Rural-Urban Mortality Disparities: Variations Across Causes of Death and Race/Ethnicity, 2013–2017

2020 ◽  
Vol 110 (9) ◽  
pp. 1325-1327 ◽  
Author(s):  
Janice C. Probst ◽  
Whitney E. Zahnd ◽  
Peiyin Hung ◽  
Jan M. Eberth ◽  
Elizabeth L. Crouch ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Alaska Native ◽  
Causes Of Death ◽  
The United States ◽  
Death Rates ◽  
All Cause Mortality ◽  
Race Ethnicity ◽  
Black Populations ◽  
Lower Respiratory Disease ◽  
Hispanic White

Objectives. To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. Methods. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and stroke) by rural versus urban county of residence in the United States and race/ethnicity for the period 2013 to 2017. Results. Rural populations, across all racial/ethnic groups, had higher all-cause mortality rates than did their urban counterparts. Comparisons within causes of death documented rural disparities for all conditions except cancer and stroke among Hispanic individuals; Hispanic rural residents had death rates similar to or lower than urban residents. Rural Black populations experienced the highest mortality for cardiovascular disease, cancer, and stroke. Unintentional injury and chronic lower respiratory disease mortality were highest in rural AI/AN and rural non-Hispanic White populations, respectively. Conclusions. Investigating rural-urban disparities without also considering race/ethnicity leaves minority health disparities unexamined and thus unaddressed. Further research is needed to clarify local factors associated with these disparities and to test appropriate interventions.

scholarly journals Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 149S-157S
Author(s):  
Benedict I. Truman ◽  
Ramal Moonesinghe ◽  
Yolanda T. Brown ◽  
Man-Huei Chang ◽  
Jonathan H. Mermin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Rate Of Change ◽  
Fiscal Year ◽  
Death Rates ◽  
Black Residents ◽  
Race Ethnicity ◽  
Hiv Funding ◽  
Racial Ethnic ◽  
Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

scholarly journals Alcohol Consumption and Chronic Liver Disease Mortality in New Mexico and the United States, 1999-2013

2018 ◽  
Vol 133 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Laura E. Tomedi ◽  
Jim Roeber ◽  
Michael Landen
Keyword(s):  
United States ◽  
New Mexico ◽  
Liver Disease ◽  
American Indian ◽  
The United States ◽  
Death Rates ◽  
Attributable Fractions ◽  
Hispanic Men ◽  
Race Ethnicity ◽  
Hispanic White

Objective: Current chronic liver disease (CLD) mortality surveillance methods may not adequately capture data on all causes of CLD mortality. The objective of this study was to calculate and compare CLD death rates in New Mexico and the United States by using both an expanded definition of CLD and estimates of the fractional impact of alcohol on CLD deaths. Methods: We defined CLD mortality as deaths due to alcoholic liver disease, cirrhosis, viral hepatitis, and other liver conditions. We estimated alcohol-attributable CLD deaths by using national and state alcohol-attributable fractions from the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application. We classified causes of CLD death as being alcohol-attributable, non–alcohol-attributable, or hepatitis C. We calculated average annual age-adjusted CLD death rates during five 3-year periods from 1999 through 2013, and we stratified those rates by sex, age, and race/ethnicity. Results: By cause of death, CLD death rates were highest for alcohol-attributable CLD. By sex and race/ethnicity, CLD death rates per 100 000 population increased from 1999-2001 to 2011-2013 among American Indian men in New Mexico (67.4-90.6) and the United States (38.9-49.4), American Indian women in New Mexico (48.4-63.0) and the United States (27.5-39.5), Hispanic men in New Mexico (48.6-52.0), Hispanic women in New Mexico (16.9-24.0) and the United States (12.8-13.1), non-Hispanic white men in New Mexico (17.4-21.3) and the United States (15.9-18.4), and non-Hispanic white women in New Mexico (9.7-11.6) and the United States (7.6-9.7). CLD death rates decreased among Hispanic men in the United States (30.5-27.4). Conclusions: An expanded CLD definition and alcohol-attributable fractions can be used to create comprehensive data on CLD mortality. When stratified by CLD cause and demographic characteristics, these data may help states and jurisdictions improve CLD prevention programs.

scholarly journals Black and Native Overdose Mortality Overtook that of White Individuals During the COVID-19 Pandemic

