@article{ref1,
title="The epidemic of despair among white americans: trends in the leading causes of premature death, 1999-2015",
journal="American journal of public health",
year="2017",
author="Stein, Elizabeth M. and Gennuso, Keith P. and Ugboaja, Donna C. and Remington, Patrick L.",
volume="107",
number="10",
pages="1541-1547",
abstract="OBJECTIVES: To evaluate trends in premature death rates by cause of death, age, race, and urbanization level in the United States. <br><br>METHODS: We calculated cause-specific death rates using the Compressed Mortality File, National Center for Health Statistics data for adults aged 25 to 64 years in 2 time periods: 1999 to 2001 and 2013 to 2015. We defined 48 subpopulations by 10-year age groups, race/ethnicity, and county urbanization level (large urban, suburban, small or medium metropolitan, and rural). <br><br>RESULTS: The age-adjusted premature death rates for all adults declined by 8% between 1999 to 2001 and 2013 to 2015, with decreases in 39 of the 48 subpopulations. Most decreases in death rates were attributable to HIV, cardiovascular disease, and cancer. All 9 subpopulations with increased death rates were non-Hispanic Whites, largely outside large urban areas. Most increases in death rates were attributable to suicide, poisoning, and liver disease. <br><br>CONCLUSIONS: The unfavorable recent trends in premature death rate among non-Hispanic Whites outside large urban areas were primarily caused by self-destructive health behaviors likely related to underlying social and economic factors in these communities. (Am J Public Health. Published online ahead of print August 17, 2017: e1-e7. doi:10.2105/AJPH.2017.303941).<p /> <p>Language: en</p>",
language="en",
issn="0090-0036",
doi="10.2105/AJPH.2017.303941",
url="http://dx.doi.org/10.2105/AJPH.2017.303941"
}