title: United States counties with low black male mortality rates.
abstract: OBJECTIVE
  In the United States, young and middle-aged black men have significantly higher total mortality than any other racial or ethnic group. We describe the characteristics of US counties with low non-Hispanic Black or African American male mortality (ages 25-64 years, 1999-2007).
  
  
  METHODS
  Information was accessed through public data, the US Census, the US Compressed Mortality File, and the Native American Graves Repatriation Act military database.
  
  
  RESULTS
  Of 1307 counties with black mortality rates classified as reliable by the National Center for Health Statistics (at least 20 deaths), 66 recorded lower mortality among black men than corresponding US whites. Most notable, 97% of the 66 counties were home to or adjacent a military installation versus 37% of comparable US counties (P<.001). Blacks in these counties had less poverty, higher percentages of elderly civilian veterans, and higher per capita income. Within these counties, national black:white disparities in mortality were eliminated for ischemic heart disease, accidents, diseases of the liver, chronic lower respiratory diseases, and mental disorder from psychoactive substance use. Application of age-, race-, ethnicity-, gender-, and urbanization-specific mortality rates from counties with relatively low mortality would reduce the black:white mortality rate ratio for black men aged 25 to 64 years from 1.67 to 1.20 nationally and to 1.00 in areas outside large central metropolitan areas.
  
  
  CONCLUSIONS
  These descriptive data demonstrate a small number of communities with low mortality rates among young and middle-aged black/African American men. Their characteristics may provide clinical and public health insights to reduce these higher mortality rates in the US population. Analytic epidemiologic studies are necessary to test these hypotheses.
authors.affiliation: Department of Family and Community Medicine, Meharry Medical College, Nashville, TN, USA.
authors.forename: Robert S
authors.initials: RS
authors.lastname: Levine
authors.forename: George
authors.initials: G
authors.lastname: Rust
authors.forename: Muktar
authors.initials: M
authors.lastname: Aliyu
authors.forename: Maria
authors.initials: M
authors.lastname: Pisu
authors.forename: Roger
authors.initials: R
authors.lastname: Zoorob
authors.forename: Irwin
authors.initials: I
authors.lastname: Goldzweig
authors.forename: Paul
authors.initials: P
authors.lastname: Juarez
authors.forename: Baqar
authors.initials: B
authors.lastname: Husaini
authors.forename: Charles H
authors.initials: CH
authors.lastname: Hennekens
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology*; D014481:United States / Q000453:epidemiology