Life and death in a small town

John Cougar Mellencamp sang in his 1985 hit song Small Town, “I was born in a small town… probably die in a small town.” Unfortunately for John, it also appears that he will probably die sooner in a small town. A study published last month in the American Journal of Preventative Medicine by Dr. Gopal Singh examines the trends in life expectancy disparities between rural and urban areas in the United States between 1969 and 2009. The article finds that the disparity has increased since 1990, because life expectancy has grown more rapidly in urban than in rural areas. “Between 1969 and 2009, residents in metropolitan areas experienced larger gains in life expectancy than those in nonmetropolitan areas, contributing to the widening gap,” Singh stated in his conclusion. According to the research findings, the life expectancy disparity of urban over rural areas stood at 2.4 years in 2005-2009. Furthermore, the findings indicate that mortality from cardiovascular diseases, injuries, lung cancer and COPD is much higher in rural than in urban areas. For more data on this, visit NRHA’s “What’s Different About Rural Health.” “The rural poor and rural blacks currently experience survival probabilities that urban rich and urban whites enjoyed four decades earlier,” according to the report’s conclusion. Four decades. Another way of saying this is that advances in public health and preventative care are not reaching rural communities. Life expectancy estimates are routinely available for gender, racial/ethnic and socioeconomic groups. However, few articles have looked at how disparities in life expectancy have changed over time. Zip codes should never be a predictor of life expectancy. And this recent study points to a disturbing trend that certainly merits more research and a closer look at national policies that are leading toward longer, healthier lives in cities over small towns.

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