Rural-Urban Gap in U.S. Death Rates Tripled Even Before Pandemic

The gap between the death rates of rural and urban U.S. residents tripled over the past two decades as city-dwellers enjoyed robust health improvement and drugs and disease pervaded the countryside.

A study in the journal JAMA published Monday compares mortality rates in 1999 and 2019. It finds that death rates dropped in all groups except middle-aged rural White and Native-American people, but fell most in cities.

“What we’re seeing is a ripple effect from the economic downturn in rural areas that’s now being manifested as a public-health crisis,” said senior author Haider Warraich, a physician and researcher at the …