Open AccessRural-Urban Mortality Disparities: Variations Across Causes of Death and Race/Ethnicity, 2013–2017
Author(s) -
Janice C. Probst,
Whitney E. Zahnd,
Peiyin Hung,
Jan M. Eberth,
Elizabeth Crouch,
Melinda A. Merrell
Publication year - 2020
Publication title -
american journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.284
H-Index - 264
eISSN - 1541-0048
pISSN - 0090-0036
DOI - 10.2105/ajph.2020.305703
Subject(s) - medicine , ethnic group , demography , pacific islanders , cause of death , residence , rural area , health equity , gerontology , psychological intervention , mortality rate , race (biology) , disease , environmental health , public health , population , pathology , botany , psychiatry , sociology , anthropology , biology
Objectives. To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. Methods. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and stroke) by rural versus urban county of residence in the United States and race/ethnicity for the period 2013 to 2017. Results. Rural populations, across all racial/ethnic groups, had higher all-cause mortality rates than did their urban counterparts. Comparisons within causes of death documented rural disparities for all conditions except cancer and stroke among Hispanic individuals; Hispanic rural residents had death rates similar to or lower than urban residents. Rural Black populations experienced the highest mortality for cardiovascular disease, cancer, and stroke. Unintentional injury and chronic lower respiratory disease mortality were highest in rural AI/AN and rural non-Hispanic White populations, respectively. Conclusions. Investigating rural-urban disparities without also considering race/ethnicity leaves minority health disparities unexamined and thus unaddressed. Further research is needed to clarify local factors associated with these disparities and to test appropriate interventions.