Stability and Volatility in the Contextual Predictors of Working-Age Mortality in the United States

IF 6.3 1区医学 Q1 PSYCHOLOGY, SOCIAL

Journal of Health and Social Behavior Pub Date : 2024-09-14 DOI:10.1177/00221465241271072

Jennifer Karas Montez, Shannon M. Monnat, Emily E. Wiemers, Douglas A. Wolf, Xue Zhang

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Abstract

The contextual predictors of mortality in the United States are well documented, but the COVID-19 pandemic may have upended those associations. Informed by the social history of disease framework (SHDF), this study examined how the importance of county contexts on adult deaths from all causes, drug poisonings, and COVID-19-related causes fluctuated during the pandemic. Using 2018 to 2021 vital statistics data, for each quarter, we estimated associations between county-level deaths among adults ages 25 to 64 and prepandemic county-level contexts (economic conditions, racial-ethnic composition, population health profile, and physician supply). The pandemic significantly elevated the importance of county contexts—particularly median household income and counties’ preexisting health profile—on all-cause and drug poisoning deaths. The elevated importance of household income may be long-lasting. Contextual inequalities in COVID-19-related deaths rose and then fell, as the SHDF predicts, but rose again along with socio-political disruptions. The findings support and extend the SHDF.

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美国劳动年龄死亡率背景预测因素的稳定性和波动性

在美国，预测死亡率的背景因素已被充分记录，但 COVID-19 大流行可能颠覆了这些关联。在疾病社会史框架（SHDF）的指导下，本研究考察了在大流行期间，县域环境对所有原因、药物中毒和COVID-19相关原因造成的成人死亡的重要性是如何波动的。利用 2018 年至 2021 年的生命统计数据，我们估算了每个季度县级 25 至 64 岁成人死亡人数与大流行前县级背景（经济条件、种族-民族构成、人口健康状况和医生供应）之间的关联。大流行大大提高了县级环境（尤其是家庭收入中位数和县原有的健康状况）对全因死亡和药物中毒死亡的重要性。家庭收入的重要性可能会长期存在。正如SHDF所预测的那样，COVID-19相关死亡中的环境不平等先上升后下降，但随着社会政治动荡又再次上升。研究结果支持并扩展了SHDF。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Health and Social Behavior Multiple-

CiteScore

6.50

自引率

4.00%

发文量

期刊介绍： Journal of Health and Social Behavior is a medical sociology journal that publishes empirical and theoretical articles that apply sociological concepts and methods to the understanding of health and illness and the organization of medicine and health care. Its editorial policy favors manuscripts that are grounded in important theoretical issues in medical sociology or the sociology of mental health and that advance theoretical understanding of the processes by which social factors and human health are inter-related.