The U.S. National Academy of Sciences (NAS) released a report on Feb. 2, 2022, which indicated that mortality for U.S. adults is “steepest for White adults in rural areas who tend to be the least educated and have the lowest income, dramatically reversing the centuries-old pattern of lower mortality in the countryside and higher mortality in cities.”

The report, written by Peter Sterling, Ph.D, and Michael Platt, Ph.D., and which appeared in the Journal of the American Medical Association, said. “The rise is largely attributable to deaths of despair (suicide and poisoning by alcohol and drugs) with strong contributions from the cardiovascular effect of rising obesity.”

The NAS report stated that U.S. mortality rates are higher than a 16-nation control group (Australia, Austria, Belgium, Canada, Denmark, Finland, France, Germany, Italy, Japan, Norway, Portugal, Spain, Sweden, Switzerland and the United Kingdom). The high mortality rate in the United States has been evident at all ages from birth to 80 years for a half century, but since 2000 the U.S. mortality rate has increased significantly.

The NAS report said rising mortality contributors also include deaths from obesity by eating greasy and sweet foods that contributes to diabetes, cardiovascular disease and other health compromises. Insufficient physical exertion also contributed to early deaths, as have heightened rates of violence, including shootings.

Drug-related fatalities, the authors said, include poisoning by opiates, cocaine, amphetamines, alcohol and tobacco.

The pattern of deaths traditionally was much higher among Blacks in the United States, but mortality among Blacks has declined during recent years and is approaching the mortality rates of Whites, which are increasing lately. The mortality rate of Hispanic individuals is lowest of all the racial and ethnic groups and is declining further.

The report observes that although people are living longer these days, the U.S. rank among the 16-nation group is declining. Do other evaluations corroborate the NAS conclusions? Do the NAS conclusions have implications for people engaged in agriculture?

Suicide was ranked as the 10th leading cause of death in America in 2019. Despite the COVID outbreak, suicide has declined for two successive years, according to another report in the Journal of the American Medical Association, this one on April 13, 2021.

The recent decline of suicides is for the United States as a whole. There are indications that suicide also declined recently among farm owners and operators, as I reported in a May 2021 article in this publication, but suicide remains highest among farm workers and low-income rural residents, according to the CDC.

Deaths due to opioids rose from 48,802 in 2018 to 68,630 through 2020, according to a January 2022 report by the National Institute on Drug Abuse. Deaths by suicide and drug poisoning are more common among economically distressed persons than among persons who are not economically challenged.

For several decades, the U.S. Census has consistently indicated that rural areas in America contain a higher proportion of impoverished residents than non-rural areas. Generally, wages are lower for working rural persons in the countryside and towns than for suburban and urban residents who work.

However, well-educated rural residents, professionals and skilled workers, including farm owners and operators, experience lifestyles on par with those of their similarly educated metropolitan residents. This may explain their lower rates of suicide and substance misuse than farm workers and low-paid laborers in agriculture, rural industries and rural services.

Lesser educated persons, whether living in rural or metropolitan areas, are more likely to experience economic insufficiency and accompanying lifestyles that contribute to what the NAS report describes as despair. Moreover, low-income people are likely to consume diets that contain high amounts of sugar and other carbohydrates that contribute to obesity and cardiovascular disease.

Most impoverished persons don’t choose their lifestyles and they don’t seek government assistance fraudulently. Supplemental Nutrition Assistance Program benefits fraud was estimated to occur among 1.6 to 4 percent of the recipients, according to the USDA in 2013. Most of the fraud was conducted by organized crime rings.

Similarly, scammers, not low income rural or metropolitan residents, obtained about $36 billion fraudulently through the CARES ACT that was implemented in the spring of 2020 to combat COVID.  However, fraud by scammers in the United States and abroad has been dropping as the Small Business Administration and other government relief programs tightened their requirements in 2021.

Moreover, the number of U.S. residents who relied on unemployment, rent or food assistance programs during the early part of the COVID era decreased rapidly during 2021 and early 2022.

In summary, poverty and low education are positively – and conclusively – correlated with the self-destructive behaviors of suicide, drug poisonings and consumption of unhealthy foods. Poor and lesser educated White rural residents are at the highest risk for shorter lifespans.

These conclusions are offset by the fact that many Americans are leaving metropolitan areas to live in rural areas. They are seeking less pressured and more self-sufficient lifestyles; they can help to improve the overall well-being in rural areas.

Dr. Rosmann can be contacted at: mike@agbehavioralhealth.com.