In the 2016 election, the electorate heard both candidates highlight the plight of urban communities and call for a resolution to common problems of crime, poverty, and unemployment. This spotlight, however, has led many to disregard a variety of problems that exist in smaller, rural, low-income communities. These communities are facing a plethora of challenges, one of which is rising death rates for white women in their forties.

A study, conducted by researchers Case and Deaton, shows that rural white communities are facing increasing death rates. White women in particular have seen an increase in morbidity rates by 30%. The trend of rising morbidity started in 2000; in rural communities, 228 white women in their late forties would die for every 100,000 women. Sixteen years later, the rate increased by 77%, with 296 women dying for every 100,000. Between 1992 and 2006, female mortality increased in 42.8% of counties nationwide.

The two questions that must be addressed are why is this trend occurring and where is it happening? A study conducted in 21 counties throughout the South and Midwest found that the death rate for white women has at least doubled since the turn of the century. For example, in Victoria County, Texas, a rural area near the Gulf Coast, deaths among women 45 to 54 have climbed by 169% in that time period. The death rate climbed from 216 per 100,000 people to 583. Lauren Friedman from Business Insider concluded that “if the 2013 rate had remained the same as it was in 1999, there would have been roughly 10,000 fewer deaths that year in this group.” These trends are reflected in the chart below:

This trend has been evident for years. An increase in morbidity rates has coincided with a decline in jobs and an increase in incarceration and suicide rates. Labor participation for women decreased between 2000 and 2014 by three percentage points, and for young women, it has decreased by more than nine percentage points. Between 2007 and 2011, state and local governments fired roughly 765,000 employees. Women comprised about 70% of those losses.  The loss of jobs in these rural communities has occurred at the same time as an increase in incarceration rates for white women. Between 2000 and 2014 incarceration rates have increased from 34% to 53%. Drug and alcohol overdose rates for working-age white women have quadrupled. Suicide rates are also up by as much as 50%.

While high death rates have long plagued minority women, for the first time in history we have seen a decline in morbidity rates for minority women and an increase in deaths for white women.  In at least thirty counties in the South, black women have lower mortality rates than middle-aged white women. Specifically, in Newton County, Georgia, southeast of Atlanta, death rates for black women between the ages of 35 and 54 dropped from 472 to 234 per 100,000 people. The rate for white women increased from 255 to 472. From this trend, it is clear that morbidity rates are high and must be addressed in a way regardless of race. This trend should not be used by public officials to qualify legislative neglect; no policy should benefit one group of women over another. No one should discount the variety of challenges minority women face in regards to incarceration rates, equal pay, and access to education. However, it is time the rising death rates of white women are addressed.

In January, President-elect Trump will be inaugurated and has discussed the need to invest more in infrastructure moving forward. Regardless of what side of the political aisle one may fall on, the need for investments in buildings, roads and services is an area that Republicans and Democrats can agree upon. In any infrastructure plan, there should be funding set aside to create healthcare centers in rural communities that are easily accessible. Research shows that already existing healthcare centers save the country $24 billion in costs by reducing hospitalizations and emergency room visits. However, between 2015 and 2016, federal funding for healthcare centers declined by $809 million. Renewed investment in creating high-quality healthcare centers is needed because research shows that over 40% of rural residents have to travel more than 30 minutes to be treated at a hospital. Patients with serious conditions such as heart disease or cancer that require a specialist may have to travel longer. Greater access to quality care could potentially help prevent patients from developing serious conditions; a major issue the Affordable Care Act has encountered is providing insurance to high-risk patients who are under-insured or uninsured due to a lack of access.

Hospitalizations account for 32% of federal healthcare funding. The Affordable Care Act is facing rising premiums, which are expected to increase by 85% due to the fact that a majority of those who are opting for federal healthcare coverage have pre-existing health problems. By making healthcare accessible, patients are more likely to receive premeditated treatment instead of waiting for their health to deteriorate to an insolvable point. Accessibility to a healthcare center also increases the likelihood that individuals will seek to obtain health insurance. The increase in demand has the potential to benefit private insurers and public healthcare provided through Medicare and the Affordable Care Act.

President-Elect Trump often spoke during his campaign about the neglect of millions of Americans by politicians in the last few decades. By using money from his infrastructure plan to create health centers, the health of millions of Americans can be improved. By building health facilities in these communities, President-elect Trump will have the opportunity to not only stop the trend of increasing death rates for white women but will have a direct impact on death rates for all races and genders as a whole.

Image source: David Goldman/AP.