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Journal of Urban Health

, Volume 96, Issue 2, pp 149–158 | Cite as

Separate and Sick: Residential Segregation and the Health of Children and Youth in Metropolitan Statistical Areas

  • Jack A. Kotecki
  • Keith P. GennusoEmail author
  • Marjory L. Givens
  • David A. Kindig
Article

Abstract

The purpose of this study was to better understand residential segregation and child/youth health by examining the relationship between a measure of Black-White residential segregation, the index of dissimilarity, and a suite of child and youth health measures in 235 U.S. metropolitan statistical areas (MSAs). MSAs are urban areas with a population of 50,000 or more and adjacent communities that share a high degree of economic and social integration. MSAs are defined by the Office of Management and Budget. Health-related measures included child mortality (CDC WONDER), teen births (NCHS natality data), children in poverty (SAIPE program), and disconnected youth (Measure of America). Simple linear regression and two-level hierarchical linear regression models, controlling for income, total population, % Black, and census region, examined the association between segregation and Black health, White health, and Black-White disparities in health. As segregation increased, Black children and youth had worse health across all four measures, regardless of MSA total and Black population size. White children and youth in small MSAs with large Black populations had worse levels of disconnected youth and teen births with increasing segregation, but no associations were found for White children and youth in other MSAs. Segregation worsened Black-White health disparities across all four measures, regardless of MSA total and Black population size. Segregation adversely affects the health of Black children in all MSAs and White children in smaller MSAs with large Black populations, and these effects are seen in measures that span all of childhood. Residential segregation may be an important target to consider in efforts to improve neighborhood conditions that influence the health of families and children.

Keywords

Residential segregation Children Youth Health outcomes Metropolitan statistical areas Disparities 

Notes

Acknowledgments

This project was financially sponsored by the University of Wisconsin School of Medicine and Public Health, the Herman and Gwendolyn Shapiro Foundation, and the University of Wisconsin Department of Population Health Sciences. The sponsor played no role in the study design; in the collection, analysis, and interpretation of the data; in the writing of the article; or in the decision to submit it for publication.

