The Role of Changing Socioeconomic Conditions, Healthcare, and Health Behaviors in U.S. County-Level Mortality Trends, 2000-2015

Nick Graetz , University of Pennsylvania
Irma T. Elo, University of Pennsylvania

Many studies have documented significant divergence in U.S. county-level mortality trends since 2000. Recent analyses have utilized spatially-explicit Bayesian hierarchical models to make robust estimates of county-level mortality over space and time. However, few studies have examined a comprehensive set of time-varying contextual characteristics within such a modelling framework to illustrate how differences in mortality trajectories by county are associated with shifting levels of these predictors. Combing vital statistics data with county-level characteristics related to healthcare, health behaviors, socioeconomic profile and population composition, this paper utilizes a spatially-explicit Bayesian hierarchical modelling framework to analyze how changing levels of mortality across age groups are associated with changes in county-levels exposures. We employ a Shapley decomposition on the time-varying components of our models to illustrate the additive contributions of each changing characteristic to the observed mortality change in each U.S. county since 2000.

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 Presented in Session 86. Spatial Distribution of Diseases and Deaths