Primary care, social inequalities, and all-cause, heart disease, and cancer mortality in US counties, 1990.
OBJECTIVE
We tested the association between the availability of primary care and income inequality on several categories of mortality in US counties.


METHODS
We used cross-sectional analysis of data from counties (n=3081) in 1990, including analysis of variance and multivariate ordinary least squares regression. Independent variables included primary care resources, income inequality, and sociodemographics.


RESULTS
Counties with higher availability of primary care resources experienced between 2% and 3% lower mortality than counties with less primary care. Counties with high income inequality experienced between 11% and 13% higher mortality than counties with less inequality.


CONCLUSIONS
Primary care resources may partially moderate the effects of income inequality on health outcomes at the county level.
Shi
Leiyu
L
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Room 406, Baltimore, MD 21205, USA. lshi@jhsph.edu
Macinko
James
J
Starfield
Barbara
B
Politzer
Robert
R
Wulu
John
J
Xu
Jiahong
J
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002423:Cause of Death; D003430:Cross-Sectional Studies; D005260:Female; D006297:Health Services Accessibility; D006331:Heart Diseases / Q000401:mortality*; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology