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The difference in mortality rates between rural and urban America is widening across racial boundaries, the researchers warn.
While overall mortality rates for both urban and rural residents have declined over the past 20 years, the decline has been much slower among US rural residents, which fell 9% compared to 23% for urban residents.
The difference in mortality between rural and urban areas tripled between 1999 and 2019, according to a study published Tuesday in Journal of the American Medical Association.
In contrast, the gap between mortality rates among blacks and whites has been narrowing over the past two decades, according to study co-author Dr. Haider Warreich, associate physician at Brigham and Women’s Hospital in Boston.
The smallest decline in death rates was seen among white men, from 900 deaths per 100,000 in 1999 to 833 deaths in 2019. The slow decline was partly due to an increase in mortality among white rural residents between the ages of 25 and 64. …
“We usually like to think that as medical innovation and technology improves, this inequality will be reduced or minimized,” Warrich said. “But what we see here is actually the exact opposite.”
According to Warraich, health-risk behaviors such as smoking, alcohol and drug use, and obesity have led to a steady rise in chronic illness among rural residents. Previous research co-authored with Warraich published in JAMA in May found that the incidence of cardiovascular disease between rural and urban areas nearly doubled from 1999 to 2017.
Rural communities were also hit hard by the aftermath of the opioid crisis when drug overdose deaths jumped up during a pandemic.
“Often times, when we think about the countryside, we have this sunny, really optimistic view of what rural life looks like,” Warrich said. “But many of the bad eating habits, smoking and lack of exercise that we first associated with urban areas have been transferred to rural areas.”
In rural areas, many hospitals have also been lost over the past decade, leading to chronic illness and death. Since 2010, more than 180 rural hospitals closed their doors forever due to financial difficulties.
While hospital closures have played a role in limiting the ability to provide emergency care to villagers, Warrach said it is only one piece of the puzzle that involves the urgent need to strengthen primary and preventive care services.
The need to tackle health care in rural areas has more serious implications for the rest of the country, as a lack of investment in such care services has played a role in areas where COVID-19 vaccination rates are lower than in urban areas, which increases the chances for the United States. will reach the vaccination threshold of 70% of the population to achieve herd immunity from the virus is less likely in the next few months.
“The idea that this is a closed crisis is short-sighted,” Warrich said.
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