Economic Inequality and Social Differentials in Mortality

[...]In this paper, I draw on analyses that aimed todetermine whether impoverished U.S. locales varied byrace or urban/rural location in their rates and causes ofexcess mortality, and whether mortality gaps betweenimpoverished and other U.S. populations widened over thedecade from 1980 to 1990. The focus on urban versus ruralareas reflects the fact that in the first half of the TwentiethCentury, rural Americans enjoyed longer life expectanciesthan urban dwellers (Fox et al. 1970). Evidence based on more recent cohorts is mixed and suggests little, if any,mortality advantage for rural residents compared withurban dwellers in young and middle adulthood (Kitagawaand Hauser 1973; Miller et al. 1987; Elo and Preston 1996).However, with some resurgence of infectious disease entitiesas important causes of death in urban areas and generalperceptions of central cities as having become more dangerousand unhealthy in the most recent decades (Wilson1987; Brown 1993), the fortunes of rural dwellers—eventhose in poverty—may have again increased relative to theirurban counterparts. In addition, recent comparisons ofrural and urban dwellers do not focus on those in poverty.Important interactions between race, poverty, and rural/urban residence may exist, but may be unobserved inanalyses of national data sets where only the main effects ofresidence are estimated as a product of averaging across allrural versus urban dwellers.[...]