TY - JOUR
T1 - Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US
T2 - A multilevel statistical analysis
AU - Subramanian, S. V.
AU - Acevedo-Garcia, Dolores
AU - Osypuk, Theresa L.
N1 - Copyright:
Copyright 2017 Elsevier B.V., All rights reserved.
PY - 2005/4
Y1 - 2005/4
N2 - Existing evidence demonstrating a relationship between racial residential segregation and health has been based on aggregate analysis. Using a multilevel analytical framework, we assess the extent of geographic variation in black/white disparities in self-rated health across US metropolitan areas, and whether racial residential segregation accounts for such variation. We estimated multilevel regression models of poor self-rated health among 51,316 non-Hispanic white and non-Hispanic black adults nested within 207 metropolitan areas to assess the multilevel relationship between segregation and racial disparities in health. We found statistically significant variation in the black/white disparity in poor self-rated health across metropolitan areas, after controlling for individual level factors (age, sex, marital status, education and income) and residential segregation. High black isolation was associated with increased odds of reporting poor health among blacks (p<0.05). While a similar pattern was observed for white/black dissimilarity and white isolation, they were not statistically significant. Our multilevel analysis only partially supports the previously reported aggregate findings linking segregation to health. Additional multilevel statistical investigations across different health outcomes are required to draw firmer conclusions regarding the adverse effects of segregation on health.
AB - Existing evidence demonstrating a relationship between racial residential segregation and health has been based on aggregate analysis. Using a multilevel analytical framework, we assess the extent of geographic variation in black/white disparities in self-rated health across US metropolitan areas, and whether racial residential segregation accounts for such variation. We estimated multilevel regression models of poor self-rated health among 51,316 non-Hispanic white and non-Hispanic black adults nested within 207 metropolitan areas to assess the multilevel relationship between segregation and racial disparities in health. We found statistically significant variation in the black/white disparity in poor self-rated health across metropolitan areas, after controlling for individual level factors (age, sex, marital status, education and income) and residential segregation. High black isolation was associated with increased odds of reporting poor health among blacks (p<0.05). While a similar pattern was observed for white/black dissimilarity and white isolation, they were not statistically significant. Our multilevel analysis only partially supports the previously reported aggregate findings linking segregation to health. Additional multilevel statistical investigations across different health outcomes are required to draw firmer conclusions regarding the adverse effects of segregation on health.
KW - Multilevel statistical approach
KW - Racial residential segregation
KW - Self-rated health
KW - US metropolitan statistical areas
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U2 - 10.1016/j.socscimed.2004.08.040
DO - 10.1016/j.socscimed.2004.08.040
M3 - Article
C2 - 15686800
AN - SCOPUS:15944429369
SN - 0277-9536
VL - 60
SP - 1667
EP - 1679
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - 8
ER -
