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Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014.
MMWR Surveill Summ. 2017 Jan 13; 66(1):1-8.MS

Abstract

PROBLEM/CONDITION

Higher rates of death in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas have been described but not systematically assessed.

PERIOD COVERED

1999-2014 DESCRIPTION OF SYSTEM: Mortality data for U.S. residents from the National Vital Statistics System were used to calculate age-adjusted death rates and potentially excess deaths for nonmetropolitan and metropolitan areas for the five leading causes of death. Age-adjusted death rates included all ages and were adjusted to the 2000 U.S. standard population by the direct method. Potentially excess deaths are defined as deaths among persons aged <80 years that exceed the numbers that would be expected if the death rates of states with the lowest rates (i.e., benchmark states) occurred across all states. (Benchmark states were the three states with the lowest rates for each cause during 2008-2010.) Potentially excess deaths were calculated separately for nonmetropolitan and metropolitan areas. Data are presented for the United States and the 10 U.S. Department of Health and Human Services public health regions.

RESULTS

Across the United States, nonmetropolitan areas experienced higher age-adjusted death rates than metropolitan areas. The percentages of potentially excess deaths among persons aged <80 years from the five leading causes were higher in nonmetropolitan areas than in metropolitan areas. For example, approximately half of deaths from unintentional injury and chronic lower respiratory disease in nonmetropolitan areas were potentially excess deaths, compared with 39.2% and 30.9%, respectively, in metropolitan areas. Potentially excess deaths also differed among and within public health regions; within regions, nonmetropolitan areas tended to have higher percentages of potentially excess deaths than metropolitan areas.

INTERPRETATION

Compared with metropolitan areas, nonmetropolitan areas have higher age-adjusted death rates and greater percentages of potentially excess deaths from the five leading causes of death, nationally and across public health regions.

PUBLIC HEALTH ACTION

Routine tracking of potentially excess deaths in nonmetropolitan areas might help public health departments identify emerging health problems, monitor known problems, and focus interventions to reduce preventable deaths in these areas.

Authors+Show Affiliations

National Center for Health Statistics, CDC.Center for Surveillance, Epidemiology, and Laboratory Services, CDC.National Center for Health Statistics, CDC.National Center for Health Statistics, CDC.National Center for Health Statistics, CDC.National Center for Injury Prevention and Control, CDC.National Center for Chronic Disease Prevention and Health Promotion, CDC.National Center for Chronic Disease Prevention and Health Promotion, CDC.National Center for Chronic Disease Prevention and Health Promotion, CDC.Center for Surveillance, Epidemiology, and Laboratory Services, CDC.Center for Surveillance, Epidemiology, and Laboratory Services, CDC.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28081058

Citation

Moy, Ernest, et al. "Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014." Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002), vol. 66, no. 1, 2017, pp. 1-8.
Moy E, Garcia MC, Bastian B, et al. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014. MMWR Surveill Summ. 2017;66(1):1-8.
Moy, E., Garcia, M. C., Bastian, B., Rossen, L. M., Ingram, D. D., Faul, M., Massetti, G. M., Thomas, C. C., Hong, Y., Yoon, P. W., & Iademarco, M. F. (2017). Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014. Morbidity and Mortality Weekly Report. Surveillance Summaries (Washington, D.C. : 2002), 66(1), 1-8. https://doi.org/10.15585/mmwr.ss6601a1
Moy E, et al. Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014. MMWR Surveill Summ. 2017 Jan 13;66(1):1-8. PubMed PMID: 28081058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Leading Causes of Death in Nonmetropolitan and Metropolitan Areas- United States, 1999-2014. AU - Moy,Ernest, AU - Garcia,Macarena C, AU - Bastian,Brigham, AU - Rossen,Lauren M, AU - Ingram,Deborah D, AU - Faul,Mark, AU - Massetti,Greta M, AU - Thomas,Cheryll C, AU - Hong,Yuling, AU - Yoon,Paula W, AU - Iademarco,Michael F, Y1 - 2017/01/13/ PY - 2017/1/13/entrez PY - 2017/1/13/pubmed PY - 2017/5/4/medline SP - 1 EP - 8 JF - Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) JO - MMWR Surveill Summ VL - 66 IS - 1 N2 - PROBLEM/CONDITION: Higher rates of death in nonmetropolitan areas (often referred to as rural areas) compared with metropolitan areas have been described but not systematically assessed. PERIOD COVERED: 1999-2014 DESCRIPTION OF SYSTEM: Mortality data for U.S. residents from the National Vital Statistics System were used to calculate age-adjusted death rates and potentially excess deaths for nonmetropolitan and metropolitan areas for the five leading causes of death. Age-adjusted death rates included all ages and were adjusted to the 2000 U.S. standard population by the direct method. Potentially excess deaths are defined as deaths among persons aged <80 years that exceed the numbers that would be expected if the death rates of states with the lowest rates (i.e., benchmark states) occurred across all states. (Benchmark states were the three states with the lowest rates for each cause during 2008-2010.) Potentially excess deaths were calculated separately for nonmetropolitan and metropolitan areas. Data are presented for the United States and the 10 U.S. Department of Health and Human Services public health regions. RESULTS: Across the United States, nonmetropolitan areas experienced higher age-adjusted death rates than metropolitan areas. The percentages of potentially excess deaths among persons aged <80 years from the five leading causes were higher in nonmetropolitan areas than in metropolitan areas. For example, approximately half of deaths from unintentional injury and chronic lower respiratory disease in nonmetropolitan areas were potentially excess deaths, compared with 39.2% and 30.9%, respectively, in metropolitan areas. Potentially excess deaths also differed among and within public health regions; within regions, nonmetropolitan areas tended to have higher percentages of potentially excess deaths than metropolitan areas. INTERPRETATION: Compared with metropolitan areas, nonmetropolitan areas have higher age-adjusted death rates and greater percentages of potentially excess deaths from the five leading causes of death, nationally and across public health regions. PUBLIC HEALTH ACTION: Routine tracking of potentially excess deaths in nonmetropolitan areas might help public health departments identify emerging health problems, monitor known problems, and focus interventions to reduce preventable deaths in these areas. SN - 1545-8636 UR - https://www.unboundmedicine.com/medline/citation/28081058/Leading_Causes_of_Death_in_Nonmetropolitan_and_Metropolitan_Areas__United_States_1999_2014_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/28081058/ DB - PRIME DP - Unbound Medicine ER -