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Examination of inequalities in HIV/AIDS mortality in the United States from a fundamental cause perspective

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  • Rubin, M.S.
  • Colen, C.G.
  • Link, B.G.

Abstract

Objectives. We examined changes in socioeconomic status (SES) and Black to White inequalities in HIV/AIDS mortality in the United States before and after the introduction of highly active antiretroviral therapy (HAART). Methods. Taking a fundamental cause perspective, we used negative binomial regression to analyze trends in county-level gender-, race-, and age-specific HIV/ AIDS mortality rates among those aged 15 to 64 years during the period 19872005. Results. Although HIV/AIDS mortality rates decreased once HAART became available, the declines were not uniformly distributed among population groups. The associations between SES and HIV/AIDS mortality and between race and HIV/AIDS mortality, although present in the pre-HAART period, were significantly greater in the peri- and post-HAART periods, with higher SES and White race associated with the greatest declines in mortality during the post-HAART period. Conclusions. Our findings support the fundamental cause hypothesis, as the introduction of a life-extending treatment exacerbated inequalities in HIV/AIDS mortality by SES and by race. In addition to a strong focus on factors that improve overall population health, more effective public health interventions and policies would facilitate an equitable distribution of health-enhancing innovations.

Suggested Citation

  • Rubin, M.S. & Colen, C.G. & Link, B.G., 2010. "Examination of inequalities in HIV/AIDS mortality in the United States from a fundamental cause perspective," American Journal of Public Health, American Public Health Association, vol. 100(6), pages 1053-1059.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2009.170241_0
    DOI: 10.2105/AJPH.2009.170241
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    Cited by:

    1. Daniel Weiss & Håvard T Rydland & Emil Øversveen & Magnus Rom Jensen & Solvor Solhaug & Steinar Krokstad, 2018. "Innovative technologies and social inequalities in health: A scoping review of the literature," PLOS ONE, Public Library of Science, vol. 13(4), pages 1-20, April.
    2. Rubin, Marcie S. & Clouston, Sean & Link, Bruce G., 2014. "A fundamental cause approach to the study of disparities in lung cancer and pancreatic cancer mortality in the United States," Social Science & Medicine, Elsevier, vol. 100(C), pages 54-61.
    3. Hermann Pythagore Pierre Donfouet & Shukri F. Mohamed & Eric Malin, 2021. "Socioeconomic inequality in tobacco use in Kenya: a concentration analysis," International Journal of Health Economics and Management, Springer, vol. 21(2), pages 247-269, June.
    4. Zapata-Moya, Angel R. & Freese, Jeremy & Bracke, Piet, 2023. "Mechanism substitution in preventive innovations: Dissecting the reproduction of health inequalities in the United States," Social Science & Medicine, Elsevier, vol. 337(C).
    5. Barton Hamilton & Andrés Hincapié & Emma C. Kalish & Nicholas W. Papageorge, 2021. "Medical Innovation and Health Disparities," NBER Working Papers 28864, National Bureau of Economic Research, Inc.
    6. Polonijo, Andrea N. & Carpiano, Richard M., 2013. "Social inequalities in adolescent human papillomavirus (HPV) vaccination: A test of fundamental cause theory," Social Science & Medicine, Elsevier, vol. 82(C), pages 115-125.
    7. Sean A. P. Clouston & Marcie S. Rubin & Jo C. Phelan & Bruce G. Link, 2016. "A Social History of Disease: Contextualizing the Rise and Fall of Social Inequalities in Cause-Specific Mortality," Demography, Springer;Population Association of America (PAA), vol. 53(5), pages 1631-1656, October.
    8. Everett, Bethany G. & Hatzenbuehler, Mark L. & Hughes, Tonda L., 2016. "The impact of civil union legislation on minority stress, depression, and hazardous drinking in a diverse sample of sexual-minority women: A quasi-natural experiment," Social Science & Medicine, Elsevier, vol. 169(C), pages 180-190.
    9. Sam Harper & Nicholas B King & Meredith E Young, 2013. "Impact of Selective Evidence Presentation on Judgments of Health Inequality Trends: An Experimental Study," PLOS ONE, Public Library of Science, vol. 8(5), pages 1-7, May.
    10. Irma Elo & Hiram Beltrán-Sánchez & James Macinko, 2014. "The Contribution of Health Care and Other Interventions to Black–White Disparities in Life Expectancy, 1980–2007," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 33(1), pages 97-126, February.
    11. Clouston, Sean A.P. & Rubin, Marcie S. & Chae, David H. & Freese, Jeremy & Nemesure, Barbara & Link, Bruce G., 2017. "Fundamental causes of accelerated declines in colorectal cancer mortality: Modeling multiple ways that disadvantage influences mortality risk," Social Science & Medicine, Elsevier, vol. 187(C), pages 1-10.

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