Local Residential Segregation Matters: Stronger Association of Census Tract Compared to Conventional City-Level Measures with Fatal and Non-Fatal Assaults (Total and Firearm Related), Using the Index of Concentration at the Extremes (ICE) for Racial, Economic, and Racialized Economic Segregation, Massachusetts (US), 1995–2010

Abstract

Research on residential segregation and health, primarily conducted in the USA, has chiefly employed city or regional measures of racial segregation. To test our hypothesis that stronger associations would be observed using local measures, especially for racialized economic segregation, we analyzed risk of fatal and non-fatal assault in Massachusetts (1995–2010), since this outcome is strongly associated with residential segregation. The segregation metrics comprised the Index of Concentration at the Extremes (ICE), the Index of Dissimilarity, and poverty rate, with measures computed at both the census tract and city/town level. Key results were that larger associations between fatal and non-fatal assaults and residential segregation occurred for models using the census tract vs. city/town measures, with the greatest associations observed for racialized economic segregation. For fatal assaults, comparing the bottom vs. top quintiles, the incidence rate ratio (and 95% confidence interval (CI)) in models using the census tract measures equaled 3.96 (95% CI 3.10, 5.06) for the ICE for racialized economic segregation, 3.26 (95% CI 2.58, 4.14) for the ICE for income, 3.14 (95% CI 2.47, 3.99) for poverty, 2.90 (95% CI 2.21, 3.81) for the ICE for race/ethnicity, and only 0.93 (95% CI 0.79, 1.11) for the Index of Dissimilarity; in models that included both census tract and city/town ICE measures, this risk ratio for the ICE for racialized economic segregation was higher at the census tract (3.29; 95% CI 2.43, 4.46) vs. city/town level (1.61; 95% CI 1.12, 2.32). These results suggest that, at least in the case of fatal and non-fatal assaults, research on residential segregation should employ local measures, including of racialized economic segregation, to avoid underestimating the adverse impact of segregation on health.

This is a preview of subscription content, access via your institution.

Fig. 1
Fig. 2

References

  1. 1.

    Piketty T. Capital in the Twenty-First Century. (transl. Arthur Goldhammer). Harvard University Press, Cambridge, MA: Harvard University Press; 2014.

  2. 2.

    Stiglitz JE. The Great Divide: Unequal Societies and What We Can Do About Them. New York, NY: W.W. Norton; 2015.

  3. 3.

    Walks A. From financialization to sociospatial polarization of the city? Evidence from Canada. Econ Geogr. 2013; 90: 33–66.

    Article  Google Scholar 

  4. 4.

    Bradby H, Frenz M, Snow S. Migration and danger: ethnicity and health. Ethn Health. 2016; 21: 333–339.

    Article  PubMed  Google Scholar 

  5. 5.

    Omi M, Winant H. Racial Formation in the United States. 3rd edition. New York, NY: Routledge; 2015.

  6. 6.

    Krieger N. Discrimination and health inequities. In: Berkman LF, Kawachi I, Glymour M, editors. Social Epidemiology. 2nd ed. New York, NY: Oxford University Press; 2014. p. 63–125; reprinted as: Krieger N. Discrimination and health inequities. Int J Health Services 2014; 44:643–710.

  7. 7.

    Iceland J, Weinberg DH, Steinmetz E. Racial and ethnic residential segregation in the United States: 1980–2000. Census 2000 Special Report. US Census Bureau, Washington, DC: US Census Bureau, 2002. http://www.census.gov/prod/2002pubs/censr-3.pdf . Accessed 20 November 2016.

  8. 8.

    Kramer M, Hogue C. Is segregation bad for your health? Epidemiol Rev. 2009; 31: 178–194.

    Article  PubMed  PubMed Central  Google Scholar 

  9. 9.

    White K, Borrell LN. Racial/ethnic residential segregation: framing the context of health risk and health disparities. Health Place. 2011; 17: 438–448.

    Article  PubMed  Google Scholar 

  10. 10.

    Acevedo-Garcia D, Lochner KA, Osypuk TL, et al. Future directions in residential segregation and health research: a multilevel approach. Am J Public Health. 2003; 93: 215–221.

    Article  PubMed  PubMed Central  Google Scholar 

  11. 11.

    Williams DR, Collins C. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001; 116: 404–416.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Watson T. Inequality and the measurement of residential segregation by income in American neighborhoods. Rev Income Wealth. 2009; 55: 820–844.

