@article{ref1,
title="Race, class, and place modify mortality rates for the leading causes of death in the United States, 1999-2021",
journal="Journal of general internal medicine",
year="2023",
author="Formanack, Allison and Doshi, Ayush and Valdez, Rupa and Williams, Ishan and Moorman, J. Randall and Chernyavskiy, Pavel",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: Race and ethnicity, socioeconomic class, and geographic location are well-known social determinants of health in the US. Studies of population mortality often consider two, but not all three of these risk factors. <br><br>OBJECTIVES: To disarticulate the associations of race (whiteness), class (socioeconomic status), and place (county) with risk of cause-specific death in the US. <br><br>DESIGN: We conducted a retrospective analysis of death certificate data. Bayesian regression models, adjusted for age and race/ethnicity from the American Community Survey and the county Area Deprivation Index, were used for inference.   MAIN MEASURES: County-level mortality for 11 leading causes of death (1999-2019) and COVID-19 (2020-2021).   KEY RESULTS: County &quot;whiteness&quot; and socioeconomic status modified death rates; geospatial effects differed by cause of death. Other factors equal, a 20% increase in county whiteness was associated with 5-8% increase in death from three causes and 4-15% reduction in death from others, including COVID-19. Other factors equal, advantaged counties had significantly lower death rates, even when juxtaposed with disadvantaged ones. Patterns of residual risk, measured by spatial county effects, varied by cause of death; for example: cancer and heart disease death rates were better explained by age, socioeconomic status, and county whiteness than were COVID-19 and suicide deaths. <br><br>CONCLUSIONS: There are important independent contributions from race, class, and geography to risk of death in the US.<p /> <p>Language: en</p>",
language="en",
issn="0884-8734",
doi="10.1007/s11606-023-08062-1",
url="http://dx.doi.org/10.1007/s11606-023-08062-1"
}