The authors are with the Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia.
Am J Public Health. 2020 Sep;110(9):1325-1327. doi: 10.2105/AJPH.2020.305703. Epub 2020 Jul 16.
To examine rural-urban disparities in overall mortality and leading causes of death across Hispanic (any race) and non-Hispanic White, Black, American Indian/Alaska Native (AI/AN), and Asian/Pacific Islander populations. We performed a retrospective analysis of age-adjusted death rates for all-cause mortality and 5 leading causes of death (cardiovascular, cancer, unintentional injuries, chronic lower respiratory disease, and stroke) by rural versus urban county of residence in the United States and race/ethnicity for the period 2013 to 2017. Rural populations, across all racial/ethnic groups, had higher all-cause mortality rates than did their urban counterparts. Comparisons within causes of death documented rural disparities for all conditions except cancer and stroke among Hispanic individuals; Hispanic rural residents had death rates similar to or lower than urban residents. Rural Black populations experienced the highest mortality for cardiovascular disease, cancer, and stroke. Unintentional injury and chronic lower respiratory disease mortality were highest in rural AI/AN and rural non-Hispanic White populations, respectively. Investigating rural-urban disparities without also considering race/ethnicity leaves minority health disparities unexamined and thus unaddressed. Further research is needed to clarify local factors associated with these disparities and to test appropriate interventions.
为了研究西班牙裔（任何种族）和非西班牙裔白种人、黑种人、美国印第安人/阿拉斯加原住民（AI/AN）以及亚洲/太平洋岛民人群中全因死亡率和主要死因的城乡差异。我们对美国 2013 年至 2017 年期间按城乡县居住和种族/族裔划分的全因死亡率和 5 种主要死因（心血管疾病、癌症、意外伤害、慢性下呼吸道疾病和中风）的年龄调整死亡率进行了回顾性分析。与城市相比，所有种族/族裔的农村人口全因死亡率更高。除了癌症和中风以外，在所有死因中，农村地区的西班牙裔人群死亡率都比城市高。农村黑人的心血管疾病、癌症和中风死亡率最高。农村非西班牙裔白人和农村美洲印第安人/阿拉斯加原住民的意外伤害和慢性下呼吸道疾病死亡率最高。如果不考虑种族/族裔，只研究城乡差异，就会忽视少数民族的健康差异，从而无法解决这些差异。需要进一步研究来阐明与这些差异相关的地方因素，并测试适当的干预措施。
