Research

Geographic mortality and morbidity disparities in the US and Washington State: Migration, rurality, and wildfire smoke

David Coomes | 2026

Advisor: Steve J. Mooney

Research Area(s): Environmental & Occupational Health, Psychiatric Epidemiology, Social Determinants of Health

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This dissertation examined geographic all-cause and cause-specific mortality disparities in theUS and mental health disparities associated with wildfire-specific air pollution exposure in Washington State. Geographic analyses found that migration and rurality were associated with all-cause mortality, and migration, poverty, and rurality were associated with cause-specific mortality patterns in the US from 2000-2019. Higher county-level out migration was associated with higher age-adjusted mortality and with higher chronic mortality. County-level poverty rates were positively associated with mortality from all causes. In Washington, heavy wildfire air pollution led to increased visits to emergency departments with a mental health diagnosis between 2019 and 2023. The observed effects were strongest among men, those aged 26-45, and in urban areas.