scholarly journals RACIAL DISPARITIES IN RURAL-URBAN MORTALITY GAP IN THE UNITED STATES: A 24-YEAR LONGITUDINAL STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Nasim Ferdows ◽  
Soroosh Baghban Ferdows ◽  
Amit Kumar
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Fixed Effects ◽  
The United States ◽  
Mortality Rates ◽  
Race And Gender ◽  
Racial Gap ◽  
The Us ◽  
And Gender

Abstract Although overall life expectancy in the US has improved rapidly over the course of the 20th century and the racial gap in all-cause mortality has declined in recent decades, geographical disparities in mortality have increased in the last three decades. This research aims to study racial and geographical disparities by comparing the race and sex-specific mortality trends of the US rural and urban populations. We created a longitudinal county level analytic file of the US population 65 years and older, over the period of 1968 to 2015 obtained from CDC-WONDER and Area Health Resources Files. First, we used an OLS regression of age-adjusted mortality rate onto year indicators interaction with race and gender to depict the race and sex-specific trend in age-adjusted mortality rates. We also estimated the change in in mortality rate over time, for each race and gender, relative to values in 1968. Finally, we estimated race and sex specific trend in rural-urban mortality gap using state fixed effects regression. Our results indicate that racial gap in mortality rates has only declined in urban areas. Mortality rates of the whites in rural areas declined more rapidly than their Black counterparts, resulting in a gap that has been widening in the last three decades. The racial gap has increased considerably for males residing in rural counties not adjacent to an urban county. Thus, racial disparity in mortality has increased in rural areas, with a considerable widening between white and black male population living in the more remote rural areas.

scholarly journals Trends in Diabetes Mortality in Urban and Rural China, 1987–2019: A Joinpoint Regression Analysis

2022 ◽  
Vol 12 ◽  
Author(s):  
Binbin Su ◽  
Yiran Wang ◽  
Yanhui Dong ◽  
Gang Hu ◽  
Yike Xu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Mortality Rates ◽  
Health Statistics ◽  
Joinpoint Regression ◽  
Diabetes Mortality ◽  
The Past ◽  
Joinpoint Regression Analysis

PurposeDiabetes mellitus is emerging as an epidemic worldwide, and the incidence and prevalence of diabetes have drastically changed in China over the past 30 years, but data on its mortality rate are scarce. This study aimed to analyze the time trends of mortality rates among patients with diabetes in the rural and urban population in China between 1987 and 2019.MethodsThe research data come from China’s annual report on national health statistics and the Chinese Health Statistics Yearbook. Age-standardized mortality rates were calculated by using the direct method based on the World Standard Population from the WHO. Joinpoint regression analysis was employed to estimate the annual percent change and average annual percentage changes of mortality rates of diabetes mellitus.ResultsAn overall trend for increment in diabetes mortality was observed. The crude mortality rates and age-standardized mortality rates of diabetes for urban and rural residents in China showed a significant increasing trend between 1987 and 2019. Mortality due to diabetes in urban areas has been higher than in rural areas for 30 years. However, due to the rapid increase of rural diabetes mortality in the past decade, the gap between the two gradually narrowed. The age-standardized mortality rates of diabetes increased by about 38.5% in urban areas and 254.9% in rural areas over the whole study period. In addition, the age-standardized mortality rate of females with diabetes was higher than that of males, but this pattern began to change in urban areas in 2012. Finally, the age-standardized mortality rates in the elderly population in China are higher with a faster growth rate, especially in rural areas.ConclusionThe mortality rate of diabetes is on the rise in China. The rapid growth of the mortality rate of diabetes in rural areas leads to the reduction of the urban–rural gap. Male mortality rates in urban areas have surpassed those of women. At the same time, the mortality rate of diabetes showed obvious elder-group orientation. As China’s population ages, the burden of death and disability caused by diabetes and its complications will continue to increase. These results indicate that diabetes has become a significant public health problem in China. Such an effect increases the demand for strategies aimed at the prevention and treatment of diabetes mellitus. In addition to the prevention and intervention of diabetes in high-risk groups, it is also necessary to establish diabetes screening networks to identify patients with mild symptoms. Early detection and timely intervention can effectively reduce the incidence and mortality of diabetes.

