Examination of Inequalities in HIV/AIDS Mortality in the United States From a Fundamental Cause Perspective

Abstract

Our findings support the fundamental cause hypothesis, as the introduction of a life-extending treatment exacerbated inequalities in HIV/AIDS mortality by SES and by race. In addition to a strong focus on factors that improve overall population health, more effective public health interventions and policies would facilitate an equitable distribution of health-enhancing innovations.

Fundamental Causes of Colorectal Cancer Mortality in the United States: Understanding the Importance of Socioeconomic Status in Creating Inequality in Mortality

“…We used factor analysis to derive a unifactoral SES measure that we standardized, to simplify interpretation, so that a 1-unit change referred to a 1 standard deviation change in SES. 14,15 The data for intercensal years were linearly interpolated.…”

“…This approach is appropriate when analyzing count data and is particularly effective when overdispersion in the data is evident. 15 In the multivariate context, mortality rates are seen as dependent on a set of observed variables shared by individuals within each county and during each year or period. We used robust Huber---White standard errors and included controls for countylevel clustering of rates over time.…”

Socioeconomic Status and Survival of People with Human Immunodeficiency Virus Infection before and after the Introduction of Highly Active Antiretroviral Therapy: A Systematic Literature Review

“…Eight cross-sectional [37][38][39][40][41][42][43][44] and eight ecologic studies [45][46][47][48][49][50][51][52] were excluded from the analysis because they examined absolute and relative differences in mortality risk for HIV/AIDS according to the socioeconomic characteristics of the area of patients' residence at the time of AIDS diagnosis. Therefore, it was not possible to determine the extent of mortality due to poor survival of people with HIV/AIDS versus differences in HIV incidence and prevalence by socioeconomic group.…”

Commentary: Thirty Years of AIDS in America: A Story of Infinite Hope

“…Rodrick and Deborah Wallace, who recognized and called attention to the complex interrelationship between social and community structures and the spread of AIDS (Wallace & Wallace, 1990). But, without question, as we seek to resolve health disparities in this fourth decade of the U.S. HIV/AIDS epidemic, it is apparent that the public health community has come to accept the reality that health inequities cannot be resolved without addressing fundamental social inequalities (CDC, 2011g;Rubin, Colen, & Link, 2009).…”