DHHS publication ; no. (PHS)

Maps have played a fundamental role in public health since the mid-1800\u2019s. Soon after a call for studying the geographic patterns of disease, Dr. John Snow linked the London cholera epidemic to a contaminated water supply. For over a hundred years afterward, however, the usefulness of mapping health outcomes in the United States was limited to either detailed views of a single area or national maps at a State or regional level. Then in 1975, when computer systems had become sufficiently powerful to automate the mapping process, the National Cancer Institute published maps of U.S. cancer death rates at the small-area level. Previously unnoticed clusters of high-rate counties on these maps led to numerous field studies, which uncovered, for example, the links between shipyard asbestos exposure and lung cancer and snuff dipping and oral cancer. This first atlas demonstrated that mapping small-area death rates could be a valuable public health tool by generating etiologic hypotheses and identifying highrate communities where intervention efforts might be warranted. Its publication was followed by others from the National Cancer Institute and instigated similar efforts around the world. Following the success of these atlases in advancing the understanding of cancer etiology, this monograph presents maps of the leading causes of death in the United States for the period 1988\u201392.The research underlying this project has led to improved statistical methods for modeling death rates and innovative presentation formats for maps and graphics based on cognitive research. In this atlas, information previously available only in tabular form or summarized on a single map is presented on multiple maps and graphs. Broad geographic patterns by age group are highlighted by application of a new smoothing algorithm, and the geographic unit for mapping is defined on the basis of patterns of health care. These new features allow the public health researcher to examine the data at several geographic levels \u2013 to read an approximate rate for an area, to discern clusters of similar-rate areas, to visualize broad geographic patterns, and to compare regional rates. With these additional tools, important geographic patterns of cause-specific mortality in the United States can more easily be identified.Although many causes of death included in this atlas have been mapped before, previous efforts have focused on a limited range of causes or have presented data only at the State level. This is the first publication of maps of all leading causes of death in the United States on a small-area scale. Comparisons of map patterns across causes of death, sex, or race can provide clues to disease etiology. For this reason unlike many earlier atlases, separate maps by sex and race are included in the same volume, using consistent methods of presentation.Suggested citation: Pickle LW, Mungiole M, Jones GK, White AA. Atlas of United States mortality. Hyattsville, Maryland: National Center for Health Statistics. 1996.Introduction -- Methods: Data sources; Causes of death; Geographic unit; Reader\u2019s guide; Graphical design; Statistical methods -- Results: Heart disease; All cancer; Lung cancer; Colorectal cancer; Prostate cancer; Breast cancer; Stroke; Unintentional injuries; Motor vehicle injuries; Chronic obstructive pulmonary diseases; Pneumonia & influenza; Diabetes; Suicide; Firearm suicide; Liver disease; Human immunodeficiency virus infection; Homicide; Firearm homicide; All causes -- Maps:Heart disease; All cancer; Lung cancer; Colorectal cancer; Prostate cancer; Breast cancer; Stroke; Unintentional injuries; Motor vehicle injuries; COPD; Pneumonia & influenza; Diabetes; Suicide; Firearm suicide; Liver disease; HIV; Homicide; Firearm homicide; All causes -- References -- Appendix I. Health service areas -- Appendix II. Statistical modeling -- Appendix III. Supplemental maps.1996709