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Primary care, race, and mortality in US states

Author

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  • Shi, Leiyu
  • Macinko, James
  • Starfield, Barbara
  • Politzer, Robert
  • Xu, Jiahong

Abstract

This study used US state-level data from 1985 to 1995 to examine the relationship of primary care resources and income inequality with all-cause mortality within the entire population, and in black and white populations. The study is a pooled ecological design with repeated measures using 11 years of state-level data (n=549). Analyses controlled for socioeconomic and demographic characteristics. Contemporaneous and time-lagged covariates were modeled, and all analyses were stratified by race/ethnicity. In all models, primary care was associated with lower mortality. An increase of one primary care doctor per 10,000 population was associated with a reduction of 14.4 deaths per 100,000. The magnitude of primary care coefficients was higher for black mortality than for white mortality. Income inequality was not associated with mortality after controlling for state-level sociodemographic covariates. The study provides evidence that primary care resources are associated with population health and could aid in reducing socioeconomic disparities in health.

Suggested Citation

  • Shi, Leiyu & Macinko, James & Starfield, Barbara & Politzer, Robert & Xu, Jiahong, 2005. "Primary care, race, and mortality in US states," Social Science & Medicine, Elsevier, vol. 61(1), pages 65-75, July.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:1:p:65-75
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    References listed on IDEAS

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    Cited by:

    1. Chen, Zhuo & Roy, Kakoli & Haddix, Anne C. & Thacker, Stephen B., 2010. "Factors associated with differences in mortality and self-reported health across states in the United States," Health Policy, Elsevier, vol. 94(3), pages 203-210, March.
    2. TCHICAYA Anastase & LORENTZ Nathalie, 2011. "Disparités sociales de mortalité au Luxembourg," LISER Working Paper Series 2011-37, Luxembourg Institute of Socio-Economic Research (LISER).
    3. Raffaele Lagravinese & Paolo Liberati & Giuliano Resce, 2017. "Exploring health outcomes by stochastic multi-objective acceptability analysis: an application to Italian regions," Working Papers. Collection B: Regional and sectoral economics 1703, Universidade de Vigo, GEN - Governance and Economics research Network.
    4. Christopher J. Holmes & Anna Zajacova, 2014. "Education as “the Great Equalizer”: Health Benefits for Black and White Adults," Social Science Quarterly, Southwestern Social Science Association, vol. 95(4), pages 1064-1085, December.
    5. Raffaele Lagravinese & Paolo Liberati & Giuliano Resce, 2020. "Measuring Health Inequality in US: A Composite Index Approach," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 147(3), pages 921-946, February.
    6. Xiaolin Wei & Haitao Li & Nan Yang & Samuel Y S Wong & Onikepe Owolabi & Jianguang Xu & Leiyu Shi & Jinling Tang & Donald Li & Sian M Griffiths, 2015. "Comparing Quality of Public Primary Care between Hong Kong and Shanghai Using Validated Patient Assessment Tools," PLOS ONE, Public Library of Science, vol. 10(3), pages 1-15, March.
    7. Igor Akushevich & Julia S. Kravchenko & Kenneth G. Manton, 2007. "Health‐Based Population Forecasting: Effects of Smoking on Mortality and Fertility," Risk Analysis, John Wiley & Sons, vol. 27(2), pages 467-482, April.
    8. Mora-García, Claudio A. & Pesec, Madeline & Prado, Andrea M., 2024. "The effect of primary healthcare on mortality: Evidence from Costa Rica," Journal of Health Economics, Elsevier, vol. 93(C).

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