摘要：We explored how place shapes mortality by examining 35 consecutive years of US mortality data. Mapping age-adjusted county mortality rates showed both persistent temporal and spatial clustering of high and low mortality rates. Counties with high mortality rates and counties with low mortality rates both experienced younger population out-migration, had economic decline, and were predominantly rural. These mortality patterns have important implications for proper research model specification and for health resource allocation policies. Although US research has identified effects of socioeconomic and environmental conditions on mortality, these approaches have tended to be aspatial, because they ignore how place may contribute to mortality. Yet research also has shown that community factors influence mortality beyond individual factors. 1 , 2 We mapped US mortality rates across 35 years to identify place-based mortality patterns as a precursor to more formal exploratory spatial analyses.
