TY  - JOUR
PY  - 2017//
TI  - The epidemic of despair among white americans: trends in the leading causes of premature death, 1999-2015
JO  - American journal of public health
A1  - Stein, Elizabeth M.
A1  - Gennuso, Keith P.
A1  - Ugboaja, Donna C.
A1  - Remington, Patrick L.
SP  - 1541
EP  - 1547
VL  - 107
IS  - 10
N2  - 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>
LA  - en
SN  - 0090-0036
UR  - http://dx.doi.org/10.2105/AJPH.2017.303941
ID  - ref1
ER  -