better choices

-We don't abuse ourselves with drink and drugs

-We are better connected to our communities

-We don't rely on the government for health insurance

-etc. etc.

You get the idea. Hard to blame yourself when you're so used to blaming others for your problems.

BlueTsunami2018

(3,550 posts)
15. I have a hospital literally a block away from my house.
Mon Apr 15, 2024, 08:17 PM
Apr 15

Living out in the sticks has a significant disadvantage when dealing with life and death matters that require immediate attention.

ProfessorGAC

(66,048 posts)
29. We're On The Fringes Of Chicagoland
Mon Apr 15, 2024, 09:07 PM
Apr 15

People in the city would probably consider us rural, but:
We are 20 minutes by ambulance from a Level II trauma center, same time to a Level III, and in a different direction, another Level III & a Level IV.
Obviously, there's a plethora of doctors, specialists, & other Healthcare options.
Drive 45 miles south or west & you'd hit Healthcare wasteland. Go another 100 and the people there are way underserved.
I think this conversation is onto something.

Kaleva

(36,556 posts)
34. It's 41 miles to the nearest hospital for me
Mon Apr 15, 2024, 09:17 PM
Apr 15

Add the time waiting for the ambulance to arrive to that .

People who need serious care are usually flown out to Wausau WI or Duluth MN

Probatim

(2,626 posts)
16. At least they're voting for people who will put their kids to work after they're dead.
Mon Apr 15, 2024, 08:17 PM
Apr 15

They won't have to worry about who's caring for them...

Heartless... Likely. Accurate... Definitely.

Tree Lady

(11,614 posts)
18. All of the things others have said
Mon Apr 15, 2024, 08:19 PM
Apr 15

Healthcare not as available, people walk more and go to gym more in the city. Probably because of the lack of exercise, more overweight, I wonder if more pollution from chemicals in fields.

Not as much to do and I read as a senior you live longer if you keep more active and are more social.

BlueWaveNeverEnd

(8,461 posts)
26. I remember reading how badly fried fish impacted the heath of southerners
Mon Apr 15, 2024, 08:45 PM
Apr 15

my southern mom cooked it when we were kids... salty, crunchy goodness.

other than the rare fish n chips shops, i never see fried fish on menus in my area.

Tree Lady

(11,614 posts)
41. True, I try to stay away from fried food
Mon Apr 15, 2024, 10:33 PM
Apr 15

I do cook my eggs in olive oil and use avacado oil but they are healthy fats.

dlk

(11,695 posts)
21. Republicans, in their determination to be cruel, are killing off their voters
Mon Apr 15, 2024, 08:30 PM
Apr 15

They are completely irrational

OceanPete

(29 posts)
23. Insecticides&herbicides
Mon Apr 15, 2024, 08:44 PM
Apr 15

Could it bee the vast amounts of these products sprayed on surrounding crops? It's in the air!

twodogsbarking

(10,291 posts)
30. It is likely a number of things. Manual jobs in all weather and poor working conditions are two I think.
Mon Apr 15, 2024, 09:07 PM
Apr 15

It sucks to be poor would cover most all reasons.

JustAnotherGen

(32,292 posts)
31. Medicaid expansion has not been implemented
Mon Apr 15, 2024, 09:11 PM
Apr 15

Add to that drug addiction - and you have a recipe for disaster.

Indigenous Americans aside and African Americans in Southern states (Voter suppression and racism) . . .

These people voted for these bowls full of shit.

As long as Indigenous and Black folks are getting screwed over - they don't care.

I've said it before at DU and I haven't said it for a few years:

We could have medicare for all as long as its treated like The Raw (New) Deal - for white Americans only.

Kaleva

(36,556 posts)
32. Rates can be misleading when talking about small numbers
Mon Apr 15, 2024, 09:12 PM
Apr 15

In Michigan, 3% of the population lives in the northern 1/3 of the state while about 80% lives in the lowest 1/3 of the state.

While the rural north may have a higher mortality rate, a few extra deaths per year spread out over 15 counties probably isn't even noticable.

Cheezoholic

(2,096 posts)
35. I live 30 miles from the closest hospital equipped with a Cath Lab
Mon Apr 15, 2024, 09:30 PM
Apr 15

I also live 3 miles from a small town that used to be a full blown hospital capable of handling any emergency that most people needed. Its still got 75 beds and it served the rural area within a 40 mile radius of it. I was born there. I had a massive heart attack in October 2022. I drove myself to that hospital. They could do nothing but give me an IV and some drugs, slap an ECG on me to monitor and wait for an ambulance. Oh, and try and jump start me if I died. Weather was too bad for a chopper. City has 2 750k dollar ambulances but they can't go out of town. They held a phone to my ear while I was screaming in pain so a heart surgeon 30 miles away could explain the risk of having a chemical thrombolysis procedure. He basically told me without knowing how soon they could get me to him (at the same medical system as the local hospital) and seeing my ECG I may die without it. That was 90 min after I had gotten there. I had to sign a freakin' release form. Yeah, it probably saved my life but also significantly increased the possibility of a stroke for the next 90 days or so. I finally got to that specific hospital (in their ambulance). I went straight from the ambulance to my ass hitting the Cath Lab table and the last words I heard were "his ECG is looking really bad" before they knocked me out. I came close to losing consciousness but was afraid I'd die, so I just screamed in pain the whole time to stay awake. That was FOUR HOURS after I got to the hospital in that small town.

I lost 30% of my heart muscle that morning because IMO, it took them too long to get me to a capable facility. I did a little research, there are 10 Cath Labs within 35 miles. There are over 100 ambulances both fire rescue and private (hospitals, private companies) within 35 miles. But theres only 1 hospital with a couple Cath Lab's and 6 Ambulances within 35 miles directly associated with this hospital system. 4 hours is not acceptable with that much availability within a 30 min ambulance ride.

Yeah, don't get sick in a cornfield.

hunter

(38,459 posts)
44. I notice the food first when I visit family in "rural America."
Mon Apr 15, 2024, 11:46 PM
Apr 15

I live in California and there are dozens of ethnic restaurants and food markets within two miles of my house. The supermarket nearest our home stocks a wide variety of fresh fruits and vegetables. Maybe forty percent of my neighbors are immigrants and the children of immigrants, from all over the world, so the supermarkets sell foods that are familiar to them. Even our WalMart has a decent produce selection.

I do most of the cooking in our house and spend a lot of time in the kitchen at family gatherings. When I'm visiting rural U.S.A. I hardly know what to cook, the ingredients for half my "go to" recopies are simply unavailable. My wife is a vegetarian-approaching-vegan and servers in rural restaurants and cafes will sometimes look at her like she's an alien.

I think a lot of people in rural U.S.A. are simply malnourished. Certain urban areas are also "food deserts."

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