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Progress in reducing mortality from 10 major causes by county poverty level, from 1990-1994 to 2016-2020, in the US
Wiese Daniel, Sung Hyuna, Jemal Ahmedin, Islami Farhad. Med (New York, N.Y.), 2024-12-21
Topic: Risk, prevention and care in population studies
Overall death rates in the US have been declining in the past few decades. However, progress against mortality across counties with different socioeconomic profiles has not been well described. The objective of this study was to examine changes in death rates from leading causes of death by county poverty level in the contiguous US. Using county-level death (all causes, 10 leading causes in 2020, excluding COVID-19) and population data derived from the National Center for Health Statistics, we calculated absolute and relative changes in age-standardized death rates by county poverty level from 1990-1994 to 2016-2020. From 1990-1994 to 2016-2020, death rates from all causes, diseases of the heart, cancer, cerebrovascular disease, and pneumonia/influenza declined nationally, but rates increased for unintentional injury, chronic obstructive pulmonary disease, Alzheimer's disease, diabetes, suicide/self-inflicted injury, and kidney disease mortality. Counties with higher poverty levels (≥20%) had smaller declines or larger increases in death rates for each evaluated cause of death, exacerbating the disparities in mortality by county poverty level, except for unintentional injury and suicide/self-inflicted injury. Consequently, in 2016-2020, the death rates for leading causes of death were 12% (for Alzheimer's disease; suicide/self-inflicted injury) to 81% (for diabetes) higher in people residing in counties with the highest poverty level than in those residing in counties with the lowest poverty level. Disparities in mortality from most leading causes of death by county poverty level widened during the past three decades. There was no external funding for this study.
Key findings
- Overall death rates in the US have been declining in the past few decades.
Why it matters
From 1990-1994 to 2016-2020, Alzheimer's disease death rates increased nationally, and counties with higher poverty had smaller declines or larger increases across causes of death. This describes mortality trends and disparities, not any treatment or prevention.
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Study details
- Evidence strengthLow
How this study scored 31/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Med (New York, N.Y.)) |
| Journal's citation record | 0 / 4 | Med: journal h-index 67 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.3 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 1 / 6 | Cited 0.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Farhad Islami: h-index 100 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | American Cancer Society: institution h-index 727 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39706181) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 31 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Daniel, W., Hyuna, S., Ahmedin, J., & Farhad, I. (2025). Progress in reducing mortality from 10 major causes by county poverty level, from 1990-1994 to 2016-2020, in the US. Med (New York, N.Y.). https://doi.org/10.1016/j.medj.2024.11.009
Vancouver
Daniel W, Hyuna S, Ahmedin J, Farhad I. Progress in reducing mortality from 10 major causes by county poverty level, from 1990-1994 to 2016-2020, in the US. Med (New York, N.Y.). 2025. doi:10.1016/j.medj.2024.11.009. PMID: 39706181.
BibTeX
@article{daniel2025-39706181,
author = {Daniel, Wiese and Hyuna, Sung and Ahmedin, Jemal and Farhad, Islami},
title = {{Progress in reducing mortality from 10 major causes by county poverty level, from 1990-1994 to 2016-2020, in the US}},
journal = {Med (New York, N.Y.)},
year = {2025},
doi = {10.1016/j.medj.2024.11.009},
pmid = {39706181},
url = {https://doi.org/10.1016/j.medj.2024.11.009}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.