Descriptive and analytic epidemiologic studies to identify modifiable determinants of disparities in mortality rates between Blacks and Whites.
BACKGROUND
Descriptive and epidemiologic studies of US national data reveal no sustained decrease in disparities in mortality between Blacks and Whites since World War II. In contrast, descriptive studies of variations in racial mortality trends across comparable geographic areas might lead to the formulation of hypotheses for testing in analytical epidemiologic studies to identify modifiable determinants.


METHODS
Using the CDC Wonder system, the 41 peer-geographic areas to Davidson County, Tennessee, in which Meharry Medical College resides, were identified. For 1999-2000, race- and sex-specific, age-adjusted annual mortality rate ratios (MRRs) for Blacks compared to Whites, stratified by age (<1, 1-24, 25-64, and > or = 65 years), were calculated. In 39 of the 41, MRR was >1.0, indicating higher death rates for Blacks.


RESULTS
In 20 counties with low Black:White poverty ratios, MRRs were higher in 18 and achieved statistical significance in 13. In 21 counties with high Black:White poverty ratios, MRRs were higher in 20 counties and achieved statistical significance in 19. No MRRs were significantly lower for Blacks.


CONCLUSIONS
This new pathway includes descriptive data to explore racial mortality trends across peer-geographic areas to formulate hypotheses for analytical epidemiologic studies for the identification of modifiable determinants of disparities in mortality rates between Blacks and Whites.
Levine
Robert S
RS
National Center for Primary Care, Morehouse School of Medicine, Atlanta, Georgia 30310, USA. rlevine@msm.edu
Briggs
Nathaniel C
NC
Hollar
Danielle
D
Husaini
Baqar A
BA
Hennekens
Charles H
CH
Kilbourne
Barbara J
BJ
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003710:Demography; D016021:Epidemiologic Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D013714:Tennessee / Q000453:epidemiology; D044465:White People