Comparing Unintentional Opioid Poisoning Mortality in Metropolitan and Non-Metropolitan Counties, United States, 1999–2003

2008 ◽  
pp. 175-192 ◽  
Author(s):  
Nabarun Dasgupta ◽  
Michele Jönsson Funk ◽  
John S. Brownstein
Keyword(s):  
United States ◽  
Metropolitan Counties

scholarly journals Income Inequality Across the Rural-Urban Continuum in the United States, 1970-2016

2019 ◽  
Author(s):  
Brian C. Thiede ◽  
Jaclyn L.W. Butler ◽  
David L. Brown ◽  
Leif Jensen
Keyword(s):  
United States ◽  
Income Inequality ◽  
The United States ◽  
Research Literature ◽  
Central Plains ◽  
Rural And Urban ◽  
Urban Rural ◽  
Almost All ◽  
Metropolitan Counties ◽  
The U.S

Since the 1970s, the U.S. has experienced dramatic increases in income inequality. Although this macro-level trend is well-established in research literature, less is known about subnational patterns of income inequality in the U.S., particularly as they vary between and within rural and urban localities. Using Census and ACS data, this study produces Gini estimates of within-county income inequality and examines these trends across a six-strata urban-rural typology from 1970 to 2016. This study finds the following. Income inequality has remained consistently higher in nonmetropolitan counties than metropolitan counties throughout the study period. However, levels of inequality have converged by 2016, a convergence that has been driven by increases in metropolitan counties. There are notable exceptions to the secular trend of increasing inequality. The central Plains region has experienced decreasing levels of inequality, and inequality in large, peripheral metropolitan counties lags noticeably behind other types of counties. Almost all low-inequality counties in 1970 have shifted to moderate- or high-inequality, such that almost no one lives in low-inequality places by 2016. This increase in exposure to inequality has been particularly dramatic among residents of large, central metropolitan counties. As the only county-level analysis to track income inequality across the rural-urban continuum from 1970 to 2016, this study lays the foundation for more sophisticated analyses that explain spatial variation in income inequality and that account for the demographic and economic diversity of the rural and urban United States.

scholarly journals Invasive Cancer Incidence, 2004–2013, and Deaths, 2006–2015, in Nonmetropolitan and Metropolitan Counties — United States

2017 ◽  
Vol 66 (14) ◽  
pp. 1-13 ◽  
Author(s):  
S. Jane Henley ◽  
Robert N. Anderson ◽  
Cheryll C. Thomas ◽  
Greta M. Massetti ◽  
Brandy Peaker ◽  
...  
Keyword(s):  
United States ◽  
Cancer Incidence ◽  
Invasive Cancer ◽  
Metropolitan Counties

scholarly journals Cost of living variation, non-metropolitan America, and implications for the Supplemental Poverty Measure

2021 ◽  
Author(s):  
Tom Mueller ◽  
Matthew M Brooks ◽  
Jose Pacas
Keyword(s):  
United States ◽  
Metropolitan Areas ◽  
The United States ◽  
Community Survey ◽  
Cost Of Living ◽  
Poverty Measure ◽  
Housing Costs ◽  
Wide Variability ◽  
Metropolitan Counties ◽  
Research And Policy

Poverty scholarship in the United States is increasingly reliant upon the Supplemental Poverty Measure (SPM) as opposed to the Official Poverty Measure of the United States for research and policy analysis. However, the SPM still faces several critiques from scholars focused on poverty of non-metropolitan areas. Key among these critiques is the geographic adjustment for cost of living employed in the SPM, which is based solely upon median rental costs and pools together all non-metropolitan counties within each state. Here, we evaluate the current geographic adjustment of the SPM using both microdata and aggregate data from the American Community Survey for 2014-2018. By comparing housing costs, tenure, and commuting, we determine median rent is likely an appropriate basis for geographic adjustment. However, by demonstrating the wide variability between median rents of non-metropolitan counties within the same state, we show that the current operationalization of this geographic adjustment is sorely lacking.

