Format

Send to

Choose Destination
See comment in PubMed Commons below
Am J Public Health. 1999 Jun;89(6):893-8.

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

Author information

1
Center for Health Services Research and Development, East Carolina University, Greenville, NC 27858, USA. mansfield@brody.med.ecu.edu

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, household 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.

PMID:
10358681
PMCID:
PMC1508666
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for PubMed Central
    Loading ...
    Support Center