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

Author(s):  
Marie Gottschalk

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.

2021 ◽  
Vol 7 (18) ◽  
pp. eabf4491
Author(s):  
Christopher W. Tessum ◽  
David A. Paolella ◽  
Sarah E. Chambliss ◽  
Joshua S. Apte ◽  
Jason D. Hill ◽  
...  

Racial-ethnic minorities in the United States are exposed to disproportionately high levels of ambient fine particulate air pollution (PM2.5), the largest environmental cause of human mortality. However, it is unknown which emission sources drive this disparity and whether differences exist by emission sector, geography, or demographics. Quantifying the PM2.5 exposure caused by each emitter type, we show that nearly all major emission categories—consistently across states, urban and rural areas, income levels, and exposure levels—contribute to the systemic PM2.5 exposure disparity experienced by people of color. We identify the most inequitable emission source types by state and city, thereby highlighting potential opportunities for addressing this persistent environmental inequity.


The Forum ◽  
2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Kenneth M. Johnson ◽  
Dante J. Scala

Abstract This study of the 2018 congressional midterms demonstrates how voting patterns and political attitudes vary across a spectrum of urban and rural areas in the United States. Rural America is no more a monolith than is urban America. The rural-urban gradient is better represented by a continuum than a dichotomy. This is evident in the voting results in 2018, just as it was in 2016. We found that the political tipping point lies beyond major metropolitan areas, in the suburban counties of smaller metropolitan areas. Democrats enjoyed even greater success in densely populated urban areas in 2018 than in 2016. Residents of these urban areas display distinctive and consistent social and political attitudes across a range of scales. At the other end of the continuum in remote rural areas, Republican candidates continued to command voter support despite the challenging national political environment. Voters in these rural regions expressed social and political attitudes diametrically opposed to their counterparts in large urban cores.


2020 ◽  
Author(s):  
Alina Schnake-Mahl ◽  
Usama Bilal

AbstractThe national COVID-19 conversation in the US has mostly focused on urban areas, without sufficient examination of another geography with large vulnerable populations: the suburbs. While suburbs are often thought of as areas of uniform affluence and racial homogeneity, over the past 20 years, poverty and diversity have increased substantially in the suburbs. In this study, we compare geographic and temporal trends in COVID-19 cases and deaths in Louisiana, one of the few states with high rates of COVID-19 during both the spring and summer. We find that incidence and mortality rates were initially highest in New Orleans. By the second peak, trends reversed: suburban areas experienced higher rates than New Orleans and similar rates to other urban and rural areas. We also find that increased social vulnerability was associated with increased positivity and incidence during the first peak. During the second peak, these associations reversed in New Orleans while persisting in other urban, suburban, and rural areas. The work draws attention to the high rates of COVID-19 cases and deaths in suburban areas and the importance of metropolitan-wide actions to address COVID-19.RegistrationN/AFunding sourceNIH (DP5OD26429) and RWJF (77644)Code and data availabilityCode for replication along with data is available here: https://github.com/alinasmahl1/COVID_Louisiana_Suburban/.


2021 ◽  
Vol 10 (6) ◽  
pp. 417
Author(s):  
Lan Mu ◽  
Yusi Liu ◽  
Donglan Zhang ◽  
Yong Gao ◽  
Michelle Nuss ◽  
...  

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.


2006 ◽  
Vol 8 (3) ◽  
pp. 89-97 ◽  
Author(s):  
Robert J. Buchanan ◽  
Randolph Schiffer ◽  
Alexa Stuifbergen ◽  
Li Zhu ◽  
Suojin Wang ◽  
...  

This study compares demographic and disease-related characteristics of people with multiple sclerosis (MS) living in urban and rural areas. The data analyzed for this study were collected from a survey of 1518 people with MS living throughout the United States from October 2004 through January 2005. We found significant urban-rural differences in various MS characteristics, including type of MS. A significantly larger proportion of people with MS in remote rural areas than their urban counterparts responded that they had primary progressive MS. People with MS in rural areas were significantly more likely than those in urban areas to report that MS symptoms interfered with their independence. A significantly larger proportion of people with MS in remote rural areas than in urban areas were not receiving disease-modifying medications. Our results suggest that MS disease expression varies across urban-rural gradients. Although the findings are not definitive, we hope that other investigative groups will build on these results and work toward confirming and understanding them.


