Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.

Life expectancy at birth, estimated from United States period life tables, has been shown to vary systematically and widely by region and race. We use the same tables to estimate the probability of survival from birth to age 70 (S(70)), a measure of mortality more sensitive to disparities and more r...

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Autores principales:	Mark R Cullen, Clint Cummins, Victor R Fuchs
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2012
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c6aa1563d5d046868a120db98ca11d02
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spelling	oai:doaj.org-article:c6aa1563d5d046868a120db98ca11d022021-11-18T07:21:59ZGeographic and racial variation in premature mortality in the U.S.: analyzing the disparities.1932-620310.1371/journal.pone.0032930https://doaj.org/article/c6aa1563d5d046868a120db98ca11d022012-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/22529892/?tool=EBIhttps://doaj.org/toc/1932-6203Life expectancy at birth, estimated from United States period life tables, has been shown to vary systematically and widely by region and race. We use the same tables to estimate the probability of survival from birth to age 70 (S(70)), a measure of mortality more sensitive to disparities and more reliably calculated for small populations, to describe the variation and identify its sources in greater detail to assess the patterns of this variation. Examination of the unadjusted probability of S(70) for each US county with a sufficient population of whites and blacks reveals large geographic differences for each race-sex group. For example, white males born in the ten percent healthiest counties have a 77 percent probability of survival to age 70, but only a 61 percent chance if born in the ten percent least healthy counties. Similar geographical disparities face white women and blacks of each sex. Moreover, within each county, large differences in S(70) prevail between blacks and whites, on average 17 percentage points for men and 12 percentage points for women. In linear regressions for each race-sex group, nearly all of the geographic variation is accounted for by a common set of 22 socio-economic and environmental variables, selected for previously suspected impact on mortality; R(2) ranges from 0.86 for white males to 0.72 for black females. Analysis of black-white survival chances within each county reveals that the same variables account for most of the race gap in S(70) as well. When actual white male values for each explanatory variable are substituted for black in the black male prediction equation to assess the role explanatory variables play in the black-white survival difference, residual black-white differences at the county level shrink markedly to a mean of -2.4% (+/-2.4); for women the mean difference is -3.7% (+/-2.3).Mark R CullenClint CumminsVictor R FuchsPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 7, Iss 4, p e32930 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mark R Cullen Clint Cummins Victor R Fuchs Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.
description	Life expectancy at birth, estimated from United States period life tables, has been shown to vary systematically and widely by region and race. We use the same tables to estimate the probability of survival from birth to age 70 (S(70)), a measure of mortality more sensitive to disparities and more reliably calculated for small populations, to describe the variation and identify its sources in greater detail to assess the patterns of this variation. Examination of the unadjusted probability of S(70) for each US county with a sufficient population of whites and blacks reveals large geographic differences for each race-sex group. For example, white males born in the ten percent healthiest counties have a 77 percent probability of survival to age 70, but only a 61 percent chance if born in the ten percent least healthy counties. Similar geographical disparities face white women and blacks of each sex. Moreover, within each county, large differences in S(70) prevail between blacks and whites, on average 17 percentage points for men and 12 percentage points for women. In linear regressions for each race-sex group, nearly all of the geographic variation is accounted for by a common set of 22 socio-economic and environmental variables, selected for previously suspected impact on mortality; R(2) ranges from 0.86 for white males to 0.72 for black females. Analysis of black-white survival chances within each county reveals that the same variables account for most of the race gap in S(70) as well. When actual white male values for each explanatory variable are substituted for black in the black male prediction equation to assess the role explanatory variables play in the black-white survival difference, residual black-white differences at the county level shrink markedly to a mean of -2.4% (+/-2.4); for women the mean difference is -3.7% (+/-2.3).
format	article
author	Mark R Cullen Clint Cummins Victor R Fuchs
author_facet	Mark R Cullen Clint Cummins Victor R Fuchs
author_sort	Mark R Cullen
title	Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.
title_short	Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.
title_full	Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.
title_fullStr	Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.
title_full_unstemmed	Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.
title_sort	geographic and racial variation in premature mortality in the u.s.: analyzing the disparities.
publisher	Public Library of Science (PLoS)
publishDate	2012
url	https://doaj.org/article/c6aa1563d5d046868a120db98ca11d02
work_keys_str_mv	AT markrcullen geographicandracialvariationinprematuremortalityintheusanalyzingthedisparities AT clintcummins geographicandracialvariationinprematuremortalityintheusanalyzingthedisparities AT victorrfuchs geographicandracialvariationinprematuremortalityintheusanalyzingthedisparities
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Geographic and racial variation in premature mortality in the U.S.: analyzing the disparities.

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