Race, Gender, and Space Exploration: A Chapter in the Social History of the Space Age

2007 ◽  
Vol 41 (2) ◽  
pp. 405-434 ◽  
Author(s):  
KIM MCQUAID
Keyword(s):  
Civil Rights ◽  
Social History ◽  
Space Exploration ◽  
The United States ◽  
Social Changes ◽  
Race And Gender ◽  
The Social ◽  
The Us ◽  
History Of ◽  
And Gender

An era of space explorations and an era of expanded civil rights for racial minorities and women began simultaneously in the United States. But such important social changes are very rarely discussed in relation to each other. Four recent books on how the US astronaut program finally opened to women and minorities in 1978 address a key part of this connection, without discussing the struggles that compelled the ending of traditional race and gender exclusions. This essay examines the organizational and political dynamics of how civil rights in employment came to the US civilian space program in the decades after 1970.

scholarly journals Rurality and Origin–Destination Trajectories of Medical School Application and Matriculation in the United States

2021 ◽  
Vol 10 (6) ◽  
pp. 417
Author(s):  
Lan Mu ◽  
Yusi Liu ◽  
Donglan Zhang ◽  
Yong Gao ◽  
Michelle Nuss ◽  
...  
Keyword(s):  
Medical School ◽  
Rural Areas ◽  
Urban Areas ◽  
The United States ◽  
Application Rate ◽  
School Students ◽  
Rural Counties ◽  
Physician Shortages ◽  
The Us ◽  
Using Data

Physician shortages are more pronounced in rural than in urban areas. The geography of medical school application and matriculation could provide insights into geographic differences in physician availability. Using data from the Association of American Medical Colleges (AAMC), we conducted geospatial analyses, and developed origin–destination (O–D) trajectories and conceptual graphs to understand the root cause of rural physician shortages. Geographic disparities exist at a significant level in medical school applications in the US. The total number of medical school applications increased by 38% from 2001 to 2015, but the number had decreased by 2% in completely rural counties. Most counties with no medical school applicants were in rural areas (88%). Rurality had a significant negative association with the application rate and explained 15.3% of the variation at the county level. The number of medical school applications in a county was disproportional to the population by rurality. Applicants from completely rural counties (2% of the US population) represented less than 1% of the total medical school applications. Our results can inform recruitment strategies for new medical school students, elucidate location decisions of new medical schools, provide recommendations to close the rural–urban gap in medical school applications, and reduce physician shortages in rural areas.

scholarly journals Six-year mortality in a street-recruited cohort of homeless youth in San Francisco, California

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e1909 ◽  
Author(s):  
Colette L. Auerswald ◽  
Jessica S. Lin ◽  
Andrea Parriott
Keyword(s):  
Substance Abuse ◽  
Mortality Rate ◽  
San Francisco ◽  
Homeless Youth ◽  
Premature Mortality ◽  
The United States ◽  
Street Youth ◽  
Standardized Mortality Ratio ◽  
Race And Gender ◽  
And Gender

Objectives.The mortality rate of a street-recruited homeless youth cohort in the United States has not yet been reported. We examined the six-year mortality rate for a cohort of street youth recruited from San Francisco street venues in 2004.Methods.Using data collected from a longitudinal, venue-based sample of street youth 15–24 years of age, we calculated age, race, and gender-adjusted mortality rates.Results.Of a sample of 218 participants, 11 died from enrollment in 2004 to December 31, 2010. The majority of deaths were due to suicide and/or substance abuse. The death rate was 9.6 deaths per hundred thousand person-years. The age, race and gender-adjusted standardized mortality ratio was 10.6 (95% CI [5.3–18.9]). Gender specific SMRs were 16.1 (95% CI [3.3–47.1]) for females and 9.4 (95% CI [4.0–18.4]) for males.Conclusions.Street-recruited homeless youth in San Francisco experience a mortality rate in excess of ten times that of the state’s general youth population. Services and programs, particularly housing, mental health and substance abuse interventions, are urgently needed to prevent premature mortality in this vulnerable population.

Deplorable or Disposable? The Carceral State and ‘Breaking Bad’ in Rural America

2021 ◽  
pp. 94-132
Author(s):  
Marie Gottschalk
Keyword(s):  
Rural Areas ◽  
Urban Areas ◽  
Mass Incarceration ◽  
War On Drugs ◽  
The United States ◽  
Carceral State ◽  
Breaking Bad ◽  
The Us ◽  
Urban And Rural Areas ◽  
Racial Ethnic

This chapter examines the limitations of viewing the US carceral state primarily through a racial disparities lens centred on differences in incarceration rates between whites and blacks. It surveys important shifts since the 1970s in who is being incarcerated in the United States, including racial, ethnic, gender, and geographic shifts, most notably between urban and rural areas. It deploys three common frameworks used to help explain the rise of mass incarceration and the hyper-incarceration of African Americans—the culture of control, the culture of poverty, and the war on drugs—to analyse the deepening penetration of the carceral state outside of major urban areas and to examine the opioid crisis.

