Primary care, social inequalities, and all-cause, heart disease, and cancer mortality in US counties, 1990

Am J Public Health. 2005 Apr;95(4):674-80. doi: 10.2105/AJPH.2003.031716.


Objectives: We tested the association between the availability of primary care and income inequality on several categories of mortality in US counties.

Methods: We used cross-sectional analysis of data from counties (n=3081) in 1990, including analysis of variance and multivariate ordinary least squares regression. Independent variables included primary care resources, income inequality, and sociodemographics.

Results: Counties with higher availability of primary care resources experienced between 2% and 3% lower mortality than counties with less primary care. Counties with high income inequality experienced between 11% and 13% higher mortality than counties with less inequality.

Conclusions: Primary care resources may partially moderate the effects of income inequality on health outcomes at the county level.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Cause of Death*
  • Cross-Sectional Studies
  • Female
  • Health Services Accessibility*
  • Heart Diseases / mortality*
  • Humans
  • Income / statistics & numerical data
  • Male
  • Middle Aged
  • Neoplasms / mortality*
  • Primary Health Care / statistics & numerical data*
  • Regression Analysis
  • Socioeconomic Factors
  • United States / epidemiology