Document Detail

Urbanisation and coronary heart disease mortality among African Americans in the US South.
MedLine Citation:
PMID:  8935454     Owner:  NLM     Status:  MEDLINE    
STUDY OBJECTIVE: Despite significant declines since the late 1960s, coronary mortality remains the leading cause of death for African Americans. African Americans in the US South suffer higher rates of cardiovascular disease than African Americans in other regions; yet the mortality experiences of rural-dwelling African Americans, most of whom live in the South, have not been described in detail. This study examined urban-rural differentials in coronary mortality trends among African Americans for the period 1968-86. SETTING: The United States South, comprising 16 states and the District of Columbia. STUDY POPULATION: African American men and women aged 35-74 years. DESIGN: Analysis of urban-rural differentials in temporal trends in coronary mortality for a 19 year study period. All counties in the US South were grouped into five categories: greater metropolitan, lesser metropolitan, adjacent to metropolitan, semirural, and isolated rural. Annual age adjusted mortality rates were calculated for each urban status group. In 1968, observed excesses in coronary mortality were 29% for men and 45% for women, compared with isolated rural areas. Metropolitan areas experienced greater declines in mortality than rural areas, so by 1986 the urban-rural differentials in coronary mortality were 3% for men and 11% for women. CONCLUSIONS: Harsh living conditions in rural areas of the South precluded important coronary risk factors and contributed to lower mortality rates compared with urban areas during the 1960s. The dramatic transformation from an agriculturally based economy to manufacturing and services employment over the course of the study period contributed to improved living conditions which promoted coronary mortality declines in all areas of the South; however, the most favourable economic and mortality trends occurred in metropolitan areas.
E Barnett; D Strogatz; D Armstrong; S Wing
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of epidemiology and community health     Volume:  50     ISSN:  0143-005X     ISO Abbreviation:  J Epidemiol Community Health     Publication Date:  1996 Jun 
Date Detail:
Created Date:  1997-06-26     Completed Date:  1997-06-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  7909766     Medline TA:  J Epidemiol Community Health     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  252-7     Citation Subset:  IM    
Prevention Research Center, West Virginia University, Morgantown 26506-9005, USA.
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MeSH Terms
Africa / ethnology
Coronary Disease / mortality*
Middle Aged
Rural Health
Sex Factors
Socioeconomic Factors
Suburban Health
United States / epidemiology
Urban Health
Grant Support

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