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All Rural Places Are Not Created Equal

Revisiting the Rural Mortality Penalty in the United States

Bibliographic Data

ID11017289
AuthorsWesley L James (Wesley L. James is with the Department of Sociology at The University of Memphis, Memphis, TN.), Wesley James (University of Memphis, corresponding author)
Year2014
Volume104
Issue11
Pages2122-2129
Publication date2014-11-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueAmerican Journal of Public Health (JOURNAL)
Journal identifiersISSN: 0090-0036 • E-ISSN: 1541-0048
PublisherAmerican Public Health Association (PUBLISHER • US)
DOI10.2105/ajph.2014.301989
PMID25211763
OpenAlexW2153669591
LanguageEN
Citations received53
References cited50

Objectives. I investigated mortality disparities between urban and rural areas by measuring disparities in urban US areas compared with 6 rural classifications, ranging from suburban to remote locales. Methods. Data from the Compressed Mortality File, National Center for Health Statistics, from 1968 to 2007, was used to calculate age-adjusted mortality rates for all rural and urban regions by year. Criteria measuring disparity between regions included excess deaths, annual rate of change in mortality, and proportion of excess deaths by population size. I used multivariable analysis to test for differences in determinants across regions. Results. The rural mortality penalty existed in all rural classifications, but the degree of disparity varied considerably. Rural–urban continuum code 6 was highly disadvantaged, and rural–urban continuum code 9 displayed a favorable mortality profile. Population, socioeconomic, and health care determinants of mortality varied across regions. Conclusions. A 2-decade long trend in mortality disparities existed in all rural classifications, but the penalty was not distributed evenly. This constitutes an important public health problem. Research should target the slow rates of improvement in mortality in the rural United States as an area of concern

Environmental health · Geography · Population · Rural area · Rural health · Rural population · Sociology · Demography · Geriatric Care and Nursing Homes · Global Health Workforce Issues · Health disparities and outcomes · Medicine · Gerontology

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Unique citing works53
Citations per year4,42
Citation span2014 - 2026 (13)
Citation velocitycurrent
Highly citedNo
Citation typesNeutral: 47
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