scholarly journals Urban-rural differences in COVID-19 exposures and outcomes in the South: A preliminary analysis of South Carolina

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246548
Author(s):  
Qian Huang ◽  
Sarah Jackson ◽  
Sahar Derakhshan ◽  
Logan Lee ◽  
Erika Pham ◽  
...  
Keyword(s):  
South Carolina ◽  
Rural Areas ◽  
Urban Areas ◽  
Temporal Patterns ◽  
The United States ◽  
Mortality Rates ◽  
Small Towns ◽  
Spatial And Temporal Patterns ◽  
Urban Rural ◽  
State And Local

As the COVID-19 pandemic moved beyond the initial heavily impacted and urbanized Northeast region of the United States, hotspots of cases in other urban areas ensued across the country in early 2020. In South Carolina, the spatial and temporal patterns were different, initially concentrating in small towns within metro counties, then diffusing to centralized urban areas and rural areas. When mitigation restrictions were relaxed, hotspots reappeared in the major cities. This paper examines the county-scale spatial and temporal patterns of confirmed cases of COVID-19 for South Carolina from March 1st—September 5th, 2020. We first describe the initial diffusion of the new confirmed cases per week across the state, which remained under 2,000 cases until Memorial Day weekend (epi week 23) then dramatically increased, peaking in mid-July (epi week 29), and slowly declining thereafter. Second, we found significant differences in cases and deaths between urban and rural counties, partially related to the timing of the number of confirmed cases and deaths and the implementation of state and local mitigations. Third, we found that the case rates and mortality rates positively correlated with pre-existing social vulnerability. There was also a negative correlation between mortality rates and county resilience patterns, as expected, suggesting that counties with higher levels of inherent resilience had fewer deaths per 100,000 population.

Incidence and Mortality of Eye Cancer in Shandong, China: A Population-based Study During 2013-2017

2021 ◽  
Author(s):  
Yingmei Li ◽  
Hongtao Wang ◽  
Zilong Lu ◽  
Jiandong Sun ◽  
Jiyu Zhang ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Chinese Population ◽  
Prevention And Control ◽  
Mortality Rates ◽  
Population Based ◽  
World Population ◽  
Incidence And Mortality ◽  
And Control

Abstract Background: Eye cancer is relatively rare. Current prevalence and disease burden of eye cancer are unlcear.The purpose of this study was to understand the epidemiology in the incidence and mortality of eye cancer in Shandong Province, and to provide reference for the prevention and control of eye cancer.Methods: Population-based cancer incidence and death data from cancer registries in 2013-2017 was collected by Shandong Center for Disease Control and Prevention (SDCDC). Extracted data were firstly assessed for data quality and then were aggregated by area (urban/rural), gender, and age group [0, 1-4, 5-9, 10-14, …, 85+]. Crude and age-adjusted incidence and mortality rates were calculated.Results: The reported numbers of eye cancer incident cases and deaths in Shandong cancer registry from 2013 to 2017 were 169 and 43, respectively. The crude incidence rate, age-standardized rate of incidence by Chinese population (ASRIC, 2000) and world population (ASRIW) were 11.12/107, 8.92/107 and 12.44/107, respectively. The crude mortality rate, age-standardized rate of mortality by Chinese population (ASRMC, 2000) and world population (ASRMW) were 2.83/107, 1.89/107 and 2.58/107, respectively. There were no marked differences in the incidence and mortality rates between male and female. The incidence rates were similar between rural and urban areas. The mortality rate in rural areas was higher than that in urban areas. The mortality-to-incidence (M/I) ratio in rural areas (0.30) was considerably higher than that in urban areas (0.18). The highest incidence was observed in children aged 0-4 years old, which was true for both urban and rural areas, and for both genders,Conclusion: Eye cancer is not a common malignant tumor in this population. Prevention and control measures should be tailored according to the epidemiological characteristics and risk factors of eye cancer.

American Rural Planning, Development Policy and the Centrality of the Federal State: An Interpretative History

Rural History ◽  
1992 ◽  
Vol 3 (2) ◽  
pp. 219-242 ◽  
Author(s):  
Mark B. Lapping
Keyword(s):  
Rural Areas ◽  
The United States ◽  
Federal State ◽  
Rural People ◽  
Race And Gender ◽  
False Sense ◽  
Rugged Individualism ◽  
Planning Development ◽  
And Gender ◽  
Rural Policy

In just over two hundred years, the United States has been transformed from a very largely rural and wilderness nation into an urban one. Rural Americans have gone from being the first majority to the last minority, to paraphrase historian John Shover (Shover,1976). All through this time policies directly and indirectly oriented to rural areas and rural people have been enunciated by the federal government. Rarely was the coordination of policy sought or achieved, however. Also, for generations the easy assumption was made that agricultural policy constituted rural policy. Further, a form of rural fundamentalism, closely related to a neo-Jeffersonian social outlook, reinforced a false sense of ‘rugged individualism’ as the essence of personal and collective success. Such gross oversimplifications have tended to mask some of the truly substantive problems of poor housing, race and gender inequities, unemployment, illiteracy, poor health, and malnutrition faced by rural and small town populations.