2021 ◽  
Author(s):  
Joseph Friedman ◽  
Helena Hansen
Keyword(s):  
Alaska Native ◽  
Drug Overdose ◽  
The United States ◽  
Racial Justice ◽  
Death Rates ◽  
Overdose Death ◽  
Time Period ◽  
Race Ethnicity ◽  
Overdose Mortality ◽  
First Time

Drug overdose mortality rates have increased sharply during the COVID-19 pandemic. In recent years, overdose death rates were rising most rapidly among racial/ethnic minority communities. The pandemic has disproportionately affected communities of color in a wide swath of health, social, and economic outcomes. Careful attention is therefore warranted to trends in overdose mortality by race/ethnicity during COVID-19. We calculated total drug overdose death rates per 100,000 population by race/ethnicity for the 1999-2020 time period. We find that Black overdose mortality overtook that of White individuals in 2020 for the first time since 1999. Between 2019 and 2020 Black individuals had the largest percent increase in overdose mortality, of 48.8%, compared to 26.3% among White individuals. In 2020, Black overdose death rates rose to 36.8 per 100,000, representing 16.3% higher than the rate for White individuals for the same period. American Indian and Alaska Native (AI/AN) individuals experienced the highest rate of overdose mortality in 2020, of 41.4 per 100,000, representing 30.8% higher than the rate among White individuals. Our findings suggest that drug overdose mortality is increasingly becoming a racial justice issue in the United States and appears to have been exacerbated by the COVID-19 pandemic. Providing individuals with a safer supply of drugs, closing gaps in access to MOUD and harm reductions services, and ending routine incarceration of individuals with substance use disorders represent urgently needed, evidence-based strategies that can be employed to reduce rising inequalities in overdose.

Disparities in Opioid Overdose Death Trends by Race/Ethnicity, 2018–2019, From the HEALing Communities Study

2021 ◽  
pp. e1-e4
Author(s):  
Marc R. Larochelle ◽  
Svetla Slavova ◽  
Elisabeth D. Root ◽  
Daniel J. Feaster ◽  
Patrick J. Ward ◽  
...  
Keyword(s):  
Public Health ◽  
New York ◽  
Public Health Approach ◽  
Opioid Overdose ◽  
Death Rates ◽  
Overdose Death ◽  
Race Ethnicity ◽  
State Death ◽  
Rate Ratios ◽  
Hispanic White

Objectives. To examine trends in opioid overdose deaths by race/ethnicity from 2018 to 2019 across 67 HEALing Communities Study (HCS) communities in Kentucky, New York, Massachusetts, and Ohio. Methods. We used state death certificate records to calculate opioid overdose death rates per 100 000 adult residents of the 67 HCS communities for 2018 and 2019. We used Poisson regression to calculate the ratio of 2019 to 2018 rates. We compared changes by race/ethnicity by calculating a ratio of rate ratios (RRR) for each racial/ethnic group compared with non-Hispanic White individuals. Results. Opioid overdose death rates were 38.3 and 39.5 per 100 000 for 2018 and 2019, respectively, without a significant change from 2018 to 2019 (rate ratio = 1.03; 95% confidence interval [CI] = 0.98, 1.08). We estimated a 40% increase in opioid overdose death rate for non-Hispanic Black individuals (RRR = 1.40; 95% CI = 1.22, 1.62) relative to non-Hispanic White individuals but no change among other race/ethnicities. Conclusions. Overall opioid overdose death rates have leveled off but have increased among non-Hispanic Black individuals. Public Health Implications. An antiracist public health approach is needed to address the crisis of opioid-related harms. (Am J Public Health. Published online ahead of print September 9, 2021:e1–e4. https://doi.org/10.2105/AJPH.2021.306431 )

scholarly journals EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN AND ITS MOST AFFECTED REGION

2020 ◽  
Author(s):  
Karin Modig ◽  
Anders Ahlbom ◽  
Marcus Ebeling
Keyword(s):  
Causes Of Death ◽  
Excess Mortality ◽  
National Level ◽  
Mortality Rates ◽  
Regional Level ◽  
Death Rates ◽  
Excess Death ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Age And Sex