    Article  Google Scholar 

  13. 13.

    Waitzman NJ, Smith KR. Separate but lethal: the effects of economic segregation on mortality in metropolitan America. Milbank Q. 1998; 76: 341–373.

    CAS  Article  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Massey DS. The prodigal paradigm returns: ecology comes back to sociology. In: Booth A, Crouter A, eds. Does It Take a Village? Community Effects on Children, Adolescents, and Families. Mahwah, NJ: Lawrence Erlbaum Associates; 2001: 41–48.

    Google Scholar 

  15. 15.

    Doh DP, Dubowitz T, Bird CE, et al. Neighborhood context and ethnicity differences in body mass index: a multilevel analysis using the NHANES III survey (1988–1994). Econ Hum Biol. 2007; 5: 179–203.

    Article  Google Scholar 

  16. 16.

    Carpiano RM, Lloyd JEV, Hertzman C. Concentrated affluence, concentrated disadvantage, and children’s readiness for school: a population-based, multi-level investigation. Soc Sci Med. 2009; 69: 420–432.

    Article  PubMed  Google Scholar 

  17. 17.

    Finch BK, Do DP, Heron M, et al. Neighborhood effects on health: concentrated advantage and disadvantage. Health Place. 2010; 16: 1058–1060.

    Article  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Casciano R, Massey DS. Neighborhood disorder and anxiety symptoms: new evidence from a quasi-experimental study. Health Place. 2012; 18: 180–190.

    Article  PubMed  Google Scholar 

  19. 19.

    Krieger N, Waterman PD, Gryparis A, et al. Black carbon exposure, socioeconomic and racial/ethnic spatial polarization, and the Index of Concentration at the Extremes (ICE). Health Place. 2015; 34: 215–228.

    Article  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Feldman J, Waterman PD, Coull BA, et al. Spatial social polarization: using the index of concentration at the extremes jointly for income and race/ethnicity to analyze risk of hypertension. J Epidemiol Community Health. 2015; 69: 1199–1207.

    Article  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Krieger N, Waterman PD, Spasojevic J, et al. Public health monitoring of privilege and deprivation using the Index of Concentration at the Extremes (ICE). Am J Public Health. 2016; 106: 256–263.

    Article  PubMed  PubMed Central  Google Scholar 

  22. 22.

    Krivo LJ, Bryon RA, Calder CA, Peterson RD, Browing CR, Kwan M-P, Lee JY. Patterns of local segregation: do they matter for neighborhood crime? Soc Sci Res. 2015; 54: 303–318.

    Article  PubMed  Google Scholar 

  23. 23.

    Debbink MP, Bader MDM. Racial residential segregation and low birth weight in Michigan’s metropolitan areas. Am J Public Health. 2011; 101: 1714–1720.

    Article  PubMed  PubMed Central  Google Scholar 

  24. 24.

    Grady SC. Racial disparities in low birthweight and the contribution of residential segregation: a multilevel analysis. Soc Sci Med. 2006; 63: 3013–3029.

    Article  PubMed  Google Scholar 

  25. 25.

    Wong DWS. Modeling local segregation: a spatial interaction approach. Geogr Environ Model. 2002; 6: 81–97.

    Article  Google Scholar 

  26. 26.

    Hemenway D. Private Guns Public Health. Ann Arbor, MI: University of Michigan Press; 2006.

    Google Scholar 

  27. 27.

    Fabio A, Sauber-Schatz EK, Barbour KE, et al. The association between county-level injury rates and racial segregation revisited: a multilevel analysis. Am J Public Health. 2009; 99: 748–753.

    Article  PubMed  PubMed Central  Google Scholar 

  28. 28.

    Massey DS. Getting away with murder: segregation and violent crime in urban America. Univ Penn Law Rev. 1995; 143: 1203–1232.

    Article  Google Scholar 

  29. 29.

    Eitle D, D’Alessio SJ, Stolzenberg L. Economic segregation, race, and homicide. Soc Sci Q. 2006; 87: 638–657.

    Article  Google Scholar 

  30. 30.

    Massachusetts Department of Public Health (MDPH). Injury Surveillance Program. Weapon-related injuries to Massachusetts Residents, 1994–2007. Findings from the Weapon Related Injury Surveillance System (WRISS). Boston, MA: MDPH, 2009.

  31. 31.