Supplementary material

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References

  1. 1.
    Rossen LM, Schoendorf KC. Trends in racial and ethnic disparities in infant mortality rates in the United States, 1989–2006. Am J Public Health. 2014;104(8):1549–56.Google Scholar
  2. 2.
    National Center for Health S. Health, United States. In: Health, United States, 2015: with special feature on racial and ethnic health disparities. Hyattsville (MD): National Center for Health Statistics (US), 2016.Google Scholar
  3. 3.
    Zeng C, Wen W, Morgans AK, Pao W, Shu X-O, Zheng W. Disparities by race, age, and sex in the improvement of survival for major cancers. JAMA Oncology. 2015;1(1):88–96.Google Scholar
  4. 4.
    Centers for Disease Control and Prevention U. Health disparities experienced by black or African Americans—United States. MMWR: Morb Mortal Wkly Rep. 2005;54(1):1–3.Google Scholar
  5. 5.
    Diez Roux AV. Neighborhoods and health: where are we and were do we go from here? Rev Epidemiol Sante Publique. 2007;55(1):13–21.Google Scholar
  6. 6.
    Kawachi I, Berkman LF. Neighborhoods and health: Oxford, UK: Oxford University Press; 2003.Google Scholar
  7. 7.
    Massey DS, Denton NA. The dimensions of residential segregation. Social Forces. 1988;67(2):281–315.Google Scholar
  8. 8.
    Cutler David M, Glaeser Edward L, Vigdor Jacob L. The rise and decline of the American ghetto. J Polit Econ. 1999;107(3):455–506.Google Scholar
  9. 9.
    Kramer MR, Hogue CR. Is segregation bad for your health? Epidemiol Rev. 2009;31(1):178–94.Google Scholar
  10. 10.
    Williams DR. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001;116(5):404–16.Google Scholar
  11. 11.
    Schulz AJ, Williams DR, Israel BA, Lempert LB. Racial and spatial relations as fundamental determinants of health in Detroit. The Milbank Quarterly. 2002;80(4):677–707.Google Scholar
  12. 12.
    Mays VM, Cochran SD, Barnes NW. Race, race-based discrimination, and health outcomes among African Americans. Annu Rev Psychol. 2007;58(1):201–25.Google Scholar
  13. 13.
    Massey DS, Rothwell J, Domina T. The changing bases of segregation in the United States. Ann Am Acad Polit Soc Sci. 2009;626(1):74–90.Google Scholar
  14. 14.
    Bird ST. Separate black and white infant mortality models: differences in the importance of structural variables. Soc Sci Med. 1995;41(11):1507–12.Google Scholar
  15. 15.
    Polednak AP. Black-white differences in infant mortality in 38 standard metropolitan statistical areas. Am J Public Health. 1991;81(11):1480–2.Google Scholar
  16. 16.
    LaVeist TA. Segregation, poverty, and empowerment: health consequences for African Americans. The Milbank Quarterly. 1993;71:41–64.Google Scholar
  17. 17.
    Collins CA. Racism and health: segregation and causes of death amenable to medical intervention in major U.S. cities. Ann N Y Acad Sci. 1999;896(1):396–8.Google Scholar
  18. 18.
    Hart KD, Kunitz SJ, Sell RR, Mukamel DB. Metropolitan governance, residential segregation, and mortality among African Americans. Am J Public Health. 1998;88(3):434–8.Google Scholar
  19. 19.
    Jackson SA, Anderson RT, Johnson NJ, Sorlie PD. The relation of residential segregation to all-cause mortality: a study in black and white. Am J Public Health. 2000;90(4):615–7.Google Scholar
  20. 20.
    Polednak AP. Poverty, residential segregation, and black/white mortality ratios in urban areas. J Health Care Poor Underserved. 1993;4(4):363–73.Google Scholar
  21. 21.
    Osypuk TL, Acevedo-Garcia D. Are racial disparities in preterm birth larger in Hypersegregated areas? Am J Epidemiol. 2008;167(11):1295–304.Google Scholar
  22. 22.
    Ig E. Is segregation bad for your health? The case of low birth weight [with comments]. Brookings-Wharton Papers on Urban Affairs. 2000;203Google Scholar
  23. 23.
    Grady SC. Racial disparities in low birthweight and the contribution of residential segregation: a multilevel analysis. Soc Sci Med. 2006;63(12):3013–29.Google Scholar
  24. 24.
    Bell JF, Zimmerman FJ, Almgren GR, Mayer JD, Huebner CE. Birth outcomes among urban African-American women: a multilevel analysis of the role of racial residential segregation. Soc Sci Med. 2006;63(12):3030–45.Google Scholar
  25. 25.
    Masi CM, Hawkley LC, Harry Piotrowski Z, Pickett KE. Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population. Soc Sci Med. 2007;65(12):2440–57.Google Scholar
  26. 26.
    Fang J, Madhavan S, Bosworth W, Alderman MH. Residential segregation and mortality in New York City. Soc Sci Med. 1998;47(4):469–76.Google Scholar
  27. 27.
    Hutchinson RN, Putt MA, Dean LT, Long JA, Montagnet CA, Armstrong K. Neighborhood racial composition, social capital and black all-cause mortality in Philadelphia. Soc Sci Med. 2009;68(10):1859–65.Google Scholar
  28. 28.
    Inagami S, Borrell LN, Wong MD, Fang J, Shapiro MF, Asch SM. Residential segregation and Latino, Black and White mortality in New York City. J Urban Health. 2006;83(3):406–20.Google Scholar
  29. 29.