Mortality of Stroke and Its Subtypes in China: Results from a Nationwide Population-Based Survey

2017 ◽  
Vol 48 (3-4) ◽  
pp. 95-102 ◽  
Author(s):  
Zhenghong Chen ◽  
Bin Jiang ◽  
Xiaojuan Ru ◽  
Haixin Sun ◽  
Dongling Sun ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Mortality Rate ◽  
Rural Areas ◽  
Urban Areas ◽  
Hemorrhagic Stroke ◽  
Mortality Rates ◽  
Population Based ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Population Based Survey

Background: In China, stroke is the leading cause of death and contributes to a heavy disease burden. However, a nationwide population-based survey of the mortality of stroke and its subtypes is lacking for this country. Methods: Data derived from the National Epidemiological Survey of Stroke in China, which was a multistage, stratified clustering sampling-designed, cross-sectional survey, were analyzed. Mortality rate analyses were performed for 476,156 participants ≥20 years old from September 1, 2012 to August 31, 2013. Results: Of the 476,156 participants in the investigated population, 364 died of ischemic stroke, 373 of hemorrhagic stroke, and 21 of stroke of undetermined pathological type. The age-standardized mortality rates per 100,000 person-years among those aged ≥20 years were 114.8 for total stroke, 56.5 for ischemic stroke, and 55.8 for hemorrhagic stroke. The age-standardized mortality rates of total stroke, ischemic stroke, and hemorrhagic stroke were all higher in rural areas than those in urban areas. The stroke mortality rate was higher in the northern regions than in the south. An estimated 1.12 million people aged ≥20 years in China died of stroke during the period from September 1, 2012 to August 31, 2013. Conclusions: The burden of stroke in China is still heavy. Greater attention should be paid to improve strategies for preventing stroke.

Recent trends in age at diagnosis of colon cancer in the United States, 2004-2015, a National Cancer Database study.

2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 490-490
Author(s):  
Boone Wilder Goodgame ◽  
Jack Virostko ◽  
Anna Capasso ◽  
Thomas Yankeelov
Keyword(s):  
Colorectal Cancer ◽  
Rural Areas ◽  
Urban Areas ◽  
Advanced Disease ◽  
The United States ◽  
National Cancer Database ◽  
Younger Adults ◽  
Number Of Patients ◽  
The Us ◽  
Over Time

490 Background: The incidence of colorectal cancer (CRC) in adults younger than age 50 has been increasing in the US since 1970. The US Preventive Services Task Force recommends screening for CRC beginning at age 50, while the American Cancer Society recently revised its guidelines to advise screening at age 45. We analyzed the National Cancer Database (NCDB) from 2004 through 2015 to determine whether the proportion of patients diagnosed younger than 50 has changed during this time. Methods: This was a retrospective study of NCDB data, which includes more than 70 percent of newly diagnosed cancer cases in the US. We examined the proportion of patients diagnosed prior to age 50 as our primary endpoint. We used the Cochran–Armitage test for trend to assess changes in the proportion of cases diagnosed at age < 50 years old as a function of year of diagnosis. Results: We identified 152,749 patients diagnosed under age 50 and 1,033,014 patients diagnosed at age 50 or greater. Over the study period, the proportion of the total number of patients diagnosed with colorectal cancer under age 50 increased (14.3% in 2015 vs. 11.5% in 2004, p < 0.0001). Younger adults with CRC presented with more advanced disease, with 49.9% stage III or IV disease, as compared to 40.0% in those diagnosed over age 50. Both men and women had a rising proportion of cases diagnosed younger than 50 (p < 0.0001) over time. In men, only non-Hispanic whites had an increase in diagnosis at ages less than 50 (p < 0.0001), while in women, all racial and ethnic subgroups had an increase in younger diagnoses over time (p < 0.01). All income quartiles (p < 0.001) demonstrated a proportional increase in younger adults over time, with the highest income quartile having the highest proportion of younger cases. The proportion of younger-onset CRC rose in urban areas (p < 0.001), but did not rise in rural areas. Conclusions: The proportion of persons diagnosed with CRC under age 50 in the US has continued to increase over the past decade. Younger adults presented with more advanced disease, suggesting that screening could improve outcomes.

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