Giving Compass' Take:

• Olga Khazan explains how lung cancer and other diseases that once impacted elderly Appalachians are increasingly seen in younger adult Appalachians.

• How can funders help to improve the health outcomes of Appalachians? Where else do these trends hold true? 

• Read about making better investments in rural health. 

At the Reger Funeral Home and Chapel in Huntington, West Virginia, owner Patrick Reger says he increasingly sees 50-somethings dying of diseases—like cirrhosis of the liver or lung cancer—that used to mostly kill 80-somethings.

The numbers are even starker when stratified by race. In the most recent years studied, a black man in Appalachia could expect to die about three years earlier than a white man in Appalachia and a year younger than a black man elsewhere.

For the study, the authors, Gopal Singh and Michael Kogan from the Health Resources and Services Administration and Rebecca Slifkin from the University of North Carolina at Chapel Hill, compared deaths data from the period between 1990 and 1992 and between 2009 and 2013, the most recent years available, in the swath of 428 counties that make up Appalachia. They examined life expectancy and infant mortality—two well-established measures of overall public health.

In the early ’90s, the study authors found, the region’s infant mortality rate was about identical to that of the rest of the country, but between 2009 and 2013, it was 16 percent higher. Similarly, in 1992, the average Appalachian had a life expectancy of about 75.2 years, just half a year shorter than the average American. By the 2009 to 2013 study period, the disparity had grown to 2.4 years. In the intervening time—nearly two decades that saw the advent of DNA sequencing and other medical advancements—life expectancy increased by 2.4 years for women outside of Appalachia, but by just a fraction of a year for Appalachian women.

The numbers are even starker when stratified by race. In the most recent years studied, a black man in Appalachia could expect to die about three years earlier than a white man in Appalachia and a year younger than a black man elsewhere. A black man living in a high-poverty area in Appalachia could expect to die a full 13 years younger than a typical white woman in a low-poverty area elsewhere in America. That’s roughly the life expectancy difference between the United States and Rwanda.

Read the full article about Appalachians by Olga Khazan at The Atlantic.