Spatiotemporal Modeling of Premature Mortality in Mississippi: A County-Level YPLL Analysis, 2015–2025 County Health Ranking Release

Introduction This study examines spatiotemporal trends in premature mortality across Mississippi’s 82 counties (2015–2025) using Years of Potential Life Lost (YPLL) before age 75. Methods County-level YPLL rates were drawn from County Health Rankings & Roadmaps (2015–2025 releases; underlying deaths ≈2012–2023). Trends were compared with U.S. averages, stratified by education, income, and insurance status, mapped via GIS, analyzed for spatial clustering with LISA, and modeled using spatial lag panel regression with year fixed effects. Results Mississippi’s YPLL rate rose 35.2% (10,918 to 14,764 per 100,000), far outpacing national trends and widening the state–U.S. gap by ~50%. Contrary to expectation, the largest increases occurred in high-education, high-income, low-uninsured (mostly urban/coastal) counties. High-High clusters intensified in the rural Delta/River counties, while Low-Low clusters vanished from urban and coastal areas. Spatial lag models showed strong spatial dependence (ρ ≈ 0.32); injury deaths (β = 58.2, p < .001), percent non-Hispanic Black, and paradoxically higher median income were key drivers. Conclusion Mississippi’s premature mortality crisis has shifted: rural burdens persist, but rapid deterioration in urban and more affluent counties now drives statewide worsening. Effective policy requires sustained rural investment in chronic disease control alongside urgent urban-focused interventions targeting injury and violence prevention, trauma systems, and mental health/substance-use services.