Descriptive and analytic epidemiologic studies to identify modifiable determinants of disparities in mortality rates between Blacks and Whites.

INTRODUCTION: Descriptive and epidemiologic studies of US national data reveal no sustained decrease in disparities in mortality between Blacks and Whites since World War II. In contrast, descriptive studies of variations in racial mortality trends across comparable geographic areas might lead to the formulation of hypotheses for testing in analytical epidemiologic studies to identify modifiable determinants. METHODOLOGY: Using the CDC Wonder system, the 41 peer-geographic areas to Davidson County, Tennessee, in which Meharry Medical College resides, were identified. For 1999-2000, race- and sex-specific, age-adjusted annual mortality rate ratios (MRRs) for Blacks compared to Whites, stratified by age (<1, 1-24, 25-64, and > or = 65 years), were calculated. In 39 of the 41, MRR was >1.0, indicating higher death rates for Blacks. RESULTS: In 20 counties with low Black:White poverty ratios, MRRs were higher in 18 and achieved statistical significance in 13. In 21 counties with high Black:White poverty ratios, MRRs were higher in 20 counties and achieved statistical significance in 19. No MRRs were significantly lower for Blacks. CONCLUSION: This new pathway includes descriptive data to explore racial mortality trends across peer-geographic areas to formulate hypotheses for analytical epidemiologic studies for the identification of modifiable determinants of disparities in mortality rates between Blacks and Whites.