2023-09-28 14:46:10 +00:00
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abstract: 'This paper examines the association between US county occupational
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structure, services availability, prevalence of risk factors, and
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coronary mortality rates by sex and race, for 1984 1998. The 3137 US
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counties were classified into five occupational structure categories;
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counties with the lowest percentages of the labor force in managerial,
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professional, and technical occupations were classified in category I
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(5-16\%), counties with the highest percentages were in category V
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(32-59\%). Directly age-adjusted coronary heart disease (CHD) mortality
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rates, for aged 35-64 years, (from vital statistics and Census data),
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per-capita services (County Business Patterns), and the prevalence of
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CHD risk factors (Behavioral Risk Factor Surveillance Surveys data) were
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calculated for each occupational structure category. CHD mortality rates
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and the prevalence of risk factors were inversely monotonically
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associated with occupational structure categories for white men and
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women but not among black men and women. Numbers of producer services
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for banking, business credit, overall business services and
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personnel/employment services were 2-12 times greater in category V
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versus I counties. Consumer services such as fruit/vegetable markets,
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fitness facilities, doctor offices and social services were 1.6-3 times
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greater in category V versus I counties. Residential racial segregation
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scores remained high in most areas despite declines during 1980-1990;
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occupational segregation by race and gender were shown indicating
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continued institutional racism. An ecological model for conceptualizing
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communities and health and the overall influence of state and national
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occupational structure is discussed; intervention strategies such as
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decreased wage disparities and `living wage'' standards and development
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is discussed. (C) 2003 Elsevier Ltd. All rights reserved.'
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affiliation: 'Armstrong, DL (Corresponding Author), SUNY Albany, Dept Epidemiol, 1
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Univ Pl, Rensselaer, NY 12144 USA.
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SUNY Albany, Dept Epidemiol, Rensselaer, NY 12144 USA.'
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author: Armstrong, DL and Strogatz, D and Wang, R
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author-email: dla02@health.state.ny.us
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author_list:
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- family: Armstrong
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given: DL
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- family: Strogatz
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given: D
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- family: Wang
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given: R
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da: '2023-09-28'
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doi: 10.1016/j.socscimed.2003.08.030
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files: []
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issn: 0277-9536
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journal: SOCIAL SCIENCE \& MEDICINE
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keywords: coronary heart disease; community health; social class; US counties
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keywords-plus: 'ISCHEMIC-HEART-DISEASE; INSTITUTIONAL-RACISM; SOCIAL-CLASS;
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MYOCARDIAL-INFARCTION; SELF-EFFICACY; RISK-FACTORS; NEW-YORK; HEALTH;
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DECLINE; WORKPLACE'
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language: English
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month: JUN
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number: '11'
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number-of-cited-references: '64'
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pages: 2349-2361
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papis_id: c7400df4416895439e8af40b51ecae46
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ref: Armstrong2004unitedstates
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times-cited: '12'
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title: United States coronary mortality trends and community services associated with
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occupational structure, among blacks and whites, 1984-1998
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2023-10-01 08:15:07 +00:00
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type: article
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2023-09-28 14:46:10 +00:00
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unique-id: WOS:000220786100022
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usage-count-last-180-days: '0'
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usage-count-since-2013: '2'
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volume: '58'
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web-of-science-categories: 'Public, Environmental \& Occupational Health; Social Sciences,
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Biomedical'
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year: '2004'
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