The number of Georgia counties recording more deaths than births jumped again in 2021, due largely to a rising death toll that owed primarily to a combination of Covid-19 fatalities and lethal drug overdoses, according to data published Friday by the Georgia Department of Public Health (DPH).
The total number of Georgia’s 159 counties reporting more deaths than births rose to 123, up from 118 in 2020. That continued a trend that started about a decade ago. Up until 2010, the number of counties reporting more deaths than births had never reached 20, but since then — with a couple of exceptions — that number has climbed steadily. Pre-Covid, it appeared to have peaked at just under 80 counties in 2018 and ’19, then jumped to 118 in 2020, the first Covid year.
Statewide, the difference in the number of births and deaths narrowed to 11,618, the smallest gap ever recorded by DPH, as the chart at right illustrates. The total number of births actually ticked up slightly, but that gain was more than wiped out by the much bigger increase in deaths.
That gain took place almost entirely in TIGC’s Metro Atlanta region and on the Georgia coast, as this table shows.
Net Births by TIGC Region: 2019-2021
This table shows the difference between births and deaths for all five Trouble in God’s Country regions for the past three years. That difference has shrunk across the state, and a combination of Covid-19 and drug overdoses produced more deaths than births in predominantly rural areas of Middle, North, and South Georgia starting in 2019. The net gain in births was cut in half from 2019 to 2020, then nearly in half again in 2021. (Data Source: Georgia Department of Public Health)
While the counties reporting more deaths than births were mostly sparsely-populated rural counties, more than a half-dozen significant regional counties suffered more net deaths. Floyd and Walker counties, neighbors in northwest Georgia, reported the largest numbers of net deaths, 374 and 303, respectively. Other important regional population centers reporting more deaths than births included Bibb County (280), Glynn (261), Laurens (211), Thomas (192), and Dougherty (99).
Covid-19 claimed 15,790 Georgia lives in 2021, 14 percent of the state’s total deaths and an increase of 67.2 percent over 2020’s Covid death toll of 9,406. Fatal drug overdoses totaled 2,390, a 25.3 percent increase over 2020 and a 72 percent increase over 2019.
The Georgia Department of Public Health (DPH) is up with its 2021 county-level birth data and the good news is that the number of births last year rebounded a bit from the Covid dip in 2020. The less than good news is that the rebound was well short of the 2019 numbers and it looks like the state’s long-running baby bust is continuing.
Altogether, Georgia recorded 123,971 new births in 2021 — up nearly 1,600 from 2020 but still nearly 2,300 under pre-Covid’s 2019 totals. Nearly 98 percent of those added births took place generally north of the gnat line, in TIGC’s 12-county Metro Atlanta region or its 41-county North Georgia territory. Combined, the 106 counties in Georgia’s Middle Georgia, South Georgia and Coastal Georgia regions added only 38 births to their 2020 totals.
However, those high-level numbers mask some interesting racial and localized differences — principally a big difference in the number of White and Black births. Statewide, White births were up 2,742 in 2021, an increase of 4.0 percent over 2020 and, in fact, a slight increase over 2019. Black births, however, were down 1,422, or 3.1 percent versus 2020.
This represents something of a change from recent years, although it’s impossible to know whether it’s simply a one-year anomaly or perhaps the beginning of a trend. Whites, with a larger population in Georgia, have always produced more births than Blacks, but the trend lines have moved in rough parallel throughout the quarter-century for which DPH has data — with a couple of notable exceptions.
As the graph below shows, between 1994 and 2006, the gap between White and Black births had gradually widened — peaking at about 45,000 for several years in the early 2000s. But White births declined dramatically in 2007 and ’08, probably at least partly due to the Great Recession, and then continued to decline at a slower pace for several years. Black births also declined, although not as precipitously, with the result that the difference in the number of White and Black births has narrowed dramatically in recent years. That difference peaked at 45,553 in 2004; by 2020, it had been cut in half, down to 22,563.
Of the total 123,971 births recorded in Georgia last year, just under two-thirds took place in the 53 counties that comprise TIGC’s Metro Atlanta and North Georgia regions — 81,421 versus the 42,550 in the 106 counties in TIGC’s Middle, South and Coastal Georgia regions.
These numbers — in combination with the aforementioned fact that nearly 98 percent of the births over and above 2020’s totals took place in Metro Atlanta and North Georgia — are in line with the long-running shift in population to the northern half of the state.
