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Explaining large mortality differences between adjacent counties: a cross-sectional study.

M Schootman1,2, L Chien3, S Yun4

  • 1Department of Epidemiology, Saint Louis University College for Public Health and Social Justice, 3545 Lafayette Avenue, St. Louis, MO, 63104, USA. schootm@slu.edu.

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|August 4, 2016
PubMed
Summary
This summary is machine-generated.

Geographic disparities in mortality rates between adjacent counties are significant. Risk factors like poverty and inability to afford care contribute to these differences, guiding targeted public health interventions.

Keywords:
Bayesian analysisNeighborhood effectsSpatial statistics

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Area of Science:

  • Spatial epidemiology
  • Public health research
  • Biostatistics

Background:

  • Geographic variations in health outcomes are extensive.
  • Global health measures often overlook disparities between adjacent areas with differing mortality rates.
  • Advanced spatial analysis can reveal localized health outcome differences.

Purpose of the Study:

  • To quantify mortality rate differences between adjacent counties.
  • To identify risk factors associated with these localized mortality differences.
  • To determine if identified risk factors explain observed mortality variations.

Main Methods:

  • Cross-sectional study in Missouri (2005-2009).
  • Used age-adjusted all-cause mortality rates as the outcome.
  • Employed multi-level Gaussian models and Bayesian approaches for analysis.

Main Results:

  • Average mortality difference between adjacent counties was -3.27 per 100,000.
  • Significant risk factors included inability to obtain medical care due to cost, hospital discharge rates, prevalence of fair/poor health, hypertension, and poverty.
  • Poverty prevalence showed the strongest association with mortality differences.

Conclusions:

  • Analyzing adjacent county mortality differences offers granular insights.
  • Identified risk factors can inform targeted public health interventions.
  • Reducing geographic disparities in health outcomes requires localized strategies.