Geographic morbidity differentials in the late nineteenth-century United States

We use a national cross-sectional database, the 1880 Integrated Public Use Microdata Sample, to examine aggregate patterns and individual-level estima tes of chronic-disease morbidity and long-term disability in the United Sta tes in the late nineteenth century. Despite higher levels of urban mortalit y in 1880, morbidity prevalence pales were highest in the rural areas of th e country, especially in the western and the southern regions. Equations us ing microdata show that the estimated risk of chronic disease and impairmen t was highest for males and females who were older, of lower socioeconomic status, or from rural areas. This era was marked by geographically uneven b ut significant levels of endemic chronic disease, likely the outcomes of pr ior episodes of infectious disease and exposure to conditions generated by human action, such as the Civil War and migration.