Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US: a multilevel statistical analysis

Subramanian, S. V.; Acevedo‐García, Dolores; Osypuk, Theresa L.

doi:10.1016/j.socscimed.2004.08.040

Cited by 212 publications

(190 citation statements)

References 39 publications

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“…At the MSA-level of analysis, we controlled for the proportion of poor families in the MSA-a measure of area SES consistent with prior work. 43,44 Our findings were robust when this variable was removed from the models (results not shown), and we conclude that the results presented reflect the influence of segregation or other associated factors, over and above the influence of the proportion of poor families in the MSA. It should be noted that our poverty variable is distinct from other SES measures including economic segregation and income inequality, which we did not measure.…”

Section: Discussionsupporting

confidence: 55%

“…Isolation has been examined in prior segregation-health research 31 and has been associated with deleterious health outcomes in multilevel studies. [42][43][44] In contrast, clustering is rarely studied. In prior work, we found independent influences of isolation and clustering on birth outcomes and speculated that the geographic contiguity of minority group neighborhoods captured by clustering could reflect somewhat different health influences than those associated with isolation.…”

Section: Independent Variablesmentioning

confidence: 99%

“…34 Prior health studies have modeled segregation as a continuous variable, assuming a linear relationship. 43,44,[49][50][51][52] Here, we test the linearity assumption by modeling segregation in categories: low, moderate (reference group), and high. To account for differences in the distributions of isolation and clustering, the cut-points for the three categories were established by creating equal numbers of births in each group (i.e., the number of births in each of the three segregation categories was as equal as possible while assuring all births within a given MSA remained in the same category).…”

Section: Independent Variablesmentioning

confidence: 99%

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Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

et al. 2007

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Approximately 10% of African-American women smoke during pregnancy compared to 16% of White women. While relatively low, the prevalence of smoking during pregnancy among African-American women exceeds the Healthy People 2010 goal of 1%. In the current study, we address gaps in extant research by focusing on associations between racial/ethnic residential segregation and smoking during pregnancy among urban African-American women. We linked measures of segregation to birth certificates and data from the 2000 census in a sample of US-born AfricanAmerican women (n=403,842) living in 216 large US Metropolitan Statistical Areas (MSAs). Logistic regression models with standard errors adjusted for multiple individual observations within MSAs were used to examine associations between segregation and smoking during pregnancy and to control for important sociodemographic confounders. In all models, a u-shaped relationship was observed. Both low segregation and high segregation were associated with higher odds of smoking during pregnancy when compared to moderate segregation. We speculate that low segregation reflects a contagion process, whereby salutary minority group norms are weakened by exposure to the more harmful behavioral norms of the majority population. High segregation may reflect structural attributes associated with smoking such as less stringent tobacco control policies, exposure to urban stressors, targeted marketing of tobacco products, or limited access to treatment for tobacco dependence. A better understanding of both deleterious and protective contextual influences on smoking during pregnancy could help to inform interventions designed to meet Healthy People 2010 target goals.

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Section: Discussionsupporting

confidence: 55%

Section: Independent Variablesmentioning

confidence: 99%

Section: Independent Variablesmentioning

confidence: 99%

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Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

et al. 2007

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“…[69][70][71] A 2005 study showed that living in a city with a higher index of black isolation was significantly related to poor self-reported health among Black adults; White adults did not show significant health differences when living in cities with a higher index of white or black isolation, pointing to the disproportionate negative effects of segregation on the health of minority individuals. 72 Segregation also intensifies and concentrates the effects of mass incarceration in minority neighborhoods; this is especially true of the poorest Black neighborhoods in New York City. 38 Thus, residential segregation may be one aspect of social context that increases the prevalence of poverty, trauma, and violence in minority communities in NYC.…”

Section: Racism and The Historical Underpinnings Of The Syndemic Affementioning

confidence: 99%

Using Syndemic Theory to Understand Vulnerability to HIV Infection among Black and Latino Men in New York City

et al. 2014

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HIV is a public health crisis that disproportionately affects Black and Latino men. To understand this crisis, syndemic theory, which takes into account multiple interrelated epidemics, should be used. A syndemic is "two or more afflictions, interacting synergistically, contributing to excess burden of disease in a population." Vulnerability to HIV among Black and Latino men is increased as structural, social, and biological factors interact in the context of social marginalization. In New York City, Black and Latino men experience a syndemic of HIV/AIDS, substance abuse, trauma, incarceration, and poverty; however, current research has yet to fully identify the mechanisms of resilience that may reduce the negative impact of a syndemic or explore the potential adaptive functions of individual-level risk behaviors. To understand HIV risk as part of a syndemic and address HIV prevention in Black and Latino men, we propose the following: (1) the use of complex systems analysis, ethnography, and other mixed-methods approaches to observe changes in relations among social conditions and disease; (2) multidisciplinary and inter-institution collaboration; and (3) involvement of public health practitioners and researchers from diverse and underrepresented backgrounds.

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“…[13][14][15][16] In spite of the potential ramifications that gentrification carries onto health, no study to date has sought to untangle the complex relationships between gentrification and health using this method. Through hierarchical modeling, we answer the question of how an individual's race/ethnicity moderates the effects of neighborhood gentrification on their health.…”

Section: Introductionmentioning

confidence: 99%

The Association of Minority Self-Rated Health with Black versus White Gentrification

2016

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There exists controversy as to the impact gentrification of cities has on the well-being of minorities. Some accuse gentrification of causing health disparities for disadvantaged minority populations residing in neighborhoods that are changing as a result of these socioeconomic shifts. Past scholarship has suggested that fears of displacement and social isolation associated with gentrification lead to poorer minority health. However, there is a lack of research that directly links gentrification to minority health outcomes. We address this gap with individual data from the 2008 Philadelphia Health Management Corporation's Southeastern Pennsylvania Household Health Survey and census tract data from the 2000 Decennial Census and the 2006-2010 American Community Survey. We implement logistic multilevel models to determine whether and how a resident's self-rated health is affected by gentrification of their neighborhoods. We find that while gentrification does have a marginal effect improving self-rated health for neighborhood residents overall, it leads to worse health outcomes for Blacks. Accounting for racial change, while gentrification leading to increases in White population has no measurable effect on minority health, BBlack gentrificationl eads to marginally worse health outcomes for Black respondents. These results demonstrate the limitations that improvements of neighborhood socioeconomic character have in offsetting minority health disparities.

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Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US: a multilevel statistical analysis

Cited by 212 publications

References 39 publications

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

Associations Between Residential Segregation and Smoking During Pregnancy Among Urban African-American Women

Using Syndemic Theory to Understand Vulnerability to HIV Infection among Black and Latino Men in New York City

The Association of Minority Self-Rated Health with Black versus White Gentrification

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