Mortality differentials between rural and urban areas of states in the northeastern United States 1890–1900

It is concluded that higher urban mortality rates are generally attributable to a few diseases—tuberculosis, diarrheal diseases and several other communicable diseases—the transmission of which depend heavily on close human contact or contamination of the environment.

Abstract

Data from a number of countries show much higher mortality rates in urban than in rural areas in the nineteenth century. In this paper we examine the urban-rural mortality differential in the death registration states of the United States in 1890 and 1900. Before proceeding with the analysis, the data are evaluated and we determine that the data used for the 1900 analysis are more complete than data used in other analyses for the same date. An attempt is made to correct for the deficiencies in the 1890 data. When the urban and rural mortality levels are examined for individual states at both dates, urban mortality is generally higher than rural mortality. However, there is variability across states in urban mortality levels, rural mortality levels, and the urban-rural mortality differences. In general, the urban-rural mortality difference is larger in 1890 than in 1900. When the urban-rural mortality differences are examined in terms of the causes of death which account for the differential, we conclude that higher urban mortality rates are generally attributable to a few diseases—tuberculosis, diarrheal diseases and several other communicable diseases—the transmission of which depend heavily on close human contact or contamination of the environment.