ArticleAmerican journal of public health2019
Growth and Persistence of Place-Based Mortality in the United States: The Rural Mortality Penalty.
Article in American journal of public health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04589676 (Developing and Testing the Opioid Rapid Response System), which is not on this map. Cited by 168 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Developing and Testing the Opioid Rapid Response System
Who cites it
168 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Care for Atrial Fibrillation and Outcomes in Rural Versus Urban Communities in the United States: A Systematic and Narrative Review.Journal of the American Heart Association · 2025Pooled it
- A systematic literature review of health disparities among rural people with epilepsy (RPWE) in the United States and Canada.Epilepsy & behavior : E&B · 2021Pooled it
- Systematic Review of Clinical Insights into Novel Coronavirus (CoVID-19) Pandemic: Persisting Challenges in U.S. Rural Population.International journal of environmental research and public health · 2020Pooled it
- A Web-Based Cancer Prevention Intervention for Rural Emerging Adults: Mixed Methods Development and Pilot-Testing Study.Journal of medical Internet research · 2026Trial
- Urban-rural disparities in injury mortality in China, 2002-2021.BMC public health · 2026Article
- Evaluating the impact of virtual oncology financial and legal navigation on cancer-related financial toxicity.JNCI cancer spectrum · 2026Article
- Rural Patients' Transitional Care Experiences: A Qualitative Analysis of Provider Notes.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Article
- Rural-urban disparities in cardiovascular and other competing risk of death among cancer patients.Journal of advanced research · 2026Article
- Medical artificial intelligence and the right to health.BMC medical ethics · 2026Article
- Structural drivers of health inequality in sub-Saharan Africa: Evidence and policy implications.Health policy OPEN · 2026Article
- Four-Decade (1980-2023) Surface Ozone Concentrations across the Contiguous United States: Fine-Resolution Estimates and Health Implications.Environmental science & technology · 2026Article
- Who is benefiting from the dramatic decline in U.S. cancer mortality? Place-based evidence of disparities in rates of improvement.British journal of cancer · 2026Article
- Trends in cardiovascular disease mortality among older adults with co-occuring lung cancer in the United States from 1999 to 2020.BMC cancer · 2026Article
- What Do We Know About Rural Mobile Health Clinics? A Scoping Review.International journal of environmental research and public health · 2026Article
- Clues to the origin of rising midlife mortality: associations between recent mortality outcomes and county-level economic, social, and employment changes over multiple time periods.Population health metrics · 2026Article
- Acute Myocardial Infarction in Medicare Beneficiaries During and After the COVID-19 Pandemic.JAMA network open · 2026Article
- Trends in Unintentional Drowning Mortality Among U.S. Adults Aged ≥25 Years, 1999-2024: A U.S. Surveillance Analysis.Healthcare (Basel, Switzerland) · 2026Article
- Socioeconomic Status, Rurality, and Pediatric Critical Care Admission.JAMA network open · 2026Article
- Growing Inequities in Median Age of Death and Obesity Prevalence Between Australian Major Cities and Remote Areas: A National, Longitudinal, Spatial Analysis.Public health challenges · 2026Article
108 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
Abstract
objectivesTo examine 47 years of US urban and rural mortality trends at the county level, controlling for effects of education, income, poverty, and race.
methodsWe obtained (1) Centers for Disease Control and Prevention WONDER (Wide-ranging ONline Data for Epidemiologic Research) data (1970-2016) on 104 million deaths; (2) US Census data on education, poverty, and race; and (3) Bureau of Economic Analysis data on income. We calculated ordinary least square regression models, including interaction models, for each year. We graphed standardized parameter estimates for 47 years.
resultsRural-urban mortality disparities increased from the mid-1980s through 2016. We found education, race, and rurality to be strong predictors; we found strong interactions between percentage poverty and percentage rural, indicating that the largest penalty was in high-poverty, rural counties.
conclusionsThe rural-urban mortality disparity was persistent, growing, and large when compared to other place-based disparities. The penalty had evolved into a high-poverty, rural penalty that rivaled the effects of education and exceeded the effects of race by 2016. Public Health Implications. Targeting public health programs that focus on high-poverty, rural locales is a promising strategy for addressing disparities in mortality.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.