چکیده : 

OBJECTIVE: In the United States, young and middle-aged black men have significantly higher total

mortality than any other racial or ethnic group. We describe the characteristics of US counties with low

non–Hispanic Black or African American male mortality (ages 25-64 years, 1999-2007).

METHODS: Information was accessed through public data, the US Census, the US Compressed Mortality

File, and the Native American Graves Repatriation Act military database.

RESULTS: Of 1307 counties with black mortality rates classified as reliable by the National Center for

Health Statistics (at least 20 deaths), 66 recorded lower mortality among black men than corresponding US

whites. Most notable, 97% of the 66 counties were home to or adjacent a military installation versus 37%

of comparable US counties (P.001). Blacks in these counties had less poverty, higher percentages of

elderly civilian veterans, and higher per capita income. Within these counties, national black:white

disparities in mortality were eliminated for ischemic heart disease, accidents, diseases of the liver, chronic

lower respiratory diseases, and mental disorder from psychoactive substance use. Application of age-,

race-, ethnicity-, gender-, and urbanization-specific mortality rates from counties with relatively low

mortality would reduce the black:white mortality rate ratio for black men aged 25 to 64 years from 1.67

to 1.20 nationally and to 1.00 in areas outside large central metropolitan areas.

CONCLUSIONS: These descriptive data demonstrate a small number of communities with low mortality

rates among young and middle-aged black/African American men. Their characteristics may provide

clinical and public health insights to reduce these higher mortality rates in the US population. Analytic

epidemiologic studies are necessary to test these hypotheses.