United States Counties with Low Black Male Mortality Rates

In only 66 out of 1307 US counties, black men have a lower mortality than white men. What makes these counties different?

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.

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— Robert S. Levine, MD, George Rust, MD, Muktar Aliyu, MD, PhD, Maria Pisu, PhD, Roger Zoorob, MD, MPH, Irwin Goldzweig, MS, Paul Juarez, PhD, Baqar Husaini, PhD, Charles H. Hennekens, MD, DrPH

This article originally appeared in the January 2013 issue of The American Journal of Medicine.