The 2021 numbers include some unexpected anomalies. The largest percentage increase in births, for instance, took place in tiny Montgomery County, a slice-of-pie-shaped county in southeast Georgia. The number of births there increased to 124 from 87, an increase of 37, or 42.5 percent. About three hours to the west, Calhoun County was at the opposite end of the spectrum. The number of births there fell to 31 from 52, a drop of 40.4 percent.
Another somewhat surprising development is the unbroken string of counties along the Alabama line in northwest Georgia that saw the number of births fall in 2021 — Dade, Walker, Chattooga, Floyd, Polk, Haralson, Carroll and Heard on the Alabama line, plus Whitfield and Gordon just to their east.
For several years now, TIGC has monitored county-level births and deaths and reported on the rising number of Georgia counties recording more deaths than births. Last year, that number jumped to 118 counties, up from 78 in 2019, thanks in part to Covid. The state’s county-level mortality data for 2021 should be published by DPH in July or August.
The number of Georgia counties reporting more deaths than births jumped to 118 in 2020, up dramatically from 78 in 2019, according to new county-level mortality data published Monday by the Georgia Department of Public Health (DPH).
The increase was generally expected. DPH reported in June that 2020 births were down 3.1 percent from 2019, and the Covid-19 death toll seemed certain to drive a big increase in the number of counties where burials outnumbered births.
All told, births still outnumbered deaths in Georgia, but by the narrowest margin recorded in the quarter-century DPH has been reporting county-level birth and death data. The 19,265 surplus of births over deaths was less than half the 40,000-plus surplus recorded in 2018 and ’19, and not even a quarter of the 83,051 surplus record set in 2007.
As the graph at the right shows, the birth and death lines have been converging for nearly 15 years now. One curiosity in the 2020 death numbers is that Covid-19 accounted for only a little over half of the total increase in the number of deaths over 2019.
Statewide, the total number of deaths skyrocketed from 85,641 in 2019 to 103,114 in 2020 — and Covid-19 was cited as the cause of death in only 9,446 of those 2020 cases.
Even without the Covid-19 deaths, 2020 would have set a record for the total number of deaths and the percentage increase over the previous year. With the Covid-19 deaths included, the number of deaths rose 20.4 percent over 2019; without the Covid-19 deaths, the increase was 9.4 percent. In the 25 years DPH has been reporting data, the number of deaths had never hit five percent in a single year — and the increase was usually much less.
(A cursory review of the DPH data failed to turn up a big chunk of deaths attributable to a single cause of death — although a number of categories appeared to be up by somewhat higher percentages. TIGC will continue to sift through the data for a more complete explanation.)
Also unsurprising: the surplus of births over deaths was concentrated primarily in and around Metro Atlanta and, to a lesser degree, the Georgia coast, as this map illustrates:
Indeed, TIGC's North Georgia, Middle Georgia and South Georgia regions all posted more deaths than births. TIGC's 12 Metro Atlanta counties reported 21,050 more births than deaths while TIGC's seven Coastal Georgia counties posted a surplus of 1,926 births -- this despite the fact that Glynn County suffered the biggest death-to-birth deficit in the state. It posted 313 more deaths than births, and 2020 was only the second time in the past quarter-century that it hasn't recorded more births. Gwinnett County posted the biggest surplus of births over deaths -- 5,331.
Few if any of these numbers are surprising, and they are in line with county-level 2020 Census data that was released last week.
The number of counties reporting more deaths than births began to rise about a decade ago, and was first reported by TIGC several years ago. The big jump from 78 to 118 counties -- more than two-thirds of Georgia's total of 159 counties -- was far and away the biggest one-year increase since the current trendline started rising in the wake of the Great Recession.
The table below shows 2020 births and deaths for all 159 Georgia counties, along with the number of Covid-19 deaths and the percentage of total deaths caused by Covid-19.
As of Wednesday afternoon, it’s official: the $1.9 trillion Covid relief bill now headed to President Biden’s desk didn’t get a single Republican vote in the U.S. House or Senate. I will leave it to various mystics, shamans, and readers of animal entrails to find any actual logic in the GOP’s lock-step opposition to the bill (which enjoys solid public support, including from a majority of Republican voters), but I do have to wonder if any among their ranks recognize the importance of one component of the bill to their hopes of rebuilding a political majority.
I’m referring, of course, to the $100 billion child care benefit included in the bill. Under this part of the legislation, the federal government will send parents a $300 monthly child care stipend for every child under the age of 6 and $250 for every child between 6 and 17. This is in addition to the $1,400 in direct stimulus payments most Americans will receive under the legislation.
