About a decade ago, still fairly early in my TIGC noodling, I came across an article about declining birth rates in rural areas in some other part of the country. Gee, I wondered. What’s the situation in rural Georgia?
As it turned out, that was easy enough to figure out, thanks to an excellent public database operated by the Georgia Department of Public Health (DPH). Known as OASIS (an acronym for “Online Analytical Statistical Information System”), it’s a repository for a wealth of population health data, including the number of births and deaths for all 159 counties going back to 1994.
This was, as I recall, in late 2016 or early 2017. I downloaded all the county-level birth and death numbers from 1994 through 2015 (the latest data available at the time), dumped it all into Excel, and let the spreadsheet calculate the difference between births and deaths for each county and each year. That entire process probably took less than 10 minutes, 15 at the most.
The next step involved a bit of semi-manual data wrangling and took a few minutes longer. I wanted to know how many counties had reported more deaths than births for each year, but couldn’t figure out how to get Excel to do that in one swell foop and wound up having to do year-by-year counts. Even that wasn’t all that difficult, but at first I thought I had gone down a rabbit hole that would prove to be a waste of time.
In 1994, only 12 counties reported more deaths than births; in ’95, the number was 18; in ’96, it dropped down to 9 counties and then bounced back up to 14 in ’97. Not much news here, I remember thinking. I kept going, though, and so did the boring little yawner of a trend I had unearthed. Over the first 15 years of OASIS’s data, as the graph at right shows, the number of counties reporting more deaths than births hit 19 a couple of times but never got above that. But then, starting in 2010 (or maybe a year or two earlier, actually), something obviously happened.
The first time I can remember using this data was in an April 2017 presentation to the opening session of the Georgia House Rural Development Council, held down in Tifton. The latest data available on OASIS at that point was for 2015, and the number of counties reporting more deaths than births for that year was 60 — more than double the number from 2010 (and five times what it had been in 1994).
I used this data in my PowerPoint presentation and can remember getting a bit of a rise out of otherwise mostly bored House members; one went a bit bug-eyed and looked at me like I had put a gun to his head. Which, metaphorically, I sort of had.
But this situation has continued to deteriorate, and it’s arguable now that much of rural Georgia is literally dying. As the graph above shows, the number of counties reporting more deaths than births rose steadily from 2010 on before spiking in the Covid years of 2020, ’21 and ’22. In the last two years, the number has dropped to 92 and 94, back on its pre-Covid trajectory.
The graph above tells part of the story and is frightening enough. But map the data over time and you can’t help but get the sense that you’re witnessing the spread of some kind of socioeconomic cancer consuming more and more of the state.
The 1994 map at right shows the 12 counties that reported more deaths than births that year, and there’s not much all that troubling about it. With median ages in the mid-50s, the three mountain counties highlighted on the state’s northern border — Fannin, Union and Towns — were all in negative birth-to-death territory, but they have continued to grow steadily thanks to in-migration.
Ten years later, the number of counties reporting more births than deaths was only up to 15, but certain patterns that would soon become more significant were starting to take shape. Down in southwest Georgia — aka SOWEGA — Stewart County had joined Quitman and Clay, hard on the Alabama line, in reporting more deaths than births. And a bit to the northeast, Upson had joined Talbot in this unhappy club.
Over in east-central Georgia, Warren and Wilkes had joined Glascock and Taliaferro to form a growing subregion of impoverished rural counties that were upside down on births and deaths — as, a county or two to the south, was Johnson County.
By the mid-2010s, this particular socioeconomic cancer was approaching full bloom. When I made my aforementioned April 2017 presentation to the House Rural Development Council, with 2015 data, the number of counties reporting more deaths than births had quadrupled to 60, with two others at break-even — reporting exactly the same number of births and deaths.
More significantly, the regions only being hinted at in the 2004 map were pretty much fully formed — and still growing and metastasizing toward one another. Of the southwest Georgia counties on or near the Alabama line, only Early County was still producing more births than deaths. What’s more, a chain of impoverished upside-down counties was forming in interior Middle and South Georgia — and beginning to connect to the growing cluster of equally upside-down counties in east-central Georgia.
This was basically a part of the state that the late George Berry, who served as commissioner of the Department of Industry, Trade & Tourism (now Economic Development) under Governor Joe Frank Harris, once described to me as a “crescent of poverty” whose problems he found unsolvable. Berry held that position through most of the 1980s, and things have only gotten worse since then.
Indeed, the number of counties reporting more deaths than births has continued to climb since my presentation to the HRDC. By 2019, the number was up to 78 — and then exploded when Covid hit.
The peak came in 2021 when 124 of the state’s 159 counties found themselves under water, with more burials than births. As this map shows, this particularly unhappy condition had with, with few exceptions, covered nearly all of rural Middle and South Georgia, crept up the state’s eastern border with South Carolina, and all the way across its northern border with North Carolina and Tennessee.
Outside Metro Atlanta, only a handful of counties and regions dodged a direct hit from this public health hurricane.
As Covid largely passed after 2022, this trend seems to have settled back into its pre-Covid trajectory. As the graph above shows, it dropped to 92 in 2023 and 94 in 2024 (map at right). But that’s not exactly good news. By my math, that’s about where it would have been without Covid.
The good news, of a sort, is that this situation can’t get a whole lot worse — at least in terms of the number of counties with more deaths than births each year. Metro Atlanta’s growth serves as a buffer against the trend north of the gnat line, and several important economic assets — Georgia Southern University in Statesboro, the new Hyundai plant in Bryan County, and the Savannah ports — seem to be holding off the grim reaper in southeast and coastal Georgia.
But for much of interior rural Georgia, this cancer seems terminal.
Back up in the top half of the story, I noted that “something” had happened around 2010 but never got around to explaining what. I’m working now on a post that will take a stab at that.
Copyright Trouble in God’s Country 2025
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