Abstract Background Sweden has one of the highest numbers of COVID-19 deaths per inhabitant globally. However, absolute death counts can be misleading. Estimating age- and sex-specific mortality rates is necessary in order to account for the underlying population structure. Furthermore, given the difficulty of assigning causes of death, excess all-cause mortality should be estimated to assess the overall burden of the pandemic. Methods By estimating weekly age- and sex-specific death rates during 2020 and during the preceding five years, our aim is to get more accurate estimates of the excess mortality attributed to COVID-19 in Sweden, and in the most affected region Stockholm. Results Eight weeks after Sweden’s first confirmed case, the death rates at all ages above 60 were higher than for previous years. Persons above age 80 were disproportionally more affected, and men suffered greater excess mortality than women in ages up to 75 years. At older ages, the excess mortality was similar for men and women, with up to 1.5 times higher death rates for Sweden and up to 3 times higher for Stockholm. Life expectancy at age 50 declined by less than 1 year for Sweden and 1.5 years for Stockholm compared to 2019. Conclusions The excess mortality has been high in older ages during the pandemic, but it remains to be answered if this is because of age itself being a prognostic factor or a proxy for comorbidity. Only monitoring deaths at a national level may hide the effect of the pandemic on the regional level.

The Independent and Combined Effects of Aerobic Physical Activity and Muscular Strengthening Activity on All-Cause Mortality: An Analysis of Effect Modification by Race-Ethnicity

2020 ◽  
Vol 17 (9) ◽  
pp. 881-888
Author(s):  
William Boyer ◽  
James Churilla ◽  
Amy Miller ◽  
Trevor Gillum ◽  
Marshare Penny
Keyword(s):  
Physical Activity ◽  
Mexican American ◽  
Significant Risk ◽  
Potential Effect ◽  
Effect Modification ◽  
Health And Nutrition ◽  
All Cause Mortality ◽  
Cox Proportional Hazard Models ◽  
Race Ethnicity ◽  
Hispanic White

Background: The effects of aerobic physical activity (PA) and muscular strengthening activity (MSA) on all-cause mortality risk need further exploration among ethnically diverse populations. Purpose: To examine potential effect modification of race-ethnicity on meeting the PA guidelines and on all-cause mortality. Methods: The study sample (N = 14,384) included adults (20–79 y of age) from the 1999–2006 National Health and Nutrition Examination Survey. PA was categorized into 6 categories based on the 2018 PA guidelines: category 1 (inactive), category 2 (insufficient PA and no MSA), category 3 (active and no MSA), category 4 (no PA and sufficient MSA), category 5 (insufficient PA and sufficient MSA), and category 6 (meeting both recommendations). Race-ethnic groups examined included non-Hispanic white, non-Hispanic black, and Mexican American. Cox-proportional hazard models were used. Results: Significant risk reductions were found for categories 2, 3, and 6 for non-Hispanic white and non-Hispanic black. Among Mexican American, significant risk reductions were found in category 6. Conclusion: In support of the 2018 PA guidelines, meeting both the aerobic PA and MSA guidelines significantly reduced risk for all-cause mortality independent of race-ethnicity. The effects of aerobic PA alone seem to be isolated to non-Hispanic white and non-Hispanic black.

Afro-Latina/os

2019 ◽  
Author(s):  
Carlos Ulises Decena
Keyword(s):  
United States ◽  
20Th Century ◽  
African Ancestry ◽  
Racial Diversity ◽  
The United States ◽  
Racial Identification ◽  
Latin Americans ◽  
Race Ethnicity ◽  
Black Populations ◽  
Politics Of Race

The term Afro Latina/os references people in Latin America and in the Latino United States who claim African ancestry. Although the use of the prefix Afrocan be traced back to the work of intellectuals in Cuba, Mexico, and Brazil at the beginning of the 20th century, usages were connected with anti-racist and African Diaspora struggles, organizing, and advocacy in the second half of the 20th century. More recently, the appellation Afro Latina/o has become mobilized in US Latina/o communities as a critique of the processes through which racial diversity and black populations in these communities have been rendered invisible. Because it conjures various meanings and foci, several authors engaged in the study of afrolatinidades suggest that hemispheric, transnational, and comparative approaches are necessary to appreciate the nuances of use, categorization, and experience as Afro Latina/os navigate complex histories and politics of race, ethnicity, and belonging in the United States and the Americas. The author argues that the term appellation does not resolve the complexities of racial subordination, racism, and self-making among Latin Americans and US Latina/os. He further suggests that sites of unintelligibility, confusion, and perplexity are valuable in thinking of “Afro-Latina/o” as a term that points to a cluster of urgent intellectual and political problems stemming from the irreducibility of individual experience to any term or concept. The increase in claims of Afro-Latina/o as a marker of identity must be calibrated by a consideration of how institutional sites and think tanks collaborate in the making and sedimentation of existing and emerging grids of legibility. At the same time, claiming Afro-Latina/o needs to be understood as a project related to yet distinct from one’s racial identification and relationship with blackness, and the experience of US Latina/os and other ethnic/racial minorities suggests that the work continues to be not only to understand how individuals and groups categorize themselves and others, but also to better grasp what it is that terms such as Afro-Latino/a do.

