Great Plains healthiest part of U.S., South sickest

By Anne Harding

NEW YORK (Reuters Health) - People living along the southern Atlantic coast of the US, as well as those residing along the Mississippi River, die at a faster rate than the national average, while death rates are below the norm in the upper Great Plains, a new study shows.

These patterns of mortality have been consistent for 35 years, Dr. Jeralynn Sittig Cossman and colleagues from Mississippi State University found.

"Place matters, and it matters for a long period of time," Cossman told Reuters Health in an interview. "We're trying to disentangle poverty rates, access to care, and really get to what's going to explain these pockets." Most of this variation can't be explained by race or income, she added, so as-yet unknown environmental or population factors must be at work.

Cossman and her team examined county-by-county mortality data for seven five-year periods, from 1968 to 2002. Counties were classified as having a high mortality if the death rates substantially exceeded the national average for at least four of the seven periods. Low mortality was defined as death rates below the national average for at least four of the seven periods.

The researchers found a consistent pattern of high mortality rates stretching along the Atlantic Coast from Maryland to Georgia, around the Mississippi Delta and up the river to Illinois, in Appalachia and in the northeastern quadrant of Nevada.

Mortality rates were low in substantial portions of Minnesota, Iowa, the Dakotas, Nebraska, Kansas and Colorado, as well as parts of Arizona, southern California, and the Texas-Mexico border.

Both high- and low-mortality counties tended to be rural and in economic decline, with many young people moving out.

SOURCE: American Journal of Public Health, December 2007.