    Acevedo-Garcia D, McArdle N, Osypuk T, Lefkowitz B, Krimgold B. Children left behind. Boston, MA: Center for Advancement of Health at Harvard School of Public Health;2007.Google Scholar
  30. 30.
    Phillips DA, Shonkoff JP. From neurons to neighborhoods: the science of early childhood development: Washington, DC: National Academies Press; 2000.Google Scholar
  31. 31.
    Francesconi M. Adult outcomes for children of teenage mothers. Scand J Econ. 2008;110(1):93–117.Google Scholar
  32. 32.
    Wood D. Effect of child and family poverty on child health in the United States. Pediatrics. 2003;112(3 Part 2):707–11.Google Scholar
  33. 33.
    Lewis K, Burd-Sharps S. Zeroing in on place and race. Brooklyn, NY: Measure of America, 2015.Google Scholar
  34. 34.
    Besharov DJ, Gardiner KN. Preventing youthful disconnectedness. Child Youth Serv Rev. 1998;20(9):797–818.Google Scholar
  35. 35.
    Tandon SD, Marshall B, Templeman AJ, Sonenstein FL. Health access and status of adolescents and young adults using youth employment and training programs in an urban environment. J Adolesc Health. 43(1):30–7.Google Scholar
  36. 36.
    Vancea M, Utzet M. How unemployment and precarious employment affect the health of young people: a scoping study on social determinants. Scand J Public Health. 2017;45(1):73–84.Google Scholar
  37. 37.
    Morrell SL, Taylor RJ, Jobless KCB. Unemployment and young people’s health. Med J Aust. 1998;168(5):236–40.Google Scholar
  38. 38.
    Office of Management and Budget. 2010 standards for delineating metropolitan and micropolitan statistical areas. Fed Regist. 2010;75(23):37245–52.Google Scholar
  39. 39.
    Osypuk TL, Galea S. What level macro? Choosing appropriate levels to assess how place influences population health. In: Macrosocial determinants of population health. p. 399–435.Google Scholar
  40. 40.
    Powell LM, Chaloupka FJ, Bao Y. The availability of fast-food and full-service restaurants in the United States: associations with neighborhood characteristics. Am J Prev Med. 2007;33(4, Supplement):S240–5.Google Scholar
  41. 41.
    Powell LM, Slater S, Chaloupka FJ, Harper D. Availability of physical activity-related facilities and neighborhood demographic and socioeconomic characteristics: a national study. Am J Public Health. 2006;96(9):1676–80.Google Scholar
  42. 42.
    Powell LM, Slater S, Mirtcheva D, Bao Y, Chaloupka FJ. Food store availability and neighborhood characteristics in the United States. Prev Med. 2007;44(3):189–95.Google Scholar
  43. 43.
    Nelson A. Unequal treatment: confronting racial and ethnic disparities in health care. J Natl Med Assoc. 2002;94(8):666–8.Google Scholar
  44. 44.
    Bach PB, Pham HH, Schrag D, Tate RC, Hargraves JL. Primary care physicians who treat blacks and whites. N Engl J Med. 2004;351(6):575–84.Google Scholar
  45. 45.
    Lurie N, Buntin MB. Health disparities and the quality of ambulatory care. N Engl J Med. 2002;347(21):1709–10.Google Scholar
  46. 46.
    Smith DB, Feng Z, Fennell ML, Zinn JS, Mor V. Separate and unequal: racial segregation and disparities in quality across U.S. nursing homes. Health Aff. 2007;26(5):1448–58.Google Scholar
  47. 47.
    Morello-Frosch R, Shenassa ED. The environmental ‘riskscape’ and social inequality: implications for explaining maternal and child health disparities. Environ Health Perspect. 2006;114(8):1150–3.Google Scholar
  48. 48.
    Morello-Frosch R, Lopez R. The riskscape and the color line: examining the role of segregation in environmental health disparities. Environ Res. 2006;102(2):181–96.Google Scholar
  49. 49.
    Chang VW. Racial residential segregation and weight status among US adults. Soc Sci Med. 2006;63(5):1289–303.Google Scholar
  50. 50.
    Bower KM, Thorpe RJ, Yenokyan G, McGinty EEE, Dubay L, Gaskin DJ. Racial residential segregation and disparities in obesity among women. J Urban Health. 2015;92(5):843–52.Google Scholar
  51. 51.
    Hunt MO, Wise LA, Jipguep M-C, Cozier YC, Rosenberg L. Neighborhood racial composition and perceptions of racial discrimination: evidence from the black women’s health study. Soc Psychol Q. 2007;70(3):272–89.Google Scholar
  52. 52.
    LaVeist TA. Segregation, poverty, and empowerment: health consequences for African Americans. The Milbank Quarterly. 1993;71(1):41–64.Google Scholar
  53. 53.
    LaVeist TA. The political empowerment and health status of African-Americans: mapping a new territory. Am J Sociol. 1992;97(4):1080–95.Google Scholar
  54. 54.
    Clampet-Lundquist S, Massey Douglas S. Neighborhood effects on economic self-sufficiency: a reconsideration of the moving to opportunity experiment. Am J Sociol. 2008;114(1):107–43.Google Scholar
  55. 55.
    Acevedo-Garcia D, Osypuk TL, McArdle N, Williams DR. Toward a policy-relevant analysis of geographic and racial/ethnic disparities in child health. Health Aff. 2008;27(2):321–33.Google Scholar

Copyright information

© The New York Academy of Medicine 2018

Authors and Affiliations

  1. 1.University of Wisconsin School of Medicine and Public HealthMadisonUSA
  2. 2.University of Wisconsin Population Health InstituteMadisonUSA

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