At the beginning of the twentieth century, U.S. cities had greater mortality than its rural areas; by midcentury, this had reversed. The details of when, where, and for whom the urban mortality penalty reversed is not well known, largely because data to address those questions are limited. Here, we prevent new national and regional estimates of infectious mortality, divided by race, for urban and rural areas from 1922-1944. We show that, already in 1922, rural mortality exceeds or equals urban mortality. For whites, median urban and rural mortality are strikingly similar, in the country as a whole and in each region, across this entire period. For nonwhites, regional patterns differ: nonwhites evince a rural mortality penalty in the Midwest and West but an urban penalty in the South. These results speak to ongoing debates about the public health contribution to the mortality decline.
Presented in Session 5. Health & Mortality 1