Is Rural Georgia Dying? Literally?

A basic premise of Trouble in God’s Country is that rural Georgia is dying.  Truth is, I’ve meant that figuratively rather than literally – a reference to local economies gutted by globalization and other factors, failing schools and small hospitals in danger of closing, among other things.

Recently, however, I read an article that made passing reference to the growing number of rural counties across the country where deaths outnumber births.  I wondered if that might be the case in Georgia.

A quick dive back into the Georgia Department of Public Health’s (DPH) OASIS system produced some pretty startling results.

In 1994, the first year for which DPH has data, 12 of Georgia’s 159 counties produced more deaths than births.  All were rural.

By 2013, the latest year for which DPH has data, that number had quadrupled to 48 counties, 47 of which were rural.  The only exception was Fayette County, and it is an odd one: Fayette is a rapidly growing, affluent and very healthy county on the southern edge of Metro Atlanta, but, for some reason, it’s long had a historically low birth rate, and its ratio of births-to-deaths has declined from just over 2:1 in 1994 to just under 1:1 in 2013.

Click on each map for enlarged images.

As jarring as this data may seem, it may be that this is one of those data points to which there is actually less than meets the eye, for a couple of reasons.

First, it generally parallels the well-documented trend of declining birth rates associated with the onset of the Great Recession.  The number of Georgia counties with fewer births than deaths began to climb dramatically (and steadily) in the immediate wake of the recession, as the chart below illustrates.

It’s probably worth emphasizing here that I’m looking just at the ratio of births-to-deaths in this post and not at birth rates per se, although the two do tend to parallel one another.  Statewide, Georgia’s birth-to-death ratio started the 20-year period at 1.97:1 in 1994.  It rose steadily to a peak of 2.23:1 in 2007 and then began a steady decline to 1.71:1 in 2013.  Over that same period, the state’s overall birth rate (the number of live births per 1,000 females in a particular age group) rose slowly from 45.2 in 1994 to a peak of 48.3 in 2007 and ’08, then began a recession-era decline that may still be underway; the state’s birth rate hit a low of 39.9 in 2013.

The second reason this trend may not be terribly important is that it’s not necessarily the case that producing fewer births than deaths goes hand-in-hand with community decline.  The single county that has had fewer births than deaths throughout the 20-year period is Towns County, in far North Georgia, and it has consistently ranked high among Georgia counties for both economics and health outcomes (according to the Georgia Department of Community Affairs and the Robert Wood Johnson Foundation’s County Health Rankings project, respectively).

Moreover, a comparison of the list of 48 counties with fewer births than deaths in 2013 with previous health and economic rankings doesn’t suggest any obvious correlations.  Negative birth-to-death ratios, in other words, may be the nearly exclusive province of small rural counties, but not necessarily economically depressed and unhealthy ones.

Still, it’s difficult to think that this trend is a good thing, either for most of the communities or the state as a whole – especially in the long term.

Following are the lists of counties with fewer births than deaths for both 1994 and 2013.  The sort is by Births per Year, from low to high.

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