Democrats, of course, see the child care benefit as a means of helping parents get back to work, supporting early childhood development, and lifting millions of American kids out of childhood poverty. Republicans, apparently, see it as yet another step down the slippery slope to godless communism. U.S. Senators Mike Lee (R-Utah) and Marco Rubio (R-Florida) issued a joint statement saying they could support an expanded child care tax credit, but not the advance cash payouts.
“That is not tax relief for working parents,” Lee and Rubio harrumphed. “It is welfare assistance. An essential part of being pro-family is being pro-work. Congress should expand the Child Tax Credit without undercutting the responsibility of parents to work to provide for their families.”
Well, okay. But even if Lee, Rubio, and their GOP colleagues don’t buy into the Democrats’ squishy child- and family-friendly arguments, you’d think they might see the raw political benefit of, basically, being able to use tax dollars to bribe Republicans of child-bearing age to have children.
(This is not a novel concept. European countries confronting their own baby busts have resorted to all manner of financial incentives. Don’t believe it? Google “countries paying people to have babies”. My personal favorite is the “Do it for Denmark” campaign, which features public service advertisements like this one.)
While Democrats will also benefit from this aspect of the Biden plan’s child care allowance, Republicans arguably have more to gain from it. A huge chunk of GOP voters are, after all, old and dying off.
And by “GOP voters,” I mean primarily white voters, a great number of whom reside in rural areas. TIGC has reported for the past couple of years on the increasing number of Georgia counties that now have more deaths than births. The number of counties reporting more deaths than births has increased steadily since the Great Recession. That number peaked in 2018, when 79 of the state’s 159 counties reported more deaths than births; in 2019, 78 counties fell into that category and one had exactly the same number of deaths and births.
As jarring as those numbers may be, they become starker still when you drill down and look only at white births and deaths. In 2019, 103 largely rural Georgia counties buried more white people than were born; 81 of those counties voted (heavily, in most cases) for Republicans David Perdue and Kelly Loeffler over Democrats Jon Ossoff and Raphael Warnock in the January 5, 2021, runoffs that turned the U.S. Senate blue.
The two maps below may help clarify the challenge facing Republicans. The one on the left shows the state’s political divide as it stood after the January 5th runoffs for the U.S. Senate. Democratic victors Ossoff and Warnock dominated Metro Atlanta, expanded the party’s grip on the black belt that runs from southwest Georgia north and east to Augusta, and won in significant coastal counties (all shown in blue); the Republican incumbents, Perdue and Loeffler, prevailed primarily in small rural counties and some growing exurban counties around and near the Metro Atlanta region (shown in Team GOP red).
The map to the right contrasts counties that had more white deaths than births (those in red) in the five-year period from 2015 through 2019 versus those that had more white births than deaths (blue). The two maps are obviously not a perfect match, but the extent of the overlap ought to give any sentient Republican strategist at least a mild case of insomnia and heartburn.
If the maps fail to trouble GOP war planners, the graph below might — especially over the long term. It spotlights a data point that I really hadn’t been looking for and that surprised me enough that I’ve completely double-checked my work. I went back to the Georgia Department of Public Health’s OASIS website and pulled all the raw data a second time and then rebuilt my spreadsheet from the ground up, and can now report the following:
For the past 10 years, blacks in Georgia have been posting more net births (births minus deaths) than whites.
From 1994 (the earliest year for which the Georgia Department of Public Health has data) through 2007, whites maintained an unsurprising and even growing advantage in this category, as this graph shows.
The white surplus of births over deaths peaked in 2006 at 44,768, dropped a little in 2007, and then plunged by nearly 10,000 in 2008. The black surplus of births over deaths also began to shrink around the same time — in 2008 — but not nearly as severely. The net effect was that the black and white lines crossed in 2010 and blacks have been building a growing advantage ever since. In 2019, net white births were just under 11,000 — about one-fourth of the all-time high in 2006; net black births for 2019 fell just short of 22,000, nearly double the number of net white births.
I’ve written before about the demographic, economic, and education-related aftershocks of the Great Recession — patterns and trends that began to take shape in 2008 and ’09 and have continued ever since. Without exception, these trends have taken a harder toll on rural Georgia, and this one — a demographic shift with clear political implications — seems certain to do the same.
