Inequality in men's mortality: the socioeconomic status gradient and geographic context

Lower mortality for older rural Americans, compared to urban residents, runs counter to rural-urban disparities in health care services and residents' socioeconomic resources. This paradox calls into question the ways in which community conditions influence mortality and contextualize the relationship between individuals' socioeconomic status and health. Drawing on 24 years of data from the National Longitudinal Survey of Older Men, we observe that rural older men's life expectancy advantages occur even after controlling for residential differences in social class and lifestyle factors. Our results also show that rural advantages in mortality coincide with a more equitable distribution of life chances across the social classes. The association between social class and mortality is strongest among urban men, arising from socioeconomic conditions throughout the life cycle.