Patterns of mortality from selected causes in an urban population

Mortality data for selected non-cancer causes for the period 1974-1980 were analyzed for the City of Philadelphia to examine spatial patterns. Four categories of conditions--ischemic heart disease (including acute myocardial infarction), chronic liver disease and cirrhosis, cerebrovascular disease, and external causes--demonstrated significant variation in death rates. Moreover, neighborhoods with high levels of mortality for these conditions appeared in significant clusters. With the exception of ischemic heart disease, neighborhoods with high levels of mortality were characterized by below average levels of SES. A group of predominantly black neighborhoods in the central part of the city had extremely high rates for five or more of the nine causes investigated in this paper. In an earlier analysis, all but one of these neighborhoods were found to have the highest level of overall cancer mortality. These findings support the hypothesis that there are social and behavioral factors that are associated with a wide range of disease conditions, and many of these factors are associated with socioeconomic status.