To Live and Die in the United States: Race, Place and Black/White Health Inequalities during The 1990s

Cynthia G. Colen, Ohio State University
Arline Geronimus, University of Michigan
John Bound, University of Michigan

Previous research suggests that race, poverty, and place interact to produce different distributions of mortality across geographically situated populations. In the United States, individuals residing in urban communities tend to be healthier than their rural counterparts. However, among high-poverty African-American communities, urban residents face a substantial mortality disadvantage. By employing a decidedly residential perspective and highlighting neighborhood factors, we calculate age- and sex-specific estimates of all-cause mortality, cause-specific mortality, life expectancy, and years of life lost for working age adults in 23 local areas and Blacks and Whites nationwide. Each local area encompasses the entire nonHispanic Black or nonHispanic White population within aggregates of census tracts in urban communities and counties in rural communities. Preliminary results indicate that the 1990s witnessed a continuation of the rural mortality advantage among high-poverty Black populations. However, the urban/rural discrepancy in mortality decreased, primarily as a function of declining death rates in urban areas.