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Among non-Hispanic black and white residents of New York City the association between birthplace by region (South, West/ Midwest, and Northeast) within the United States and mortality was determined by linking mortality records for 1988-1992 with the 1990 United States census data for New York City. Age-adjusted death rates computed by birthplace for blacks and whites were examined and also compared with total US data. The results indicate that death rates for New Yorkers generally exceed those of the United States overall, and black rates exceed those of whites. Moreover, Southern-born blacks have substantially higher death rates than do blacks born in the Northeast. The most striking variations are for cancer and diseases of the heart. Deaths from AIDS and homicide are higher among blacks than among whites, but the rates for Southern-born blacks do not exceed those for Northeastern-born blacks. For whites those born in the South have higher death rates overall than those born in the Northeast, but differences in cause-specific mortality are less consistent than for blacks. The results reveal substantial heterogeneity of health status based on nativity, among blacks in particular. To understand the role of the related factors, both genetic and environmental, further population and epidemiologic studies are important