Date of Graduation


Document Type


Degree Type



Eberly College of Arts and Sciences


Sociology and Anthropology

Committee Chair

Jeralynn S Cossman

Committee Co-Chair

Douglas J Myers

Committee Member

Christopher P Scheitle


Sex-specific mortality rates have been found to differ across regions of the United States; however, these areas are typically the broad Census Bureau regions (i.e., Midwest, Northeast, South, and West) that do not consider sociological factors known to affect health. By testing the predictive capabilities of theoretically driven regional classifications distinguished at county-level, I explore whether there are more accurate ways of assessing mortality differences across the United States. Specifically, I use the US Census Bureau divisions and regional groupings produced by Joel Garreau (1981) and Colin Woodard (2011) to predict sex-specific, age-adjusted, all-cause mortality for 2008-2012 (centered on 2010). Garreau's Nine Nations of North America uses the economic activities and priorities of various regions to divide the US while Woodard's American Nations: A History of the Eleven Rival Regional Cultures of North America uses the historical settlement of the US to generate culturally different nations. I examine the mediating effects of several county-level contextual and demographic factors, health behavior characteristics (including smoking), and socioeconomic measures (including labor force participation). Results suggest that Woodard's "American Nations" slightly outperform the other regional classifications, but the differences are negligible once other mediating factors are taken into account. Findings demonstrate that daily smoking behavior is the strongest predictor of county-level mortality variation for males and females. Researchers and policymakers should continue to find ways to reduce smoking, particularly in the south.