AI Article Synopsis
- The study analyzed 47 years of mortality trends in U.S. counties, focusing on differences between urban and rural areas while accounting for factors like education, income, poverty, and race.
- Researchers utilized extensive data, including death records and census information, employing statistical models to reveal mortality patterns over time.
- Findings indicated that the gap in mortality rates between rural and urban areas widened significantly since the mid-1980s, particularly in high-poverty, rural counties, suggesting a targeted approach to public health programs could help address these disparities.
Article Abstract
Objectives: To examine 47 years of US urban and rural mortality trends at the county level, controlling for effects of education, income, poverty, and race.
Methods: We obtained (1) Centers for Disease Control and Prevention WONDER (Wide-ranging ONline Data for Epidemiologic Research) data (1970-2016) on 104 million deaths; (2) US Census data on education, poverty, and race; and (3) Bureau of Economic Analysis data on income. We calculated ordinary least square regression models, including interaction models, for each year. We graphed standardized parameter estimates for 47 years.
Results: Rural-urban mortality disparities increased from the mid-1980s through 2016. We found education, race, and rurality to be strong predictors; we found strong interactions between percentage poverty and percentage rural, indicating that the largest penalty was in high-poverty, rural counties.
Conclusions: The rural-urban mortality disparity was persistent, growing, and large when compared to other place-based disparities. The penalty had evolved into a high-poverty, rural penalty that rivaled the effects of education and exceeded the effects of race by 2016. Public Health Implications. Targeting public health programs that focus on high-poverty, rural locales is a promising strategy for addressing disparities in mortality.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6301407 | PMC |
| http://dx.doi.org/10.2105/AJPH.2018.304787 | DOI Listing |
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