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Excess mortality in Harlem.

C McCord1, H P Freeman

  • 1Department of Surgery, Columbia University, New York, NY.

The New England Journal of Medicine
|January 18, 1990
PubMed
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This summary is machine-generated.

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Inner-city communities, particularly Harlem, face extremely high mortality rates, especially for those under 65. These elevated death rates from conditions like cardiovascular disease and homicide demand urgent attention and resources.

Area of Science:

  • Public Health
  • Epidemiology
  • Urban Health Disparities

Background:

  • National mortality rates mask significant disparities in inner-city communities.
  • Central Harlem, a predominantly Black and impoverished area, experiences disproportionately high mortality.

Purpose of the Study:

  • To examine mortality rates in New York City's Central Harlem health district.
  • To identify causes and demographic patterns of excess mortality in this urban community.

Main Methods:

  • Utilized 1980 census data and death certificates from 1979-1981.
  • Calculated age-adjusted mortality rates and standardized mortality ratios (SMRs) compared to the white population.
  • Conducted survival analysis to compare life expectancy.
Keywords:
Age FactorsAmericasBlacksCauses Of DeathCultural BackgroundDemographic FactorsDeveloped CountriesDifferential MortalityEthnic GroupsMortalityNew YorkNorth AmericaNorthern AmericaPopulationPopulation CharacteristicsPopulation DynamicsUnited StatesUrban Population

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Main Results:

  • Harlem's all-cause mortality rate was the highest in NYC, exceeding U.S. white and Black averages.
  • Excess mortality was concentrated in individuals under 65, with SMRs for males and females significantly elevated.
  • Leading causes of excess deaths included cardiovascular disease, cirrhosis, homicide, and neoplasms.
  • Black men in Harlem had a lower probability of reaching age 65 than men in Bangladesh.
  • 54 NYC health areas had mortality rates at least double the expected, predominantly Black or Hispanic.

Conclusions:

  • Central Harlem exhibits exceptionally high mortality rates, particularly among younger populations.
  • These findings highlight severe health inequities in inner-city, predominantly Black communities.
  • Urgent, targeted interventions are necessary for these high-mortality urban areas, akin to disaster relief.