    Krieger N. Epidemiology and The People’s Health: Theory and Context. New York, NY: Oxford University Press; 2011.

  32. 32.

    Massachusetts Department of Public Health. Registry of vital records. http://www.mass.gov/eohhs/gov/departments/dph/programs/admin/dmoa/vitals/ . Accessed 20 November 2016.

  33. 33.

    Massachusetts Department of Public Health (MDPH). Violent Deaths in Massachusetts: Surveillance Update 2009. Boston, MA: MDPH; 2012. http://www.mass.gov/eohhs/docs/dph/injury-surveillance/violentdeaths/violent-death-report-09.pdf. Accessed 20 November 2016.

  34. 34.

    Massachusetts Department of Public Health. Weapons Related Injury Surveillance System (WRISS). http://www.mass.gov/eohhs/gov/departments/dph/programs/community-health/injury-surveillance/reports/weapon-related-injury-surveillance-system.html. Accessed 20 November 2016.

  35. 35.

    Clauss KS. Massachusetts has some of the worst income inequality in America. Boston Magazine, June 16, 2016. http://www.bostonmagazine.com/news/blog/2016/06/16/massachusetts-income-inequality/. Accessed 20 November 2016.

  36. 36.

    Scharfenberg D. Boston’s struggle with income segregation. Boston Globe, March 6, 2016. https://www.bostonglobe.com/metro/2016/03/05/segregation/NiQBy000TZsGgLnAT0tHsL/story.html. Accessed 20 November 2016.

  37. 37.

    Logan JR, Stults B. The Persistence of Segregation in the Metropolis: New Findings from the 2010 Census. Census Brief prepared for Project US2010; 2011. http://parcwbcit.ad.brown.edu/Projects/Diversity/Projects/Reports.htm . Accessed 20 November 2016.

  38. 38.

    International Classification of Diseases, 2007. http://www.wolfbane.com/icd/index.html Accessed 20 November 2016.

  39. 39.

    ArcGIS, Version 10.3. http://www.esri.com/software/arcgis . Accessed 20 November 2016.

  40. 40.

    Geolytics. Census 1990, 2000, Census 2010/ACS, and Neighborhood Change Data Base. http://www.geolytics.com Accessed 20 November 2016.

  41. 41.

    US Census Bureau. American Community Survey, 2006–2010. http://www.census.gov/programs-surveys/acs/ . Accessed 20 November 2016.

  42. 42.

    US Census Bureau. American Fact Finder. Decennial Census. http://factfinder.census.gov/faces/nav/jsf/pages/index.xhtml . Accessed 20 November 2016.

  43. 43.

    US Census Bureau. How the US Census measures poverty; 2016. http://www.census.gov/hhes/www/poverty/about/overview/measure.html . Accessed 20 November 2016.

  44. 44.

    Krieger N, Chen JT, Waterman PD, et al. Painting a truer picture of US socioeconomic and racial/ethnic health inequalities: The Public Health Disparities Geocoding Project. Am J Public Health. 2005; 95: 312–323.

    Article  PubMed  PubMed Central  Google Scholar 

  45. 45.

    Kramer M. Some thoughts on measuring place and health. Presentation at Health Places Research Group, Georgia Institute of Technology, 2013. http://www.cqgrd.gatech.edu/sites/files/cqgrd/measuringneighborhoods_march2013.pdf. Accessed 20 November 2016.

  46. 46.

    US Census Bureau. Historical income data: households. Table H-1. Income limits for each fifth and top 5 percent. All races; 2016. https://www.census.gov/hhes/www/income/data/historical/household/ . Accessed 20 November 2016.

  47. 47.

    Catlin B, Jovaag A, Van Dijik Willems J. 2015 County Health Rankings Key Findings Report. Robert Wood Johnson Foundation, 2015. http://www.countyhealthrankings.org/sites/default/files/resources/CHR%26R%202015%20Key%20Findings.pdf. Accessed 20 November 2016.

  48. 48.

    Massey DS. Reflections on the dimensions of segregation. Soc Forces. 2012; 91: 39–43.

    Article  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Massey DS, Denton NA. American Apartheid: Segregation and the Making of the Underclass. Cambridge, MA: Harvard University Press; 1993.

    Google Scholar 

  50. 50.

    Massey DS, Brodmann S. Spheres of Influence: The Social Ecology of Racial and Class Inequality. New York, NY: Russell Sage Foundation; 2014.

  51. 51.

