A new divide in American death

White women have been dying prematurely at higher rates since the turn of this century, passing away in their 30s, 40s and 50s in a slow-motion crisis driven by decaying health in small-town America, according to an analysis of national health and mortality statistics by The Washington Post.

Among African Americans, Hispanics and even the oldest white Americans, death rates have continued to fall. But for white women in what should be the prime of their lives, death rates have spiked upward. In one of the hardest-hit groups — rural white women in their late 40s — the death rate has risen by 30 percent.

The Post’s analysis, which builds on academic research published last year, shows a clear divide in the health of urban and rural Americans, with the gap widening most dramatically among whites. The statistics reveal two Americas diverging, neither as healthy as it should be but one much sicker than the other.

The statistics show decaying health for all white women since 2000. The trend was most dramatic for women in the more rural areas. There, for every 100,000 women in their late 40s, 228 died at the turn of this century. Today, 296 are dying. And in rural areas, the uptick in mortality was noticeable even earlier, as far back as 1990. Since then, death rates for rural white women in midlife have risen by nearly 50 percent.

In the hardest-hit places — 21 counties arrayed across the South and Midwest — the death rate has doubled, or worse, since the turn of the century for white women in midlife.

In Victoria County, Tex., a rural area near the Gulf Coast, deaths among women 45 to 54 have climbed by 169 percent in that time period, the sharpest increase in that age group of any U.S. county. The death rate climbed from 216 per 100,000 people to 583.

White women remain an advantaged demographic, just less so, year by year. Four decades ago, the average white American woman lived eight years longer than the average white American man. Today, that health advantage has narrowed to just five years.

What we’re seeing is “the shrinking protective effect of gender in life expectancy,” said former U.S. assistant surgeon general Susan Blumenthal, a women’s-health expert.