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Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015

Centers for Disease Control and Prevention, Office of Minority Health and Health Equity, 4770 Buford Highway, TW-3, Atlanta, GA 30341, USA
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(3), 436;
Received: 18 December 2018 / Revised: 19 January 2019 / Accepted: 31 January 2019 / Published: 2 February 2019
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The value of disaggregating non-metropolitan and metropolitan area deaths in illustrating place-based health effects is evident. However, how place interacts with characteristics such as race/ethnicity has been less firmly established. This study compared socioeconomic characteristics and age-adjusted mortality rates by race/ethnicity in six rurality designations and assessed the contributions of mortality rate disparities between non-Hispanic blacks (NHBs) and non-Hispanic whites (NHWs) in each designation to national disparities. Compared to NHWs, age-adjusted mortality rates for: (1) NHBs were higher for all causes (combined), heart disease, malignant neoplasms, and cerebrovascular disease; (2) American Indian and Alaska Natives were significantly higher for all causes in rural areas; (3) Asian Pacific islanders and Hispanics were either lower or not significantly different in all areas for all causes combined and all leading causes of death examined. The largest contribution to the U.S. disparity in mortality rates between NHBs and NHWs originated from large central metropolitan areas. Place-based variations in mortality rates and disparities may reflect resource, and access inequities that are often greater and have greater health consequences for some racial/ethnic populations than others. Tailored, systems level actions may help eliminate mortality disparities existing at intersections between race/ethnicity and place. View Full-Text
Keywords: health disparities; rurality; race/ethnicity; place health disparities; rurality; race/ethnicity; place
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hall, J.E.; Moonesinghe, R.; Bouye, K.; Penman-Aguilar, A. Racial/Ethnic Disparities in Mortality: Contributions and Variations by Rurality in the United States, 2012–2015. Int. J. Environ. Res. Public Health 2019, 16, 436.

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