scholarly journals Male Mortality Trends in the United States, 1900-2010: Progress, Challenges, and Opportunities

2019 ◽  
Vol 135 (1) ◽  
pp. 150-160
Author(s):  
Wanda K. Jones ◽  
Robert A. Hahn ◽  
R. Gibson Parrish ◽  
Steven M. Teutsch ◽  
Man-Huei Chang
Keyword(s):  
United States ◽  
Causes Of Death ◽  
The United States ◽  
Recent Analysis ◽  
Mortality Data ◽  
Female Mortality ◽  
Mortality Trends ◽  
Male Mortality ◽  
Death Rates ◽  
White Males

Objectives: Male mortality fell substantially during the past century, and major causes of death changed. Building on our recent analysis of female mortality trends in the United States, we examined all-cause and cause-specific mortality trends at each decade from 1900 to 2010 among US males. Methods: We conducted a descriptive study of age-adjusted death rates (AADRs) for 11 categories of disease and injury stratified by race (white, nonwhite, and, when available, black), the excess of male mortality over female mortality ([male AADR − female AADR]/female AADR), and potential causes of persistent excess of male mortality. We used national mortality data for each decade. Results: From 1900 to 2010, the all-cause AADR declined 66.4% among white males and 74.5% among nonwhite males. Five major causes of death in 1900 were pneumonia and influenza, heart disease, stroke, tuberculosis, and unintentional nonmotor vehicle injuries; in 2010, infectious conditions were replaced by cancers and chronic lower respiratory diseases. The all-cause excess of male mortality rose from 9.1% in 1900 to 65.5% in 1980 among white males and a peak of 63.7% in 1990 among nonwhite males, subsequently falling among all groups. Conclusion: During the last century, AADRs among males declined more slowly than among females. Although the gap diminished in recent decades, exploration of social and behavioral factors may inform interventions that could further reduce death rates among males.

Incidence of testicular cancer in the United States from 1992 to 2009.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 339-339 ◽  
Author(s):  
Manas Nigam ◽  
Brisa Aschebrook-Kilfoy ◽  
Sergey Shikanov ◽  
Scott E. Eggener
Keyword(s):  
United States ◽  
Testicular Cancer ◽  
White Men ◽  
The United States ◽  
Incidence Rates ◽  
The Us ◽  
Hispanic Men ◽  
Tumor Characteristic ◽  
Race Ethnicity ◽  
Hispanic White

339 Background: The incidence of testicular cancer (TC) increased in the US through 2003. However, little is known about these trends after 2003. We sought to determine trends in TC incidence based on race, ethnicity and tumor characteristics. Methods: TC incidence and tumor characteristic data from 1992-2009 were extracted from the Surveillance, Epidemiology, and End Results-13 (SEER) registry. Trends were determined using JoinPoint. Results: TC incidence in the US increased from 1992 (5.7/100,000) to 2009 (6.8/100,000) with annual percentage change (APC) of 1.1% (p < 0.001). TC rates were highest in non-Hispanic white men (1992: 7.5/100,000; 2009: 8.6/1000) followed by Hispanic men (1992: 4.0/100,000; 2009: 6.3/100,000) and lowest among non-Hispanic black men (1992: 0.7/100,000; 2009: 1.7/100,000). Significantly increasing incidence rates were observed in non-Hispanic white men (1.2%, p < 0.001) but most prominently among Hispanics, especially from 2002-2009 (5.6%, p < 0.01). A significant increase was observed for localized TC (1.21%, p < 0.001) and metastatic TC (1.43%, p < 0.01). Increased incidence occurred in localized tumors for non-Hispanic white men (1.56%, p <0.001), while Hispanic men experienced an increase in localized (2.6%, p < 0.001), regionalized (16.5% from 2002-09, p < 0.01), and distant (2.6%, p < 0.01) disease. Conclusions: Through 2009, testicular cancer incidence continues to increase in the United States, most notably among Hispanic men. [Table: see text]

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