Race and Rural: An Investigation of the Rural Mortality Penalty

Lynne Cossman, West Virginia University
Wesley James, University of Memphis
Tony Lemonis, University of Memphis

The rural mortality penalty (growing disparities in rural-urban macro-level mortality rates) have persisted in the US since the mid-1980s. Substantial intra-rural differences exist: rural places close to urban areas experience a greater mortality burden than more remote locales. Therefore, access to medical care, a predominant explanation for rural mortality disadvantage, is not the primary mechanism of rural disadvantage. Social and economic conditions are strong predictors of mortality, but vary across rural classifications. We examine how race conditions the rural mortality penalty. Using data from the CMF (1968-2007), we calculate annual age-adjusted, race-specific mortality rates for all rural/urban regions. Indicators for access to care are from the AHRF and social and economic indicators are from Census data. Measures of access to care and socioeconomic factors over four decades are used to determine change in the factors predicting rural mortality disparities and to disentangle the role of race in rural mortality disparities.