Urban-Rural Differences in Excess Mortality Among High-Poverty Populations

Evidence from the Harlem Household Survey and the Pitt County, North Carolina Study of African American Health

The current study explored differences in mortality for high-poverty African Americans in urban and rural areas. Data examined in the study came from the Harlem Household Survey (HHS) and the Pitt County, North Carolina Study of African American Health (PCS). Participants from the HHS and PCS studies were evaluated in areas such as health status and behavior, social support and health insurance access.

Key Findings:

  • Hypertension rates for HHS and PCS participants were above national averages.
  • There was no statistically significant difference in diabetes rates for HHS and PCS respondents.
  • Obesity rates were higher for PCS participants—particularly, female participants—than for HHS respondents.
  • Mortality rates for male HHS participants were greater than those observed in PCS respondents. Health status indicators did not explain the gap in mortality between HHS male participants and PCS respondents.
  • Health insurance status accounted for 13 percent of gaps in mortality for men and 19 percent of the mortality gap for women. Social support and employment also had an impact on mortality gap rates.
  • Individuals in high-poverty urban areas may have as limited access to health care as those who live in high-poverty rural areas.