2020 ◽  
Author(s):  
Ayan Paul ◽  
Philipp Englert ◽  
Melinda Varga

COVID-19 is not a universal killer. We study the spread of COVID-19 at the county level for the United States up until the 15th of August, 2020. We show that the prevalence of the disease and the death rate are correlated with the local socio-economic conditions often going beyond local population density distributions, especially in rural areas. We correlate the COVID-19 prevalence and death rate with data from the US Census Bureau and point out how the spreading patterns of the disease show asymmetries in urban and rural areas separately and is preferentially affecting the counties where a large fraction of the population is non-white. Our findings can be used for more targeted policy building and deployment of resources for future occurrence of a pandemic due to SARS-CoV-2. Our methodology, based on interpretable machine learning and game theory, can be extended to study the spread of other diseases.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S733-S733
Author(s):  
Nasim Ferdows ◽  
Soroosh Baghban Ferdows ◽  
Amit Kumar

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.


2019 ◽  
Vol 37 (4_suppl) ◽  
pp. 490-490
Author(s):  
Boone Wilder Goodgame ◽  
Jack Virostko ◽  
Anna Capasso ◽  
Thomas Yankeelov

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.


Author(s):  
Katarzyna Zatońska ◽  
Piotr Psikus ◽  
Alicja Basiak-Rasała ◽  
Zuzanna Stępnicka ◽  
Maria Wołyniec ◽  
...  

(1) Background: Alcohol is a leading risk factor of premature morbidity and mortality. The objective of this study was to investigate the patterns of alcohol consumption in the PURE Poland cohort study baseline. (2) Methods: A Polish cohort was enrolled in the baseline study in 2007–2010. The study group consisted of 2021 adult participants of urban and rural areas from the Lower Silesia voivodeship in Poland (747 men and 1274 women). (3) Results: In the overall study population, 67.3% were current drinkers, 10.3% were former drinkers, and 22.4% were abstainers. Current use of alcohol products was more prevalent in men (77.2%), people living in urban areas (73.0%), and people with a higher level of education (78.0%). The percentage of current drinkers decreased with increasing age (from 73.4% in 30- to 44-year-olds to 48.8% in participants aged 64 and more). The majority of participants (89.2%) declared a low level of alcohol intake. The chance of high level of intake of alcohol was four times higher in men than in women (OR 4.17; CI 1.64–10.6). The majority of participants (54.6%) declared most frequent consumption of low-alcohol drinks (beer, wine) and 21% declared most frequent consumption of spirits. Current drinkers had almost 1.5-fold higher odds of diabetes and cardiovascular diseases (CVD) than never drinkers (OR 1.49, CI 1.03–2.17; OR 1.66, CI 1.27–2.18, respectively). Former drinkers had higher odds for hypertension and CVD than never drinkers (1.73, CI 1.05–2.85; OR 1.76, CI 1.22–2.53, respectively). (4) Conclusions: In our cohort study, we observed several socio-demographic factors differentiating the patterns of alcohol consumption. The preventive programs should focus predominantly on men, people aged <45 years, and those with a higher level of education.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leni Kang ◽  
Juan Liang ◽  
Chunhua He ◽  
Lei Miao ◽  
Xiaohong Li ◽  
...  

Abstract Background Breastfeeding is important for the physical and psychological health of the mother and child. Basic data on breastfeeding practice in China are out-of-date and vary widely. This study aimed to evaluate the progress of breastfeeding practice in China, as well as to explore the bottlenecks in driving better practice. Methods This was an observational study. We used data from the Under-5 Child Nutrition and Health Surveillance System in China for the period 2013–2018. The prevalence of early initiation of breastfeeding (EIBF) and exclusive breastfeeding (EBF) were calculated for each year for subgroups of China. The Cochran-Armitage test was used to explore the time trends. The annual percent of change (APC) were calculated by log-linear regression followed by exp transformation. Results The prevalence of EIBF increased significantly from 44.57% (95% CI: 44.07, 45.07) in 2013 to 55.84% (95% CI: 55.29, 56.38) in 2018 (Ptrend < 0.001), with an APC of 4.67% (95% CI: 3.51, 5.85). And the prevalence of EBF increased rapidly from 16.14% (95% CI: 15.10, 17.18) to 34.90% (95% CI: 33.54, 36.26) (Ptrend < 0.001), with an APC of 14.90% (95% CI: 9.97, 20.04). Increases were observed in both urban and rural areas, with urban areas showing greater APCs for EIBF (6.05%; 95% CI: 4.22, 7.92 v.s. 2.26%; 95% CI: 1.40, 3.12) and EBF (18.21%; 95% CI: 11.53, 25.29 v.s. 9.43%; 95% CI: 5.52, 13.49). The highest EBF prevalence was observed in the East, but the Central area showed the highest APC. The prevalence of EBF decreased with increasing age within the first 6 months, especially after 3 months. Conclusion The prevalence of both EIBF and EBF in China are improving in recent years. The rural and West China could be the key areas in the future actions. More efforts should be made to protect and promote breastfeeding to achieve near- and long-term goals for child health.


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