Decomposing Mortality Disparities in Urban and Rural U.S. Counties

Health Services Research
Jennifer C SpencerGeorge M Holmes

Abstract

To understand the role of county characteristics in the growing divide between rural and urban mortality from 1980 to 2010. Age-adjusted mortality rates for all U.S. counties from 1980 to 2010 were obtained from the CDC Compressed Mortality File and combined with county characteristics from the U.S. Census Bureau, the Area Health Resources File, and the Inter-University Consortium for Political and Social research. We used Oaxaca-Blinder decomposition to assess the extent to which rural-urban mortality disparities are explained by observed county characteristics at each decade. Decomposition shows that, at each decade, differences in rural/urban characteristics are sufficient to explain differences in mortality. Furthermore, starting in 1990, rural counties have significantly lower predicted mortality than urban counties when given identical county characteristics. We find changes in the effect of characteristics on mortality, not the characteristics themselves, drive the growing mortality divide. Differences in economic and demographic characteristics between rural and urban counties largely explain the differences in age-adjusted mortality in any given year. Over time, the role these characteristics play in improving mortalit...Continue Reading

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Citations

Dec 4, 2019·Health Affairs·Janice ProbstElizabeth Crouch
Jul 17, 2020·American Journal of Public Health·Jonathon P LeiderDavid Bishai
Aug 7, 2019·Journal of Neuro-oncology·Arash DelavarMartin H Pham
Apr 18, 2020·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Kelly M KenzikSmita Bhatia
Jan 5, 2021·Health Services Research·Asako S Moriya, Lanlan Xu
Jan 30, 2021·Journal of General Internal Medicine·Kenton J JohnstonKaren E Joynt Maddox
Jun 11, 2020·Journal of Public Health Management and Practice : JPHMP·Victoria BrunNorma F Kanarek

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