Title page
Contents
Abstract 3
Acknowledgments 3
Summary 5
Introduction 7
Natural-Cause Mortality (NCM) 10
Data and Definitions 12
Natural-Cause Mortality 12
Urban and Rural 12
Prime Working-Age Natural-Cause Mortality (NCM) Rates by Sex and Race and Ethnicity 15
Changes by Sex 15
Changes by Race and Ethnicity 17
Geographic Variation in Prime Working-Age Natural-Cause Mortality (NCM) Rates 20
Key Drivers and Conclusion 25
References 27
Appendix A: Supplemental Tables 30
Appendix B: Data and Definitions 35
Appendix C: How Is Mortality Data Collected? 37
Figure 1. Age-adjusted all-cause mortality rates for metro and nonmetro areas, 1968-2020 8
Figure 2. Change in all-cause, crude mortality rates by 5-year age cohorts for metro and nonmetro areas, 1999-2001 to 2017-2019 9
Figure 3. Change in age-adjusted, prime working-age, external- and natural-cause mortality rates for metro and nonmetro areas, 1999-2001 to 2017-2019 10
Figure 4. Change in natural-cause, crude mortality rates by 5-year age cohorts for metro and nonmetro areas, 1999-2001 to 2017-2019 11
Figure 5. Age-adjusted prime working-age natural-cause mortality rates, metro and nonmetro areas, 1999-2019 13
Figure 6. Change in age-adjusted, prime working-age natural-cause mortality across the nonmetro-metro county spectrum by sex, 1999-2001 to 2017-2019 14
Figure 7. Nonmetro age-adjusted, prime working-age mortality rates by sex for 15 leading natural causes of death, 1999-2001 and 2017-2019, as percent... 16
Figure 8. Nonmetro, age-adjusted, prime working-age natural-cause mortality by sex and race and ethnicity, 1999-2001 and 2017-2019, as a percent... 19
Figure 9. Change in age-adjusted, nonmetro prime working-age natural-cause mortality rates by sex and race and ethnicity, 1999-2001 to 2017-2019 20
Figure 10. Nonmetro age-adjusted, prime working-age natural-cause mortality rates by sex and region, 1999-2001 and 2017-2019, as a percent above... 21
Figure 11. Nonmetro change in age-adjusted, prime working-age natural-cause mortality rates by sex and region, 1999-2001 to 2017-2019 22
Figure 12. Nonmetro age-adjusted, prime working-age natural-cause mortality rates by sex, State, and census region, 1999-2001 and 2017-2019 24
Table A.1. Nonmetropolitan age-adjusted mortality rates, 1999-2001 and 2017-2019, as percent above or below corresponding metropolitan rates,... 30
Table A.2. Nonmetropolitan age-adjusted mortality rates, 1999-2001 and 2017-19, as percent above or below corresponding metropolitan rates,... 31
Table A.3. Nonmetropolitan age-adjusted, natural-cause mortality rates, 1999-2001 and 2017-2019, as percent above or below corresponding metropolitan... 32
Table A.4. Nonmetropolitan age-adjusted, natural-cause mortality rates, 1999-2001 and 2017-2019, as percent above or below corresponding metropolitan... 34
Table B.1. Definition of natural-cause mortality categories by ICD-10 codes 36
Table B.2. Definition of external mortality categories by ICD-10 codes 36