Ms. Jennifer Spencer, doctoral student in health policy and management at the University of North Carolina Gillings School of Global Public Health, is lead author of an article that explores the increasing disparity in mortality rates between urban and rural counties in the United States.
Ms. Spencer and colleagues use an economics technique called “decomposition” to examine data obtained from the Centers for Disease Control and Prevention (CDC) Mortality File. Their primary discovery is that the rural-urban mortality divide is not caused by the characteristics of urban and rural counties diverging further – many sociodemographic characteristics are similar to those in the 1980s – but rather that certain sociodemographic characteristics are becoming more predictive of health everywhere.
In other words, rural counties are not more poor now, relative to urban counties, but living in a poor county now is more predictive of a high mortality rate than it was previously.
“We started off the project trying to understand what’s changing about rural counties to cause this divide in mortality,” Ms. Spencer said. “The answer we found was that the changes are happening everywhere; we’re just seeing the effects of these national changes more dramatically in rural counties.”
Published online May 30 in Health Services Research, the study was co-authored by Mr. Jason Rotter, doctoral student, Dr. Stephanie Wheeler, associate professor, and Dr. George Mark Holmes, professor, all in the health policy and management department. Dr. Wheeler is also a member of Lineberger Comprehensive Cancer Center. Dr. Holmes is director of UNC’s Cecil G. Sheps Center for Health Services Research.
[Photo: A UNC study found that living in a rural county is increasingly predictive of a higher mortality rate.]