Incidence and Survival Outcomes Of Myelodysplastic Syndrome In The United States: A SEER Analysis 2001 - 2010

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5205-5205
Author(s):  
Hari Prasad Ravipati ◽  
Srinadh Annangi ◽  
Vamsi Kota
Keyword(s):  
United States ◽  
Median Survival ◽  
Conflicts Of Interest ◽  
Large Population ◽  
Survival Rates ◽  
Relative Survival ◽  
The United States ◽  
Incidence Rates ◽  
Significant Difference ◽  
Metropolitan Counties

Abstract Introduction Myelodysplastic syndromes (MDS) are a group of hematological disorders leading to ineffective hematopoiesis and excess blast formation. We aimed to establish the incidence rates and median survival periods in MDS by gender, race and geographic location in a large population cohort. Methods We performed a retrospective analysis of the United States (US) SEER database for MDS cases diagnosed between 2001 and 2010 using ICD-0-3 histology codes 9980/3, 9982/3, 9983/3, 9984/3 and 9986/3. Incidence rates were calculated using the 2000 US standard population. Five-year relative survival rates were measured using the Kaplan-Meier method after excluding cases diagnosed by death certificate and autopsy. Results 14,920 cases were identified of which 87.2 % (n = 13,009) were present in age group sixty years and above. Age-adjusted incidence rates (per 100,000) for males were 14.8, 10.0, and 12.7 for white, black and other races respectively. The rates for females were 7.7, 7.1, and 7.0. On US county wise MDS case analysis, 11296 (86.8%) of cases were diagnosed in metropolitan counties and 1694 (13%) cases in nonmetropolitan counties. Median relative survival for white, black and other males were 27 months, 36 months and 24 months respectively ; 35 months, 38 months and 37 months for females. Five-year relative survival for white, black, and other males were 32.5% (95% CI 30.7- 34.3), 36.1% (95% CI 28.3 - 43.9) and 30% (95% CI 24.2 - 36.0) vs. 36.2% (95%CI 34.1 - 38.3), 41.1% (95% CI 34.4 - 47.8) and 37.3% (95% CI 30.2 - 44.5) for females. Median relative survival for cases from metropolitan and non-metropolitan counties were 31 months and 31 months respectively. Five-year relative survivals were 35.1% (95% CI 33.7-36.5) and 32.6% (95% CI 29.1-36.0) for metropolitan and non-metropolitan counties MDS cases respectively. Conclusion The incidence of MDS was higher in males compared to females with the highest rate in white males. Survival rates were similar in both sexes. No significant difference in survival rates were seen among the racial groups. No significant difference in the median survival and five-year relative survival rates were noticed between metropolitan and non-metropolitan groups. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Geographical disparity and traumatic brain injury in America: Rural areas suffer poorer outcomes

2019 ◽  
Vol 10 (01) ◽  
pp. 10-15 ◽  
Author(s):  
Joshua B Brown ◽  
Marin Kheng ◽  
Nancy A Carney ◽  
Andres A Rubiano ◽  
Juan Carlos Puyana
Keyword(s):  
United States ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Rural Areas ◽  
The United States ◽  
Significant Heterogeneity ◽  
County Level ◽  
Fatality Rate ◽  
Mortality And Morbidity ◽  
Metropolitan Counties

ABSTRACTIntroduction: Significant heterogeneity exists in traumatic brain injury (TBI) outcomes. In the United States, TBI remains a primary driver of injury-related mortality and morbidity. Prior work has suggested that disparity exists in rural areas; our objective was to evaluate potential differences in TBI mortality across urban and rural areas on a national scale. Methods: Age-adjusted TBI fatality rates were obtained at the county level across the U.S. from 2008 to 2014. To evaluate geography, urban influence codes (UIC) were also obtained at the county level. UIC codes range from 1 (most urban) to 12 (most rural). Metropolitan counties are defined as those with an UIC ≤2, while nonmetropolitan counties are defined as an UIC ≥3. County-level fatality rates and UIC classification were geospatially mapped. Linear regression was used to evaluate the change in TBI fatality rate at each category of UIC. The median TBI fatality rate was also compared between metropolitan and nonmetropolitan counties. Results: Geospatial analysis demonstrated higher fatality rates distributed among nonmetropolitan counties across the United States. The TBI fatality rate was 13.00 deaths per 100,000 persons higher in the most rural UIC category compared to the most urban UIC category (95% confidence interval 12.15, 13.86; P < 0.001). The median TBI rate for nonmetropolitan counties was significantly higher than metropolitan counties (22.32 vs. 18.22 deaths per 100,000 persons, P < 0.001). Conclusions: TBI fatality rates are higher in rural areas of the United States. Additional studies to evaluate the mechanisms and solutions to this disparity are warranted and may have implications for lower-and middle-income countries.

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