Social Capital and Human Mortality: Explaining the Rural Paradox with County‐Level Mortality Data

The “rural paradox” refers to standardized mortality rates in rural areas that are unexpectedly low in view of well‐known economic and infrastructural disadvantages there. We explore this paradox by incorporating social capital, a promising explanatory factor that has seldom been incorporated into residential mortality research. We do so while being attentive to spatial dependence, a statistical problem often ignored in mortality research. Analyzing data for counties in the contiguous United States, we find that: (1) the rural paradox is confirmed with both metro‐nonmetro and rural‐urban continuum codes, (2) social capital significantly reduces the impacts of residence on mortality after controlling for race and ethnicity and socioeconomic covariates, (3) this attenuation is greater when a spatial perspective is imposed on the analysis, (4) social capital is negatively associated with mortality at the county level, and (5) spatial dependence is strongly in evidence. A spatial approach is necessary in county‐level analyses such as ours to yield unbiased estimates and optimal model fit.