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Premature mortality in the United States: The roles of geographic area, socioeconomic status, household type, and availability of medical care

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  • Mansfield, C.J.
  • Wilson, J.L.
  • Kobrinski, E.J.
  • Mitchell, J.

Abstract

Objectives. This study examined premature mortality by county in the United States and assessed its association with metro/urban/rural geographic location, socioeconomic status, house-hold type, and availability of medical care. Methods. Age-adjusted years of potential life lost before 75 years of age were calculated and mapped by county. Predictors of premature mortality were determined by multiple regression analysis. Results. Premature mortality was greatest in rural counties in the Southeast and Southwest. In a model predicting 55% of variation across counties, community structure factors explained more than availability of medical care. The proportions of female- headed households and Black populations were the strongest predictors, followed by variables measuring low education, American Indian population, and chronic unemployment. Greater availability of generalist physicians predicted fewer years of life lost in metropolitan counties but more in rural counties. Conclusions. Community structure factors statistically explain much of the variation in premature mortality. The degree to which premature mortality is predicted by percentage of female-headed households is important for policy-making and delivery of medical care. The relationships described argue strongly for broadening the biomedical model.

Suggested Citation

  • Mansfield, C.J. & Wilson, J.L. & Kobrinski, E.J. & Mitchell, J., 1999. "Premature mortality in the United States: The roles of geographic area, socioeconomic status, household type, and availability of medical care," American Journal of Public Health, American Public Health Association, vol. 89(6), pages 893-898.
    • Handle: RePEc:aph:ajpbhl:1999:89:6:893-898_3
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    Cited by:

    1. Scribner, Richard Allen & Theall, Katherine P. & Simonsen, Neal R. & Mason, Karen E. & Yu, Qingzhao, 2009. "Misspecification of the effect of race in fixed effects models of health inequalities," Social Science & Medicine, Elsevier, vol. 69(11), pages 1584-1591, December.
    2. van Hooijdonk, Carolien & Droomers, Mariël & van Loon, Jeanne A.M. & van der Lucht, Fons & Kunst, Anton E., 2007. "Exceptions to the rule: Healthy deprived areas and unhealthy wealthy areas," Social Science & Medicine, Elsevier, vol. 64(6), pages 1326-1342, March.
    3. Peter Congdon, 2014. "Estimating life expectancies for US small areas: a regression framework," Journal of Geographical Systems, Springer, vol. 16(1), pages 1-18, January.
    4. Tatiana Blinova, 2014. "Rural Mortality from External Causes in Russian Regions," ERSA conference papers ersa14p732, European Regional Science Association.
    5. Grembowski, David & Bekemeier, Betty & Conrad, Douglas & Kreuter, William, 2010. "Are local health department expenditures related to racial disparities in mortality?," Social Science & Medicine, Elsevier, vol. 71(12), pages 2057-2065, December.
    6. Mariah Caballero & Solmaz Amiri & Justin T. Denney & Pablo Monsivais & Perry Hystad & Ofer Amram, 2018. "Estimated Residential Exposure to Agricultural Chemicals and Premature Mortality by Parkinson’s Disease in Washington State," IJERPH, MDPI, vol. 15(12), pages 1-11, December.
    7. Alonso, José M. & Andrews, Rhys, 2022. "Does vertical integration of health and social care organizations work? Evidence from Scotland," Social Science & Medicine, Elsevier, vol. 307(C).
    8. Ronald Cossman & Jeralynn Cossman & Arthur Cosby & Rebel Reavis, 2008. "Reconsidering the Rural–Urban Continuum in Rural Health Research: A Test of Stable Relationships Using Mortality as a Health Measure," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 27(4), pages 459-476, August.
    9. Jamie Pearce & Karen Witten & Rosemary Hiscock & Tony Blakely, 2008. "Regional and Urban–Rural Variations in the Association of Neighbourhood Deprivation with Community Resource Access: A National Study," Environment and Planning A, , vol. 40(10), pages 2469-2489, October.

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