Last week, we posted about the declining birth rate and the potential implications of such a decline. But not only birth rates matter to growth prospects. Natural increase is equal to  births minus deaths. Natural increase is, along with net migration, a component of  population change for a given area. Natural increase is likely to drop compared to usual positive trends, and might even go negative for a given area, if births decrease (and they have, as we showed last week) and deaths increase.

So in this post, we will be looking at the trends for death rates* in the State of Georgia and the 11-county Atlanta region. And you guessed it, that trend is up. As with our birth data post, we are using data from the Georgia Department of Public Health’s OASIS (DPH) platform. Chart 1 below shows that death rates have surged statewide from 2010 to 2019, and are higher in 2019 than in 2000.

*Death rates are defined below as annual deaths per 100,000 persons.

Table 1 shows death rates for both the State of Georgia overall and in each of the 11 counties individually, for the last two decades. It illustrates that the death rates (deaths per 100,000) for both area clusters are higher in 2019 than in 2000, though the trends have been inconsistent throughout the period. Between 2000 and 2010, death rates increased only in the relatively “old” counties of Cherokee and Fayette. From 2010 to 2019, though, death rates went up across each of the 11 counties. As of 2019, Rockdale has the highest death rate, followed by Fayette and Douglas.  The death rate for the State of Georgia is higher than all counties in the ARC Region except Rockdale—this is owing to the relatively low median age of the ARC region, as well as to the relatively higher incomes that correlate with better health outcomes. Note: the table is formatted to show values, in each county-specific row from the lowest rates (in green)  to highest (in red).

Table 3 translates these death rates from numbers into a measure of the years of life lost prior to age 75, abbreviated as YPLL 75. As you see, Fulton County combines a relatively high death rate AND the highest population for  the highest YPLL—though Fulton is interestingly the only county for which YPLL declined from 2000 to 2019. Counties with fairly low death rates owing to younger populations,  e.g. Gwinnett and Cobb, have some of the highest YPLL values simply due to their large populations. The county with the highest death rate (Rockdale) also has the lowest population, and as such has the lowest associated years of life lost.

But we need to add a qualifier: Looking at just the raw death rate numbers by themselves does not tell the full story. Age-adjusted death rates (see Table 3)  account for the varying median age and different age distributions of counties that we mentioned above—when we discussed the baseline death rates (in Table 1). Table 3 shows that, after adjusting for age, the resultant death rates in a county with a large share of seniors like Fayette is quite low. Conversely, while baseline death rates in Clayton County are not high, after adjusting for age they are the highest in the region. Also, while with baseline rates only Rockdale exceeded the state’s death rate, three counties (Clayton, Rockdale, and Douglas) have higher age-adjusted death rates in 2019 than did Georgia overall.

So we have reviewed a lot of evidence on 2000 to 2019 mortality rates, but what about what is going on now? We don’t have final mortality data for the year 2020, but provisional data on life expectancy gives us a likely direction or death rates. Our research over the past five years shows that the trend in life expectancy has been down (as death rates have gone up) through the last five years—for the metro and the county—opioids played a major role (and continue to). Not surprisingly, given the pandemic’s onset and human toll, the national trend over the recent year is down as well, in fact at an unprecedented year-over-year decline of 1.5 years in life expectancy

To bring home the impact of this increase in mortality (as well as the findings on birth rates), we can look to the Census Bureau’s 2020 Evaluation Estimates for the 11 counties. These estimates are (until mid-August) the closest thing to the official Census numbers…and the directonal, aggregated trends of both datasets will be the same. Table 5 shows that for each county in the area, 2019-2020 is estimated to have the highest death rates of any year during the decade. Birth rates? Very low in 2019-2020, as well. And so, it is hardly surprising that natural increase in the 11 counties (births less deaths) is the second lowest of the decade in 2019-2020.

There’s one more component to population growth: migration—as to what happened to it 2010-2020, you have a preview below (hint: it is not increasing much at all either). But we are getting ahead of ourselves…in a few days, watch for the final post of our “population decline” series, for the rest of the story.