Widening Socioeconomic, Racial, and Geographic Disparities in HIV/AIDS Mortality in the United States, 1987–2011

Table 2

Weighted least squares regression models showing the impacts of the continuous socioeconomic deprivation index, urbanization level, primary medical care shortage areas, health uninsurance rate, and racial composition on county-level age-adjusted HIV/AIDS mortality rates, United States, 1992–1995 and 2003–2007 (N = 3141).

Covariate	Bivariate models					Multivariate models
	𝑏	β	t-stat.	P value	Adj. 𝑅^2	𝑏	β	t-stat.	P value	Adj. 𝑅^2
Total US population, 2003–2007
Socioeconomic deprivation index^1	−0.08	−0.31	−18.47	<0.001	9.81	−0.04	−0.17	−8.14	<0.001	53.53
Urbanization level^2	0.70	0.24	13.79	<0.001	5.69	0.62	0.21	13.9	<0.001
Health professional shortage area^3	2.81	0.20	11.24	<0.001	3.84	0.45	0.03	2.46	0.014
Health uninsurance rate^4	0.38	0.33	19.60	<0.001	10.91	0.10	0.08	4.72	<0.001
Percent of black population	0.28	0.69	53.34	<0.001	47.53	0.24	0.58	42.83	<0.001
Total black population, 2003–2007
Socioeconomic deprivation index	−0.16	−0.21	−11.67	<0.001	4.20	−0.09	−0.11	−3.83	<0.001	17.07
Urbanization level	1.87	0.18	10.11	<0.001	3.16	2.67	0.26	13.44	<0.001
Health professional shortage area	8.91	0.17	9.89	<0.001	3.02	3.14	0.06	3.54	<0.001
Health uninsurance rate	0.98	0.23	13.42	<0.001	5.49	0.41	0.10	4.05	<0.001
Percent of black population	0.29	0.31	17.83	<0.001	9.27	0.22	0.23	12.18	<0.001
Black male, 2003–2007
Socioeconomic deprivation index	−0.23	−0.23	−13.17	<0.001	5.32	−0.13	−0.13	−4.83	<0.001	24.50
Urbanization level	2.89	0.22	12.56	<0.001	4.83	4.03	0.31	16.86	<0.001
Health professional shortage area	12.78	0.20	11.19	<0.001	3.87	4.36	0.07	4.07	<0.001
Health uninsurance rate	1.38	0.26	15.00	<0.001	6.77	0.49	0.09	4.00	<0.001
Percent of black population	0.46	0.38	22.54	<0.001	14.11	0.36	0.29	16.24	<0.001
Black female, 2003–2007
Socioeconomic deprivation index	−0.11	−0.18	−9.97	<0.001	3.13	−0.06	−0.09	−3.03	0.002	11.13
Urbanization level	1.19	0.14	7.83	<0.001	1.92	1.76	0.21	10.52	<0.001
Health professional shortage area	5.86	0.14	8.06	<0.001	2.03	1.94	0.05	2.62	0.009
Health uninsurance rate	0.69	0.21	11.66	<0.001	4.24	0.34	0.10	4.00	<0.001
Percent of black population	0.18	0.24	13.50	<0.001	5.56	0.13	0.17	8.65	<0.001
Total US population, 1992–1995
Socioeconomic deprivation index	−0.11	−0.11	−6.41	<0.001	1.31	−0.07	−0.07	−2.95	0.003	30.85
Urbanization level	3.37	0.32	18.91	<0.001	10.35	3.18	0.30	15.39	<0.001
Health professional shortage area	10.49	0.20	11.29	<0.001	3.94	3.23	0.06	3.87	<0.001
Health uninsurance rate	1.26	0.30	17.47	<0.001	9.00	0.75	0.18	9.46	<0.001
Percent of black population	0.64	0.44	27.35	<0.001	19.48	0.45	0.31	18.49	<0.001
Total black population, 1992–1995
Socioeconomic deprivation index	−0.01	−0.01	−0.18	0.854	0.00	−0.05	−0.03	−0.93	0.352	17.61
Urbanization level	8.66	0.34	19.34	<0.001	11.38	9.68	0.38	18.32	<0.001
Health professional shortage area	23.26	0.17	9.08	<0.001	2.73	8.87	0.06	3.55	<0.001
Health uninsurance rate	1.90	0.18	9.78	<0.001	3.19	2.02	0.19	8.52	<0.001
Percent of black population	0.24	0.10	5.50	<0.001	1.00	0.13	0.05	2.72	<0.001
Black male, 1992–1995
Socioeconomic deprivation index	−0.03	−0.01	−0.48	0.631	0.01	−0.10	−0.03	−1.13	0.261	21.39
Urbanization level	14.94	0.37	21.27	<0.001	13.66	16.68	0.41	20.28	<0.001
Health professional shortage area	40.67	0.18	10.01	<0.001	3.36	15.59	0.07	4.12	<0.001
Health uninsurance rate	3.17	0.19	10.25	<0.001	3.56	3.07	0.18	8.36	<0.001
Percent of black population	0.56	0.15	7.93	<0.001	2.12	0.37	0.10	4.99	<0.001
Black female, 1992–1995
Socioeconomic deprivation index	−0.03	−0.03	−1.46	0.144	0.08	−0.07	−0.06	−2.02	0.044	10.58
Urbanization level	3.62	0.25	13.45	<0.001	6.04	4.38	0.30	13.67	<0.001
Health professional shortage area	9.25	0.12	6.14	<0.001	1.30	2.33	0.03	1.53	0.125
Health uninsurance rate	1.02	0.17	8.96	<0.001	2.79	1.07	0.18	7.41	<0.001
Percent of black population	0.23	0.10	5.22	<0.001	0.93	−0.02	−0.01	−0.56	0.574

Notes: 𝑏: unstandardized regression coefficient; β: standardized regression coefficient; 𝑅²: percentage variance explained.
β is also equal to the correlation coefficient in bivariate regression models.
¹The 1990 or 2000 census socioeconomic deprivation index is a continuous variable with a mean of 100 and a standard deviation of 20. Higher index scores denote higher levels of socioeconomic position and lower levels of deprivation.
²The 2003 rural-urban continuum is used as a continuous variable, with code 1 being the most rural county and code 9 being the most urbanized county.
³A county is designated as a health professional shortage area for primary medical care services if it has a population to primary care physician ratio of at least 3,500 : 1; the reference groups are counties designated as nonshortage areas.
⁴The percentage of population without health insurance in 2000.