Virginia has mortality rates roughly in line with the national average, although there are wide variations within the state, as can be seen in part in this image captured from the U.S. Health Map published by the Institute for Health Metrics and Evaluation. Not surprisingly, the highest mortality rates are found in the impoverished Southwest and Southside regions.
The very highest mortality rates within the Old Dominion are located in the far Southwest. Excepting a handful of localities in the Dakotas (which I suspect are home to Indian reservations) the highest mortality rates in the country are in the Central Appalachia. This is coal mining country, and it should come as no surprise that the population there has the nation’s highest rate of respiratory-related fatalities, no doubt reflecting the prevalence of black lung disease.
Virginia’s coal-mining counties share many economic and cultural attributes with their super high-mortality neighbors across the border in Kentucky and West Virginia. I’m not sure why the mortality rates on the Virginia side of the border are notably lower (though still high by comparison with the rest of the state). The rate of chronic respiratory disease is just as high in Virginia’s coal-mining counties. Mental and substance abuse disorders are almost as high.
But mortality from cardiovascular disease is measurably lower. Why would that be? Is poverty is less endemic? Is there a better (or less bad) health care system? Whatever the reason, it bears analysis.