Divergent trends in life expectancy across the rural-urban gradient and association with specific racial proportions in the contiguous USA 2000-2005

Int J Public Health. 2019 Dec;64(9):1367-1374. doi: 10.1007/s00038-019-01274-5. Epub 2019 Jul 4.

Abstract

Objectives: To estimate county-level adult life expectancy for Whites, Black/African Americans (Black), American Indian/Alaska Native (AIAN) and Asian/Pacific Islander (Asian) populations and assess the difference across racial groups in the relationship among life expectancy, rurality and specific race proportion.

Methods: We used individual-level death data to estimate county-level life expectancy at age 25 (e25) for Whites, Black, AIAN and Asian in the contiguous USA for 2000-2005. Race-sex-stratified models were used to examine the associations among e25, rurality and specific race proportion, adjusted for socioeconomic variables.

Results: Lower e25 was found in the central USA for AIANs and in the west coast for Asians. We found higher e25 in the most rural areas for Whites but in the most urban areas for AIAN and Asians. The associations between specific race proportion and e25 were positive or null for Whites but were negative for Blacks, AIAN, and Asians. The relationship between specific race proportion and e25 varied across rurality.

Conclusions: Identifying differences in adult life expectancy, both across and within racial groups, provides new insights into the geographic determinants of life expectancy disparities.

Keywords: American Indian/Alaska Native population; Asian/Pacific Islander population; Contiguous USA; Life expectancy at age 25; Rurality; Specific race proportion.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asian People / ethnology*
  • Asian People / statistics & numerical data
  • Female
  • Humans
  • Indians, North American / ethnology*
  • Indians, North American / statistics & numerical data
  • Life Expectancy / ethnology*
  • Life Expectancy / trends*
  • Male
  • Middle Aged
  • Minority Groups / statistics & numerical data*
  • Native Hawaiian or Other Pacific Islander / ethnology*
  • Native Hawaiian or Other Pacific Islander / statistics & numerical data
  • Rural Population / statistics & numerical data
  • United States
  • Urban Population / statistics & numerical data
  • White People / statistics & numerical data*