Abstract Objective. To determine changes in predictors of urban mortality between 1980 and 1990 by assessing the effects of city expenditures, urban growth, mayoral party affiliation, and income inequality. Methods. Ecological study of mortality of people under age 75 for 1980 and 1990 in U.S. cities using generalized linear models. Results. Income inequality (measured by the Gini coefficient) has a strong, positive association with age-adjusted all-cause mortality in 1990 (r=. 48 p=.0001) infant mortality (.34, p=.0001), and age-adjusted mortality due to preventable, immediate causes [i.e. asthma, homicide, suicide] (.56, p=.0001), yet no associations were found for 1980. Regression models using 1980 and 1990 data were carried out for these three mortality rates on income inequality, percent in poverty, per capita city social expenditures, urban growth and other variables. Social investment at the local level (i.e. per capita spending on police) is positively correlated with mortality rates for 1980 and 1990, suggesting that spending is a response to poor health outcomes rather than a protective benefit. Change in mayoral party between 1980 and 1990 is associated with a decline of .9 infant deaths per 1000 live births (p=.04) in 1990. Income inequality is only associated with 1990 mortality due to immediate and preventable causes. Discussion and Recommendations. Policies aimed at reducing premature mortality in US cities by reducing income inequality should address absolute poverty by minimizing material deprivation and maintaining investment in urban infrastructure.
Learning Objectives: At the conclusion of the session, the participant of the session will be able to: 1) articulate structural risks to population health; 2) list social policies that are measurable at the urban level and that affect mortality outcomes; 3) describe patterns of US urban mortality from 1980 to 1990
Keywords: Mortality, Urban Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.