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Study looks at rural areas' mortality rates

GRAND FORKS - Northwestern Minnesota has the highest infant mortality rate among the state's regions, according to a report released this week by the state Department of Health.

GRAND FORKS - Northwestern Minnesota has the highest infant mortality rate among the state's regions, according to a report released this week by the state Department of Health.

The northwest also has a higher mortality rate due to unintentional injuries and a higher rate of Alzheimer's disease among people 65 and older, according to the report: "How Healthy are Rural Minnesotans?"

The overall mortality rate is highest in the northeast (767 deaths per 100,000 person-years), with the northwest next (697), followed by the central region (687), the metro (670), the southwest (661) and the southeast (642).

While the study aimed to measure the relative health of rural Minnesotans, the authors note that 62 percent of the people in "Greater Minnesota" - outside the seven-county Twin Cities metro area - live in urban settings.

The northwest and southwest regions are the most rural. Two-thirds of the people of northwestern Minnesota live in "small or isolated rural" settings, according to the report.

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Paul Jansen, a rural health specialist with the state Health Department, said the report draws no cause-and-effect conclusions.

"Our initial purpose was to identify disparities" in health around the state, he said. "We wanted to ask what 'rural' means and then bring those disparities to light. We weren't trying to answer 'why' or 'how' questions, but to get a discussion going. A lot of people now are asking 'why,' and that was what we hoped for."

The infant mortality rate in northwestern Minnesota (2006-2009) was 6.1 per 1,000 live births, compared to 5.2 in the metro region, 4.9 in the southeast, 4.7 in the central and northeast and 4.4 in the southwest.

Though it was the state's highest by region, the northwest's infant mortality rate still was lower than the national average of 6.7 infant deaths per 1,000 births.

About one person in eight (12 percent) in northwestern Minnesota reported they were in "fair or poor health" in 2009, better than southwest Minnesota (17 percent) but not as positive as the metro region (10 percent).

The percentage of people with no health insurance was highest in northwestern Minnesota - 14 percent. Other regions reported no health insurance for between 8 percent and 11 percent of people.

Fewer people smoked in Greater Minnesota in 2009 (21 percent of men and 16 percent of women) than in 2004 (24 percent of men, 21 percent of women), but a higher percentage of adults in Greater Minnesota still smoke compared to the metro region.

Nearly three in 10 men (29 percent) in Greater Minnesota were identified as obese in 2009, the same as in 2004, but the percentage of rural women who were obese rose from 23 percent to 28 percent. Corresponding figures for the metro region in 2009 were 22 percent for men, 21 percent for women, up slightly from 2004.

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Northwestern Minnesota had the state's lowest rates of sexually transmitted diseases but ranked second in suicide rate at 14 deaths per 100,000 person-years (2006-2009). The northeast had the highest rate, 16 deaths per 100,000, and the metro the lowest (10 deaths).

The northwest and northeast also had the state's highest mortality rates due to unintentional injury, while the highest rates of mortality due to motor vehicle injury were in the southeast (18 deaths per 100,000 person-years) and the northwest (16 deaths).

From 2006 to 2009, the mortality rate for people 65 and older with Alzheimer's disease was 287 deaths per 100,000 person-years in northeastern Minnesota, followed by 231 deaths in northwestern Minnesota. The lowest rate (161 deaths) was in southeastern Minnesota.

Northeastern Minnesota also had the state's highest cancer mortality rate, more than 10 percent higher than for northwestern Minnesota, and the highest mortality rate due to heart disease.

Older Minnesotans in the rural northwest and southwest regions had the highest stroke mortality rates.

Chuck Haga writes for the Grand Forks Herald

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