摘要：There are a number of technical and statistical problems in monitoring the temporal and spatial variation of local area death rates in the United States for evidence of systematically elevated risks. An analytic strategy is proposed to reduce one of the major statistical concerns, i.e., that of identifying areas with truly elevated mortality risks from a large number of local area comparisons. This analytic strategy involves two stages. The first is a procedure for examining the entire distribution of local area death rates instead of simply selecting high risk "outliers." The second is the development of an analytic procedure to relate the temporal changes in the cross-sectional distribution of local area death rates to models of the disease process operating within the populations in those areas. The procedures are applied to data on cancer mortality for the 3050 counties (or county equivalents) of the United States over the period 1950 to 1978. A number of striking mortality patterns, both within the entire United States and within various regions and states, are identified. For example, perhaps the most persistent finding was that the risk increases in the death rates for respiratory cancer mortality were due to a "catching up" of nonmetropolitan county mortality rates with metropolitan area mortality rates. Full text Full text is available as a scanned copy of the original print version. Get a printable copy (PDF file) of the complete article (2.1M), or click on a page image below to browse page by page. Links to PubMed are also available for Selected References . 369 370 371 372 373 374 375 376 377 378 379 380
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