Death rate variation in US subpopulations.

OBJECTIVE To account for variations in death rates in population subgroups of the USA. METHODS Factors associated with age-adjusted death rates in 366 metropolitan and non- metropolitan areas of the United States were examined for 1990-92. The rates ranged from 690 to 1108 per 100 000 population (mean = 885 +/- 78 per 100 000). FINDINGS Least squares regression analysis explained 71% of this variance. Factors with the strongest independent positive association were ethnicity (African-American), less than a high school education, high Medicare expenditures, and location in western or southern regions. Factors with the strongest independent negative associations were employment in agriculture and forestry, ethnicity (Hispanic) and per capita income. CONCLUSION Additional research at the individual level is needed to determine if these associations are causal, since some of the factors with the strongest associations, such as education, have long latency periods.