The changing geography of major causes of death among middle age white Americans, 1939-1981.

Urban areas, especially the Northeast, are assumed to have the highest death rates from chronic diseases in the United States. Based on analysis of age-adjusted death rates of the white population 35-64 from 1939-1941 through 1979-1981, it is shown that chronic disease rates in the urban Northeast and Midwest have declined compared to the rest of the United States. High rates of chronic as well as traumatic causes of death now characterize the South. Hypotheses are offered to explain these changes, including changes in lifestyle, differences in state government policies, the changing geography of industry and ethnic populations, and the spread of medical care.