The effect of primary care physician supply and income inequality on mortality among blacks and whites in US metropolitan areas

Am J Public Health. 2001 Aug;91(8):1246-50. doi: 10.2105/ajph.91.8.1246.


Objectives: This study assessed whether income inequality and primary care physician supply have a different effect on mortality among Blacks compared with Whites.

Methods: We conducted a multivariate ecologic analysis of 1990 data from 273 US metropolitan areas.

Results: Both income inequality and primary care physician supply were significantly associated with White mortality (P < .01). After the inclusion of the socioeconomic status covariates, the effect of income inequality on Black mortality remained significant (P < .01), but the effect of primary care physician supply was no longer significant (P > .10), particularly in areas with high income inequality.

Conclusions: Improvement in population health requires addressing socioeconomic determinants of health, including income inequality and primary care availability and access.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Black or African American / statistics & numerical data*
  • Censuses
  • Health Services Accessibility
  • Health Status Indicators*
  • Humans
  • Income / classification
  • Income / statistics & numerical data*
  • Mortality*
  • Multivariate Analysis
  • Physicians, Family / supply & distribution*
  • Risk Factors
  • Socioeconomic Factors
  • United States / epidemiology
  • Urban Health / classification
  • Urban Health / statistics & numerical data*
  • White People / statistics & numerical data*