Long-Term Trends in Black and White Mortality in the Rural United States: Evidence of a Race-Specific Rural Mortality Penalty

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Abstract

The rural mortality penalty-growing disparities in rural-urban macro-level mortality rates-has persisted in the United States since the mid 1980s. Substantial intrarural differences exist: rural places of modest population size, close to urban areas, experience a greater mortality burden than the most rural locales. This research builds on recent findings by examining whether a race-specific rural mortality penalty exists; that is, are some rural areas more detrimental to black and/or white mortality than others?

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Understanding racial-ethnic disparities in health: sociological contributions.

Ashley R. Williams, Michelle J Sternthal (2009)

This article provides an overview of the contribution of sociologists to the study of racial and ethnic inequalities in health in the United States. It argues that sociologists have made four principal contributions. First, they have challenged and problematized the biological understanding of race. Second, they have emphasized the primacy of social structure and context as determinants of racial differences in disease. Third, they have contributed to our understanding of the multiple ways in which racism affects health. Finally, sociologists have enhanced our understanding of the ways in which migration history and status can affect health. Sociological insights on racial disparities in health have important implications for the development of effective approaches to improve health and reduce health inequities.

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Socioeconomic determinants of health. Health inequalities: relative or absolute material standards?

R Wilkinson (1997)

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Are racial disparities in health conditional on socioeconomic status?

Melissa M Farmer, Kenneth Ferraro (2005)

Racial health inequality is related to socioeconomic status (SES), but debate ensues on the nature of the relationship. Using the US National Health and Nutrition Examination Survey I and the subsequent follow-up interviews, this research examines health disparities between white and black adults and whether the SES/health gradient differs across the two groups in the USA. Two competing mechanisms for the conditional or interactive relationship between race and SES on health are examined during a 20-year period for black and white Americans. Results show that black adults began the study with more serious illnesses and poorer self-rated health than white adults and that the disparity continued over the 20 years. Significant interactions were found between race and education as well as race and employment status on health outcomes. The interaction effect of race and education showed that the racial disparity in self-rated health was largest at the higher levels of SES, providing some evidence for the "diminishing returns" hypothesis; as education levels increased, black adults did not have the same improvement in self-rated health as white adults. Overall, the findings provide evidence for the continuing significance of both race and SES in determining health status over time.