Mar 7, 2013 10:29 PM
March 7, 2013 -- A 15-year analysis of death trends in the U.S. surprised health researchers by revealing a widespread increase in premature deaths among women, especially in the Western and Southern regions of the nation.
"We ... were actually shocked to see that female [death] rates were worsening in more than 42 percent of counties," says researcher David Kindig, MD, PhD, professor emeritus of population health sciences at the University of Wisconsin School of Medicine and Public Health, in a prepared statement.
The researchers determined that of 3,140 counties studied, 1,334 (42.8%) experienced a rise in premature death among women between 1992 and 2006. In men, the rate increased in 108 counties (3.4%). The researchers defined death as premature if it happened before age 75.
On average, premature death decreased by 1.5% for women and 9.8% for men. However, the changes varied widely from county to county, the researchers write. For instance, depending on the county, women's death decreased as much as 40.7% or increased as much as 37%.
Better death rates were most strongly associated with higher income, a higher proportion of Latino residents, and college education. Higher death among women was most strongly associated with living in the rural South or the West, more smoking, and lower education rates.
However, in another surprise, the researchers found that the availability of primary medical care had no significant relationship to death rate.
To conduct their study, the researchers used health data from two periods a decade apart (1992-1996 and 2002-2006).
The researchers then took into account each county's location, population density, racial and ethnic composition, household income, education level, amount of smoking and obesity, and availability of medical care.
"These findings lend support to the contention that meaningful health improvement efforts must extend beyond a focus on health care delivery and include stronger policies affecting health behaviors and the social and environmental determinants of health, with corresponding investments in those areas," the researchers write.
The study is published in Health Affairs.
To see a version of this story for physicians, visit Medscape, the leading site for physicians and health care professionals.