County-level basics of living affects overall mortality rate in the United States - 2000

Abraham Maslow's Hierarchy of Needs theory proposed that there is a hierarchy of human needs, which range from the basics of survival to creativity. Building from Maslow's idea, this paper examines the first level of human needs and empirically constructs a basics of living (BOL) index for every United States county from 28 candidate factors. The final BOL Index includes nine measures of air, water, and income. This study examined whether county-level health would be poor if the BOL were not met. Findings showed a positive correlation between the BOL index and all cause mortality, the fewer BOL, the worse the all cause mortality. Strikingly, poor BOL is most often found in small jurisdictions (<25,000 population) and less often in larger jurisdictions (>150,000 population). In the mapping of the BOL index, areas of greatest need can be observed and in multivariate modeling, highest overall mortality is regional. The BOL index predicts a substantial amount of variation observed in county overall mortality and is independent of county poverty and quality of life.