About this Research Topic

Manuscript Submission Deadline 15 July 2022
Manuscript Extension Submission Deadline 31 August 2022

Geographic inequalities in health and mortality in the United States have grown substantially in recent years. Mortality rates vary across and within regions, states, counties, neighborhoods, and the rural-urban continuum. Mortality trends also vary by race/ethnicity and cause of death and have been ...

Geographic inequalities in health and mortality in the United States have grown substantially in recent years. Mortality rates vary across and within regions, states, counties, neighborhoods, and the rural-urban continuum. Mortality trends also vary by race/ethnicity and cause of death and have been particularly adverse for working-age adults without a 4-year college degree over the past couple of decades. This is due largely to increases in drug overdoses, alcohol-related deaths, suicides, and metabolic diseases and to a stagnation in cardiovascular disease mortality rates that had been declining for many years. COVID-19 is likely to exacerbate these long term trends within the U.S. At the same time, life expectancy in the United States continues to deteriorate relative to other high-income countries. A recent National Academy of Sciences Report on High and Rising Midlife Mortality highlighted the need for investigations of the multi-level and multidimensional drivers of these trends.

Although we know a great deal about how mortality rates vary across different geographic contexts, much less is known about the factors that have driven these trends over the last few decades. Specifically, what are the relative contributions of individual level, community level, and macro level factors to all-cause and cause-specific mortality trends at various geographic units of analysis (i.e., regions, states, counties, neighborhoods, the rural-urban continuum)? How do the factors contributing to these geographic trends vary by racial/ethnic group, gender, and educational level? For example, there is considerable rural-urban and within-rural heterogeneity in racial/ethnic, age, and educational composition; economic structure, conditions, and resources; and policies that impact health. Understanding the role of these factors in contemporary geographic mortality disparities is critical to identifying potentially modifiable mechanisms. Further investigations that shed light on factors that play a role in the deteriorating U.S. standing in mortality relative to other high income countries are also needed.

The Research Topic welcomes any submission that addresses geographic disparities in health and mortality, but we are especially interested in submissions that address the following areas:

• Clarify the macro-, meso- and individual-level factors that have contributed to the increasing geographic divergence in U.S. mortality over the last two decades.

• Identify the causes of death that have contributed most to the widening geographic divergence in mortality, at various units of analysis (e.g., states, counties, neighborhoods, rural-urban continuum).

• Examine intersections between place and sociodemographic characteristics (e.g., sex, race/ethnicity, nativity, educational attainment) in mortality trends and the underlying drivers of those trends.

• Examine the role of COVID-19 in exacerbating existing geographic disparities in mortality.

• Identify the factors that have contributed to deteriorating life expectancy in the United States relative to other high-income countries, including the recent role of COVID-19?

Keywords: geographic inequality, health and mortality, united states, race, ethnicity, life expectancy


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