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. 2003 Jul;93(7):1137-43.
doi: 10.2105/ajph.93.7.1137.

Area deprivation and widening inequalities in US mortality, 1969-1998

Gopal K Singh  1
Affiliations

Area deprivation and widening inequalities in US mortality, 1969-1998

Gopal K Singh. Am J Public Health. 2003 Jul.

Abstract

Objectives: This study examined age-, sex-, and race-specific gradients in US mortality by area deprivation between 1969 and 1998.

Methods: A census-based area deprivation index was linked to county mortality data.

Results: Area deprivation gradients in US mortality increased substantially during 1969 through 1998. The gradients were steepest for men and women aged 25 to 44 years and those younger than 25 years, with higher mortality rates observed in more deprived areas. Although area gradients were less pronounced for women in each age group, they rose sharply for women aged 25 to 44 and 45 to 64 years.

Conclusions: Areal inequalities in mortality widened because of slower mortality declines in more deprived areas. Future research needs to examine population-level social, behavioral, and medical care factors that may account for the increasing gradient.

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Figures

FIGURE 1—
FIGURE 1—
Sex- and race-specific all-cause mortality rates, by 1990 area deprivation index: United States, 1969–1998 (1970 US Standard Population).
FIGURE 2—
FIGURE 2—
Age- and race-adjusted relative risks of all-cause mortality among US men and women, by 1990 area deprivation index derived from Poisson regression models: 1969–1998. Note. All relative risks for men and women aged younger than 25 years and 25 to 44 years and for men aged 45 to 64 years were significant at P < .01. Relative risks for women aged 45 to 64 years were significant at P < .05. Whereas most relative risks were significant for men aged 65 years or older at P < .05, only those associated with the fourth and fifth deprivation quintiles between 1993 and 1998 were significant for women aged 65 years or older.
See this image and copyright information in PMC

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