“Christian and conservative women have a 35 percent fertility advantage over Democrat women,” Frost told a meeting of Oconee County Republicans in 2019. “And the more conservative a woman is, the more likely she is to be married and have lots of kids – three, four, five, six kids. And the more liberal and leftist a woman is, the less likely she is to even be married and have any children at all …”
It’s unknown just how much traction Frost’s plan has gotten among Republican women, but the Biden child care allowance might well provide just the kind of cash stimulus that would give his plan a real boost.
Either that, or Republicans may want to rethink their opposition to the graveyard vote.
The Georgia Department of Public Health earlier this week published mortality data for 2019 and TIGC can now report that, for the second year in a row, right at half the state’s 159 counties reported more deaths than births.
For 2018, as TIGC reported a year ago, 79 counties reported more deaths than births; for 2019, 78 counties reported more deaths than births and one county — Treutlen — broke even, with 77 births and 77 deaths.
Only a few of the 78 counties would not be considered rural, either by dint of a small population or remote location. Perhaps most notably, Fayette County, on the southern edge of Metro Atlanta, and Floyd County, a major population and economic center in northwest Georgia, both found themselves in negative territory for the second year in a row. Fayette County has long been recognized as a popular area for retirees and has an older-than-average population; the reasons for Floyd County’s slippage are less apparent.
Other mid-sized but remotely located counties whose birth-to-death ratio has gone negative in recent years include Baldwin County (Milledgeville) and Sumter County (Americus).
This trend of increasing numbers of counties reporting more deaths than births is one first noticed and reported on by Trouble in God’s Country several years ago. My initial focus had been on the economic, educational and civic death of Georgia’s rural areas, but I decided one day to explore whether some counties might literally be dying. DPH’s publicly available OASIS database includes county-level birth and death data going back to 1994 and makes this analysis pretty simple.
What I found, though, was stunning, and very much a part of the story of rural Georgia’s decline, as the column chart below shows. Beginning roughly with onset of the Great Recession, the number of counties reporting more deaths than births began to tick up a fairly steady pace. While the Great Recession is generally considered to be over, the number of counties reporting more deaths than births has continued to rise.
We won’t know until at least next year whether the fact that this year’s number barely changed from 2018 represents a brief plateau or perhaps the beginning of a reversal of this trend. It’s also worth noting that none of the data through 2019 reflects the impact of the Covid-19 pandemic, which of course began in early 2020. The virus took a particularly heavy toll on southwest Georgia in its earliest months and is now rampaging through east-central and southeast Georgia.
Overall, Georgia continues to produce more births than deaths, but the statewide ratio has been tightening steadily for the past decade. For the first 15 of the 25 years for which DPH has county-level birth and death data, the statewide birth-to-death ratio floated along at about 2:1. It peaked in 2007 with 2.23 births for every death and has been narrowing ever since. For 2019, Georgia posted 1.47 births for every death, down from 1.48 in 2018.
Obviously, these two trends — the tightening of the state’s overall birth-to-death ratio and the increase in the number of counties with more deaths than births — are mirror images pulled from the same bucket of data. One story in the 2019 data, as noted above, is that the state may have hit, at least temporarily, a plateau of sorts. While the number of counties in negative territory dropped by one, the state’s overall birth-to-death ratio tightened ever so slightly, by one one-hundredth of a point. In other words, stasis in both analyses.
But another story to be pulled from this data is in the regional differences. As the tables below shows, it puts yet another spotlight on the profound population shift away from rural Georgia and toward Metro Atlanta (defined by TIGC as a 12-county region).
One takeaway from the regional analysis emerges from a comparison of the 99 counties that make up Middle and South Georgia with the 12-county Metro Atlanta region. While Middle and South Georgia combined produced only 60 percent as many births as Metro Atlanta, they very nearly matched Metro Atlanta is deaths: 30,488 for Middle and South Georgia versus 30,589 for Metro Atlanta.
In closing, as a teaser of sorts, I’ll point out that there are obviously racial and political dimensions to this data. While 78 counties recorded more overall deaths than births, 103 counties reported more White deaths than White births; only 48 counties reported more Black deaths than Black births.
Statewide, the White birth-to-death ratio peaked at 1.92:1 in 2006 and has fallen steadily since then — to 1.18:1 in 2019. The Black birth-to-death ratio hit its high point a year later, in 2007, at 2.77:1 and has since fallen to 1.87:1 in 2019. I’ll try to flesh out the political implications of these trends in a future post.
Have a question or suggestion for TIGC? Email Charlie Hayslett at email@example.com