Segregation and Mortality: The Deadly Effects of Racism?

Elevated rates of mortality for African Americans compared to whites, coupled with the persistence of high levels of racial residential segregation, have directed attention to the structural manifestations of racism as potentially important pathogens for health. Using national mortality and census data for 1990 and a measure of black social isolation from whites, we examine the association between residential segregation and mortality in 107 major U.S. cities. Our analyses revealed that black social isolation tended to predict higher rates of mortality for African American males and females, although the strength of the association varied by cause of death. Socioeconomic deprivation explained a modest part of this association for black males but not for black females. Our analyses also found that a positive association between social isolation and mortality was more pronounced, for both blacks and whites, in cities that were also high on the index of dissimilarity. These findings highlight the need for research to identify the specific mechanisms and processes that link residential environments to adverse changes in health status.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45655/1/11206_2004_Article_411172.pd

An examination of the black-white adult mortality disparity: The role of residential segregation.

This research examined the extent to which multiple dimensions of racial residential segregation are associated with variations in mortality rates for black and white adults aged 15-64, and the mortality differential between them. Five residential segregation indicators were calculated based on block-group information from the 1990 U.S. Census: index of dissimilarity, isolation index, the spatial proximity index, the concentration index and the centralization index. These indices were combined with national mortality data. Mortality was classified into mortality linked to inadequate preventive medical care; curative medical intervention; and socioenvironmental factors. The units of analysis are cities with at least 100,000 persons and 10% African American. Our analyses reveal that the association between residential segregation and mortality varies by both the segregation indicator and type of mortality under consideration. Findings for three measures of residential segregation (unevenness, exposure and clustering) indicate that segregation is positively related to mortality for African Americans and whites. These indices, however, were only weakly associated with the racial gap in mortality. The remaining two indices, concentration and centralization, tended to be inversely related to mortality for both blacks and whites. That is, the rates of mortality for blacks and whites were lower in cities where blacks are geographically concentrated and where blacks reside in the center of the city compared to cities where blacks are geographically dispersed. All of the associations between segregation and mortality were strongest for causes of death linked to inadequate preventive care and for males compared to females. This study provides additional evidence that structural aspects of racism are consequential for health and highlights the need for future research that would seek to identify the intervening mechanisms and processes between residential segregation and mortality. Given that the impact of residential segregation is differentially linked to causes of death associated with inadequate preventive medical care, efforts designed to eliminate the negative effects of segregation and to understand and address potential deficiencies in the public health infrastructure should also be initiated.Ph.D.DemographyEthnic studiesHealth and Environmental SciencesPublic healthPublic policySocial SciencesUniversity of Michigan, Horace H. Rackham School of Graduate Studieshttp://deepblue.lib.umich.edu/bitstream/2027.42/129965/2/9711944.pd

US SOCIOECONOMIC AND RACIAL DIFFERENCES IN HEALTH: Patterns and Explanations

This chapter reviews recent studies of socioeconomic status (SES) and racial differences in health. It traces patterns of the social distribution of disease over time and describes the evidence for both a widening SES differential in health status and an increasing racial gap in health between blacks and whites due, in part, to the worsening health status of the African American population. We also describe variations in health status within and between other racial populations. The interactions between SES and race are examined, and we explore the link between health inequalities and socioeconomic ineqality both by examing the nature of the SES gradient and by identifying the determinants of the magnitude of SES disparities over time. We consider the ways in which major social structures and processes such as racism, acculturation, work, migration, and childhood SES produce inequalities in health. We also attend to the ways in which other intervening factors and resources are constrained by social structure. Measurement issues are addressed, and implications for health policy and future research are described

Advances in Communication Research to Reduce Childhood Obesity

XXXII, 544 p. 79 illus.online resource