As a pastor, death has been a normal part of my professional life. Seminaries prepare us to sit with the dying and the bereaved, to craft a funeral service, and to recognize the place of death in our faith lives. One thing seminary doesn’t prepare us for is difference in shape and scale death takes in various communities. I’d worked for larger churches in cities up until 5 years ago. When Melissa and I followed her call back to Pulaski, I began to realize how much more present death is in a small town.
In our last church, there were rarely funerals. We were only asked to help our senior pastor with 3. After a year in Pulaski, Melissa had presided over 10 funerals, often with multiple deaths in the same week. And as I began serving small churches in even smaller neighboring towns, the number of funerals I’ve participated in has about doubled. Plus there are those many tragedies we’ve faced as a community over the last few years, from the deaths of several young children to a murder-suicide beginning down the street from my home.
Of course, in a small town like ours, a loss shakes the whole community. But it doesn’t help when nationally, rural areas are suffering higher death and morbidity rates than our brothers and sisters living in urban centers. I’m sure that claim will be met with doubts, as cities often have higher rates of crime, accidents, and disease. Does death really dwell in Pulaski and other small towns like it more often than it does in Washington, Richmond, or even Roanoke?
The many reports floating around out there shout an overwhelming “yes”. Pulaski County’s overall death rate per 100,000 has hovered around 1,200 for 30 years, 50% higher than both the national and state death rates (each around 800). Women and young people living in rural America are dying more often than those in cities. Rural America is the epicenter of our 21st Century health crises: obesity, bringing heart disease (the #1 cause of death in Pulaski County) and diabetes; skyrocketing opioid addictions; above average use of tobacco products; and a higher rate of gun ownership. This past spring, the CDC reported that even suicide rates are worsening in small towns, nearly doubling since 2000, climbing to 22 per 100,000 residents in 2015 (large metro areas measured a little over 11 per 100,000 that year). Compound this all with the paralyzing lack of health care providers Michelle covered, both for physical and mental health, and we have an unsettling reality: death visits our small town more often than big cities.
Based on the University of Wisconsin’s “County Health Rankings” data, in 2016 Pulaski County lost 9,200 years of potential life per 100,000 residents, a figure that tracks how many died before reaching the age of 75 and how many years they ought to have lived to reach that age. The statistic is a bit off, as we don’t have 100,000 people in our county, but it amounts to 3,100 years of life lost by 150 premature deaths of Pulaskians. I’ve spent several months now digging into public county health data to get a better grasp of how Pulaski County is faring in our state and nationally. Over my next two posts, I’ll provide more details about that data. My research has been bookended by the premature deaths of two friends, both close neighbors. For all of my training, it took these painful losses to refocus my attention on the daily reality of death in our community. Their funerals have led me back to the question “Why?”, but in a new way. Why does death feel more at home in small towns like Pulaski? Are our citizens naturally weaker, or less valuable to society, or just the victims of powerful forces beyond our county limits? Hopefully, over the course of two more articles, we can shed light on that “Why?”, even if we don’t find a satisfying answer. I hope you’ll join me in exploring it.