Urban-rural differences in excess mortality among high-poverty populations: evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health.

Published

Journal Article

Black youth residing in high-poverty areas have dramatically lower probabilities of surviving to age 65 if they are urban than if they are rural. Chronic disease deaths contribute heavily. We begin to probe the reasons using the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). We compare HHS and PCS respondents on chronic disease rates, health behaviors, social support, employment, indicators of health care access, and health insurance. Chronic disease profiles do not favor Pitt County. Smoking uptake is similar across samples, but PCS respondents are more likely to quit. Indicators of access to health care and private health insurance are more favorable in Pitt County. Findings suggest rural mortality is averted through secondary or tertiary prevention, not primary. Macroeconomic and health system changes of the past 20 years may have left poor urban Blacks as medically underserved as poor rural Blacks.

Full Text

Duke Authors

Cited Authors

  • Geronimus, AT; Colen, CG; Shochet, T; Ingber, LB; James, SA

Published Date

  • August 2006

Published In

Volume / Issue

  • 17 / 3

Start / End Page

  • 532 - 558

PubMed ID

  • 16960321

Pubmed Central ID

  • 16960321

Electronic International Standard Serial Number (EISSN)

  • 1548-6869

International Standard Serial Number (ISSN)

  • 1049-2089

Digital Object Identifier (DOI)

  • 10.1353/hpu.2006.0105

Language

  • eng