Study finds infant mortality disparity in Appalachia growing

Barsaba Taglieri
Agosto 9, 2017

A new study found people who live in rural Appalachia have higher infant mortality rates and lower life expectancy compared to people living elsewhere in the country.

Life expectancy in Appalachia, a region that stretches from MS to NY, lags behind the rest of the US - and the divide is widening, a new study suggests.

A group of researchers analyzed mortality rates around the country and found that people in Appalachia are being left behind when it comes to life expectancy and according to the authors, it has to do a lot with smoking.

Higher mortality in Appalachia from heart disease, lung cancer, respiratory disorders, diabetes, kidney problems, suicide, accidental injuries, and drug overdoses all contribute to the widening survival disparities between the region and the rest of the country, the researchers note.

It's possible that poverty may be a stronger predictor of poor health in Appalachia than in the rest of the country because of the high concentration of poor people in the area, said Jennifer Karas Montez, a sociology researcher at Syracuse University in NY who wasn't involved in the study. Deaths declined in the region and the nation as a whole during the next two decades, but infant mortality rates also became 16 percent higher in Appalachia than the rest of the country. For people born in Appalachia between 1990 and 1992, the gap is narrower; for those young adults, life expectancy is seventh months shorter than it is for the U.S.as a whole.

The team used the federal Appalachian Regional Commission to define the region, which is made up of 428 counties across 13 states. It includes all of the counties in West Virginia along with some counties in Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee and Virginia.

While the region has been the focus of the opioid epidemic in recent years, the study found one of the biggest culprits was likely the prevalence of smoking and the region's tendency to be "more accepting of tobacco use as a social norm". Gopal K. Singh, a senior health equity adviser with the U.S. Department of Health and Human Services and co-author of the study, said nearly 20 percent of Appalachian women report they smoked during pregnancy.

"Smoking-related diseases accounted for more than half of the life expectancy gap between Appalachia and the rest of the country", Singh said by email.

In Kentucky, state lawmakers passed a law requiring health insurance companies to cover tobacco cessation medications that have been approved by federal regulators. However, they wouldn't be able to pass a bill that would have banned tobacco from public school campuses.

Just 36 percent of Kentucky's 173 public school districts ban all tobacco products on campus and at school-sponsored events.

Children born in Appalachia from 2009 to 2013 have a life expectancy of 76.9 years, compared with 79.3 years for the rest of the USA, the study found. The researchers believe that finding was a likely explanation for why the life expectancy among white women dropped between 1990 and 2004 while increasing for white women in the rest of the country.

Other causes included accidental deaths, such as auto wrecks. According to the researchers, about 30 percent of "unintentional injury deaths" in rural Appalachia are from vehicle accidents, which contributes considerably to the life expectancy gap.

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