Alumna, Alison Formanack's Article Published in the Journal of General Internal Medicine
Allison Formanack (Ph.D. Cultural Anthropology, 2018) has just co-authored a new article in the Journal of General Internal Medicine, "Race, Class, and Place Modify Mortality Rates for the Leading Causes of Death in the United States, 1999鈥2021."听Together with colleagues in the schools of public health and medicine at the University of Virginia, Dr. Formanack argues that data on illness and mortality in the US benefit from including place, along with race and class.
Abstract
Background
Race and ethnicity, socioeconomic class, and geographic location are well-known social determinants of health in the US. Studies of population mortality often consider two, but not all three of these risk factors.
Objectives
To disarticulate the associations of race (whiteness), class (socioeconomic status), and place (county) with risk of cause-specific death in the US.
Design
We conducted a retrospective analysis of death certificate data. Bayesian regression models, adjusted for age and race/ethnicity from the American Community Survey and the county Area Deprivation Index, were used for inference.
Main Measures
County-level mortality for 11 leading causes of death (1999鈥2019) and COVID-19 (2020鈥2021).
Key Results
County 鈥渨hiteness鈥 and socioeconomic status modified death rates; geospatial effects differed by cause of death. Other factors equal, a 20% increase in county whiteness was associated with 5鈥8% increase in death from three causes and 4鈥15% reduction in death from others, including COVID-19. Other factors equal, advantaged counties had significantly lower death rates, even when juxtaposed with disadvantaged ones. Patterns of residual risk, measured by spatial county effects, varied by cause of death; for example: cancer and heart disease death rates were better explained by age, socioeconomic status, and county whiteness than were COVID-19 and suicide deaths.
Conclusions
There are important independent contributions from race, class, and geography to risk of death in the US.
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