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March 6, 1991

Are State Mortality Differences due to Migration From the Rust Belt?-Reply

Author Affiliations

Centers for Disease Control Atlanta, Ga

Centers for Disease Control Atlanta, Ga

JAMA. 1991;265(9):1112. doi:10.1001/jama.1991.03460090059027

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In Reply.—  In our comparison of measures of excess chronic disease mortality in the United States, we used age-specific mortality rates for each state (including the 50 states and Washington, DC) in 1986 (calculated from deaths and intercensal population estimates, both for 1986). We age-standardized rates to the 1980 US population because these data are widely available.In an earlier publication (MMWR. 1989;39:17-20), we computed the rates in each state in the same way, but age-standardized them to the 1986 US population. In changing the standard population, the ranking was unchanged for 33 states, changed one place for 12 states, and changed two places for six states. In changing from the 1980 to the 1986 standard, the 10 states with the highest rates remained the top 10, while one state was added (Kansas) and one was dropped (Colorado) from the lowest 10. As Dr Richter suggests, changes in rank reflect