COMMUNITY OCCUPATIONAL STRUCTURE, MEDICAL AND ECONOMIC-RESOURCES, ANDCORONARY MORTALITY AMONG US BLACKS AND WHITES, 1980-1988

PURPOSE: To examine the association between coronary heart disease (CH D) mortality, economic and medical resources, and county occupational structure. METHODS: U.S. counties were classified into five occupation al structure categories based on the percentage of workers in white co llar occupations. Directly age-adjusted CHD mortality races (from vita l statistics and Census data) and economic and medical care data (from Census and Area Resource File data) were calculated for each occupati onal structure category. Participants were black and white, men and wo men, aged 35-64 years, in the U.S. during 1980-88. CHD mortality rates and economic and medical care data were compared across occupational structure categories. RESULTS: Among blacks, CDH rates were highest in counties with intermediate levels of occupational structure; rates am ong whites were inversely associated with occupational structure. Per capita levels of income and numbers of medical-care providers were pos itively associated with occupational structure. CONCLUSION: Strategies to improve the resources of disadvantaged communities and the access of black workers to local occupational opportunities may be important for CHD prevention in high risk populations. (C) 1998 Elsevier Science Inc.