US County-Level Trends in Mortality Rates for Major Causes of Death, 1980-2014
Original Investigation
Key Points
Novel study examines mortality in over 3,100 US counties, revealing substantial geographic differences among many causes of death. The study examines deaths in 21 cause groups, ranging from Non-communicable diseases (NCDs) like diabetes to infectious diseases, such as HIV/AIDS and tuberculosis, to accidents, including traffic fatalities. It explores mortality rates and how they have changed in every US county between 1980 and 2014, creating the most comprehensive view to date of causes of mortality in the United States.
Question
How do levels and trends in cause-specific mortality rates for 21 major causes of death vary by county within the United States?
Findings
Using a novel method, this analysis found significant variation in mortality rates and changes in mortality rates among counties for all causes of death. For example, in 2014, counties in the 90th percentile experienced mortality rates from neoplasms that were higher by 76.8 deaths per 100 000 population than counties in the 10th percentile.
The death rate from alcohol, other drugs, and mental disorders nearly triples since 1980More than 2,000 US counties witnessed increases of 200% or more in the death rates related to use of harmful substances and mental disorders since 1980.
Meaning
This method for estimating county-level cause-specific mortality rates has the potential to provide new insights into how mortality from different causes varies geographically in the United States.
Conclusions and Relevance
In this analysis of US cause-specific county-level mortality rates from 1980 through 2014, there were large between-county differences for every cause of death, although geographic patterns varied substantially by cause of death. The approach to county-level analyses with small area models used in this study has the potential to provide novel insights into US disease-specific mortality time trends and their differences across geographic regions.