TY - JOUR
PY - 2023//
TI - Race, class, and place modify mortality rates for the leading causes of death in the United States, 1999-2021
JO - Journal of general internal medicine
A1 - Formanack, Allison
A1 - Doshi, Ayush
A1 - Valdez, Rupa
A1 - Williams, Ishan
A1 - Moorman, J. Randall
A1 - Chernyavskiy, Pavel
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - 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.
OBJECTIVES: To disarticulate the associations of race (whiteness), class (socioeconomic status), and place (county) with risk of cause-specific death in the US.
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 "whiteness" 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.
CONCLUSIONS: There are important independent contributions from race, class, and geography to risk of death in the US. Language: en
LA - en
SN - 0884-8734
UR - http://dx.doi.org/10.1007/s11606-023-08062-1
ID - ref1
ER -