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Abstract
The nature and extent of spatial variations in sex‐specific cardiovascular mortality rates and sex mortality ratios are examined at the county level for the United States. The southeastern United States has the highest mortality rates for both males and females, while the central United States has the highest sex mortality ratios. When mortality is aggregated by levels of urbanization and types of migration for the United States as a whole, the pattern of relationship varies. The lowest rates for both sexes are found in large urban in‐migration counties, while large urban out‐migration counties have the lowest sex mortality ratio. The highest rates for males are in rural out‐migration areas and for females in large urban out‐migration areas. The highest sex mortality ratio occurs in rural in‐migration counties. The decomposition of sex differentials in sex‐specific mortality indicates that the sex mortality ratio is primarily a function of female mortality.