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Substance abuse and poor mental health drive up deaths among Missouri's rural whites

White residents in Missouri are dying at a higher rate than they did nearly two decades ago, according to a report from the Missouri Foundation for Health.

The increased death rate largely is occurring in the state's rural counties, especially in the Ozarks and the Bootheel region and substance abuse appears to be a major factor. For example, deaths by drug overdose have increased by nearly 600 percent in many rural counties. Poor mental health also plays a significant role, as suicides among young and middle-aged adults have increased by 30 percent since 1995. 

In Missouri's rural areas, poverty and unemployment levels tend to be high. Compared to residents in Kansas City and St. Louis, rural residents have less access to health insurance and health care providers. 

The numbers in the report bolster the need for more health services in rural counties, said Katie Reichard, director of policy and strategic communication at the Missouri Coalition for Community Behavioral Healthcare. 

"We're fighting on a state level trying to get some legislation passed so we can have more providers and 

Drug overdose, alcohol poisoning and suicide are driving up deaths among rural whites in Missouri, according to a new study funded by the Missouri Foundation for Health.
Credit Illustration by Rici Hoffarth | St. Louis Public Radio
Drug overdose, alcohol poisoning and suicide are driving up deaths among rural whites in Missouri, according to a new study funded by the Missouri Foundation for Health.

more prescribers in those areas to try and combat the opioid epidemic and substance abuse," Reichard said.

Addressing the rising rate of white mortality in the state will require more than just adding healthcare providers to rural counties, said Robert Hughes, President and CEO of the Missouri Foundation for Health. 

"Access to care is one thing, but the underlying problems are basic economic and social policies we really need to take care of," Hughes said. 

Low quality of life has pushed rural residents to move to urban areas to seek more education and job opportunities, added Hughes. But that comes at a cost to urban areas that are not prepared to provide the newcomers with the resources they need. 

Mortality rates among minority populations in Missouri, however, are dropping. The rates for African-Americans, American Indians and Alaskan Natives and Asians each fell by about a quarter. But African-Americans in Missouri are still dying at a higher rate than Caucasians. 

"We need to pay attention to disadvantaged populations across the spectrum," Hughes said.  

The study was conducted by Virginia Commonwealth University and the University of Pittsburgh, and was funded by the Missouri Foundation for Health.

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Eli Chen is the science and environment reporter at St. Louis Public Radio. She comes to St. Louis after covering the eroding Delaware coast, bat-friendly wind turbine technology, mouse love songs and various science stories for Delaware Public Media/WDDE-FM. Before that, she corralled robots and citizen scientists for the World Science Festival in New York City and spent a brief stint booking guests for Science Friday’s live events in 2013. Eli grew up in the northwest suburbs of Chicago, where a mixture of teen angst, a love for Ray Bradbury novels and the growing awareness about climate change propelled her to become the science storyteller she is today. When not working, Eli enjoys a solid bike ride, collects classic disco, watches standup comedy and is often found cuddling other people’s dogs. She has a bachelor’s in environmental sustainability and creative writing at the University of Illinois Urbana-Champaign and has a master’s degree in journalism, with a focus on science reporting, from the City University of New York Graduate School of Journalism.
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