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This study emphasizes the role that inequalities in social and economic determinants, rather than for example poverty on its own, play in Black/White diabetes mortality disparities. Data were not available at the city-level for Honolulu CDP, HI Louisville/Jefferson County, KY and Nashville/Davidson, TN. Adjusting for Black/White poverty and segregation explained 72.6 % of the disparity. The 50 most populous US cities were identified for inclusion in this analysis using Census data (American Community Survey (ACS) 2005-2007 3-year estimates).22 Nine cities were excluded. A closer look at every one of the countrys biggest cities are available below. The biggest city in the US by population is New York, followed by Los Angeles and Chicago. For more information on how we rank, read the Best Places to Live methodology. Of the 50 US states, California and Texas are the two most populated. To make the top of the list, a place had to have good value, be a desirable place to live, have a strong job market and a high quality of life. Multivariate analyses showed that adjusting for Black/White poverty alone explained 58.5 % of the disparity. News analyzed the 150 most populous metro areas to find the best places to live. Analyses showed that economic inequality was strongly correlated with the diabetes mortality disparity, driven by differences in White poverty levels. Blacks had statistically significantly higher mortality rates compared to Whites in 39 of the 41 cities included in analyses, with statistically significant rate ratios ranging from 1.57 (95 % CI: 1.33-1.86) in Baltimore to 3.78 (95 % CI: 2.84-5.02) in Washington, DC. Findings In this cross-sectional study of more than 26 million death records during a 10-year period, city mortality rates differed widely as did inequities between Black and White populations. Multivariate analyses were conducted using negative binomial regression to examine how much of the disparity could be explained by these variables. Question How do all-cause mortality rates and racial inequities in rates vary across the 30 most populous US cities. Relationships between city-level diabetes mortality RRs and 12 ecological variables were explored using bivariate correlation analyses. This study presents and compares Black/White age-adjusted diabetes mortality rate ratios (RRs), calculated using national death files and census data, for the 50 most populous US cities. While studies have consistently shown that in the USA, non-Hispanic Blacks (Blacks) have higher diabetes prevalence, complication and death rates than non-Hispanic Whites (Whites), there are no studies that compare disparities in diabetes mortality across the largest US cities.