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Smoking and the widening inequality in life expectancy between metropolitan and nonmetropolitan areas of the United States.

Front Public Health

September 2022

Department of Sociology and Criminology and Population Research Institute, The Pennsylvania State University, University Park, PA, United States.

Background: Geographic inequality in US mortality has increased rapidly over the last 25 years, particularly between metropolitan and nonmetropolitan areas. These gaps are sizeable and rival life expectancy differences between the US and other high-income countries. This study determines the contribution of smoking, a key contributor to premature mortality in the US, to geographic inequality in mortality over the past quarter century.

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The results of mitral surgery between 1961 and 1971 are presented. Pure or predominant mitral stenosis outnumbered combined mitral valve disease and mitral incompetence by two to one. Surgical treatment comprised 291 closed mitral commissurotomies, 145 open reconstructions and 81 replacements of the mitral valve.

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