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. 2007 Dec;97(12):2148-50.
doi: 10.2105/AJPH.2006.093112. Epub 2007 May 30.

Persistent clusters of mortality in the United States

Jeralynn Sittig Cossman  1 , Ronald E Cossman, Wesley L James, Carol R Campbell, Troy C Blanchard, Arthur G Cosby
Affiliations

Persistent clusters of mortality in the United States

Jeralynn Sittig Cossman et al. Am J Public Health. 2007 Dec.

Abstract

We explored how place shapes mortality by examining 35 consecutive years of US mortality data. Mapping age-adjusted county mortality rates showed both persistent temporal and spatial clustering of high and low mortality rates. Counties with high mortality rates and counties with low mortality rates both experienced younger population out-migration, had economic decline, and were predominantly rural. These mortality patterns have important implications for proper research model specification and for health resource allocation policies.

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Figures

FIGURE 1—
FIGURE 1—
US counties that had high or low age-adjusted mortality rates in at least four of seven 5-year periods. Note. Rates for Alaska and Hawaii were calculated, but they were not included in these analyses. Counties within 1 SD of the national average for 4 or more periods are shown in white. Counties with “high” mortality (black pattern) had mortality rates more than 1 SD greater than the US mean rate for at least 4 of the 7 (i.e., more than half) time periods. Counties with “low” mortality (black dotted pattern) had mortality rates more than 1 SD less than the US mean rate for at least 4 of the 7 time periods.
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