Urban mortality--race or place?

Several concomitant trends have occurred in American society in the 20th century. First, life expectancy has improved overall, and the gap between blacks and whites has narrowed. Second, as the nature of the economy has changed from rural agrarian to urban postindustrial, there have been fundamental changes in population residential patterns, with most Americans now living in metropolitan areas. Within metropolitan areas, blacks have become concentrated in poor inner cities as whites have moved to the more affluent suburbs. Black mortality rates are higher in big cities than elsewhere, and appear to be directly related to the proportion of blacks in those cities. Black-white mortality ratios, however, are lower in cities of medium size than in either very large or small cities. At the national level age-adjusted mortality ratios between blacks and whites are associated with different causes of death; but only limited cause-specific mortality data are available for large cities. Understanding and ameliorating social conditions that lead to elevated black mortality in U.S. cities will require more information at the municipal level than is currently available.