A landmark study published today in JAMA highlights the need to take a hard look at how we're approaching issues related to mental health in this country.By examining 21 causes of death in 3,100 counties, researchers from the Institute for Health Metrics and Evaluation found major changes in the years between 1980 and 2014.One of the most shocking findings is that death due to mental and/or substance disorders increased by 188 percent nationally since 1980. Where these deaths are taking place, however, are skewed heavily towards Appalachia—parts of Kentucky, West Virginia, and Ohio—where mortality rates saw increases, in some cases, by over 1,000 percent, during the same time period.Other causes of death showed different regional distinctions. Deaths from suicide and interpersonal violence, for instance, have seen a decline of 22 percent nationwide since 1980. But more than half of US counties actually saw an increase in the number of these types of deaths. Areas throughout the Southwest, Alaska, and Native American reservations are geographic clusters where suicide remains a pervasive, even growing, cause of death despite a national decline overall."The mortality trends in mental and substance use disorders, as well as with other causes of death covered in the study, point to the need for a well-considered response from local and state governments, as well as care providers, to help reduce the disparities we are seeing across the country," Christopher Murray, director of the Institute for Health Metrics and Evaluation, said in a press release.On the county-wide level, common disease-related deaths from ailments such as heart disease and cancer were also revealed to be linked to socioeconomic factors; geographic regions with higher rates of obesity, smoking, and poverty show higher mortality rates as well.
The study reveals that national mortality averages can be misleading. People in rural areas are often affected disproportionately from their urban counterparts, and any meaningful analysis needs to take that into account.