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Title: Rural/Urban and Racial Disparities in Infectious Mortality in the United States, 1922-1944

Citation Type: Conference Paper

Publication Year: 2019

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Abstract: At the beginning of the twentieth century, U.S. cities had greater mortality than its rural areas; by midcentury, this had reversed. The details of when, where, and for whom the urban mortality penalty reversed is not well known, largely because data to address those questions are limited. Here, we prevent new national and regional estimates of infectious mortality, divided by race, for urban and rural areas from 1922-1944. We show that, already in 1922, rural mortality exceeds or equals urban mortality. For whites, median urban and rural mortality are strikingly similar, in the country as a whole and in each region, across this entire period. For nonwhites, regional patterns differ: nonwhites evince a rural mortality penalty in the Midwest and West but an urban penalty in the South. These results speak to ongoing debates about the public health contribution to the mortality decline. At the beginning of the twentieth century, living in cities posed a greater risk of mortality than living in rural areas in the United States (Higgs 1973; Condran and Crimmins 1980; Haines 2001; Cain and Hong 2009). As one paper title summarized the situation heading in to the twentieth century: "Survival in 19th Century Cities: The Larger the City, the Smaller Your Chances" (Cain and Hong 2009). By midcentury, this had reversed (Haines 2001): the development of modern public health infrastructure meant that, for the first time in the historical development of cities, cities became safer places to live than rural areas. This reversal of the urban mortality penalty was driven by a reversal in where infectious diseases, in particular, were concentrated. Although this stylized history is well known, the details of when, where, and for whom the urban mortality penalty reversed is not well known, largely because data to address those questions are limited. Here, we prevent new national and regional estimates of infectious mortality, divided by race, for urban and rural areas from 1922-1944. These estimates are based on newly available data on deaths to detailed causes of death in each state, collected by the Department of Commerce at the time in the annual Vital Statistics.

Url: http://paa2019.populationassociation.org/uploads/193844

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Authors: Wrigley-Field, Elizabeth; Saliba, Jim; Feigenbaum, James; Muller, Chris

Conference Name: PAA 2019

Publisher Location: Austin, TX

Data Collections: IPUMS USA

Topics: Fertility and Mortality, Race and Ethnicity

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