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. 2019 Dec;64(9):1367-1374.
doi: 10.1007/s00038-019-01274-5. Epub 2019 Jul 4.

Divergent trends in life expectancy across the rural-urban gradient and association with specific racial proportions in the contiguous USA 2000-2005

Yun Jian  1   2 , Lucas Neas  3 , Lynne C Messer  4 , Christine L Gray  2   5 , Jyotsna S Jagai  6 , Kristen M Rappazzo  3 , Danelle T Lobdell  7
Affiliations

Divergent trends in life expectancy across the rural-urban gradient and association with specific racial proportions in the contiguous USA 2000-2005

Yun Jian et al. Int J Public Health. 2019 Dec.

Abstract

Objectives: To estimate county-level adult life expectancy for Whites, Black/African Americans (Black), American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (Asian) populations and assess the difference across racial groups in the relationship among life expectancy, rurality and specific race proportion.

Methods: We used individual-level death data to estimate county-level life expectancy at age 25 (e25) for Whites, Black, AIAN and Asian in the contiguous USA for 2000-2005. Race-sex-stratified models were used to examine the associations among e25, rurality and specific race proportion, adjusted for socioeconomic variables.

Results: Lower e25 was found in the central USA for AIANs and in the west coast for Asians. We found higher e25 in the most rural areas for Whites but in the most urban areas for AIAN and Asians. The associations between specific race proportion and e25 were positive or null for Whites but were negative for Blacks, AIAN, and Asians. The relationship between specific race proportion and e25 varied across rurality.

Conclusions: Identifying differences in adult life expectancy, both across and within racial groups, provides new insights into the geographic determinants of life expectancy disparities.

Keywords: American Indian/Alaska Native population; Asian/Pacific Islander population; Contiguous USA; Life expectancy at age 25; Rurality; Specific race proportion.

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Conflict of interest statement

Conflict of Interest:

The authors declare that they have no conflict of interest.

Figures

Figure 1.
Figure 1.
County-level life expectancy at age 25 for the contiguous US 2000–2005 (Deciles differed among sex-race groups). White patches: counties with no estimated life expectancy.
Figure 2.
Figure 2.
Differences in life expectancy at age 25 (e25) per one standard deviation change in (95% Confidence Interval) specific race proportion from the models for the contiguous US 2000–2005 with (a) specific race proportion only, (b) the models with both Rural Urban Continuum Code (RUCC) and specific race proportion, and (c) the models with RUCC, specific race proportion, and adjusting sociodemographic variables (SD). MW: Male White; MB: Male Black; MN: Male AIAN; MA: Male Asian; FW: Female White; FB: Female Black; FN: Female AIAN; FA: Female Asian
Figure 3.
Figure 3.
Difference in life expectancy at age 25 (e25) per one standard deviation change (95% Confidence Interval) in specific race proportion across rurality from the interaction models with adjusting variables for the contiguous US 2000–2005. RUCC1: metropolitan areas; RUCC2: non-metro urbanized areas; RUCC3 areas: less populated; RUCC4: thinly populated areas
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