    Fisher GM. The development and history of poverty thresholds. Soc Secur Bull. 1992; 55: 3–14.

    CAS  PubMed  Google Scholar 

  52. 52.

    O’Connor A. Poverty Knowledge: Social Science, Social Policy, and the Poor in Twentieth-Century U.S. History. Princeton University Press, Princeton, NJ: Princeton University Press, 2001.

  53. 53.

    US Census Bureau. Poverty areas. June 1995. https://www.census.gov/population/socdemo/statbriefs/povarea.html . Accessed 20 November 2016.

  54. 54.

    Bishaw A. Changes in areas with concentrated poverty: 2000 to 2010. American Community Survey Reports. June 2014. http://www.census.gov/content/dam/Census/library/publications/2014/acs/acs-27.pdf. Accessed 20 November 2016.

  55. 55.

    Casciano R, Massey DS. Neighborhoods, employment, and welfare use: assessing the influence of neighborhood socioeconomic composition. Soc Sci Res. 2008; 37(2): 544–558.

    Article  PubMed  PubMed Central  Google Scholar 

  56. 56.

    Kubrin CE, Stewart EA. Predicting who reoffends: the neglected role of neighborhood context in recidivism studies. Criminology. 2006; 44: 165–198.

    Article  Google Scholar 

  57. 57.

    Sampson RJ, Mare RD, Perkins KL. Achieving the middle ground in an age of concentrated extremes: mixed middle-income neighborhoods and emerging adulthood. Ann AAPS. 2015; 660: 156–174.

    Article  Google Scholar 

  58. 58.

    Rudolph AE, Crawford ND, Latkin C, et al. Individual and neighborhood correlates of membership in drug using networks with a higher prevalence of HIV in New York City (2006–2009). Ann Epidemiol. 2013; 23: 267–274.

    Article  PubMed  PubMed Central  Google Scholar 

  59. 59.

    Eastwood JG, Jalaludin BB, Kemp LA, et al. Immigrant maternal depression and social networks. A multilevel Bayesian spatial logistic regression in South Western Sydney, Australia. Spatial Spatio-temporal Epi. 2013; 6: 49–58.

    Article  Google Scholar 

  60. 60.

    Baglivio MT, Wolff KT, Epps N, et al. Predicting adverse childhood experiences: the importance of neighborhood context in youth trauma among delinquent youth. Crime & Delinquency 2015 (published online before print); doi: 10.1177/0011128715570628

  61. 61.

    Chen JT. Multilevel and hierarchical models for disease mapping. In: Boscoe FP (ed). Geographic health data: fundamental techniques for analysis. CABI, Oxfordshire, UK: CABI; 2013. pp. 183–208.

  62. 62.

    Lawson A, Browne WJ, Vidal Rodeiro CL. Disease Mapping with WinBUGS and MLwiN. Chichester, UK: John Wiley & Sons; 2003.

    Book  Google Scholar 

  63. 63

    King G, Honaker J, Joseph A, Scheve K. Analyzing incomplete political science data: an alternative algorithm for multiple imputation. Am Polit Sci Rev. 2001; 95: 49–69.

    Google Scholar 

  64. 64

    Bates D, Maechler M, Bolker B, et al. lme4: Linear mixed-effects models using Eigen and S4. R package version 1.1-7, 2014. https://cran.r-project.org/web/packages/lme4/index.html Accessed 20 November 2016.

  65. 65.

    CDC Wonder. Bridged-race population estimates. http://wonder.cdc.gov/bridged-race-population.html. Accessed 20 November 2016.

  66. 66

    Dankwa-Mullan I, Pérez-Stable EJ. Addressing health disparities is a place-based issue. Am J Public Health. 2016; 106: 637–639.

    Article  PubMed  Google Scholar 

  67. 67

    Vélez MB, Lyons CJ, Santoro WA. The political context of the percent black-neighborhood violence link: a multilevel analysis. Soc Probl. 2015; 61: 93–119.

    Article  Google Scholar 

  68. 68

    Webster DW, Cerdá M, Wintemute GJ, Cook PJ. Epidemiologic evidence to guide the understanding and prevention of gun violence. Epidemiol Rev. 2016; 38: 1–4.

    Article  PubMed  Google Scholar 

  69. 69

    Villanueva K, Badland H, Kvalsvig A, O’Connor M, Christian H, Woolcock G, Giles-Corti B, Goldfeld S. Can the neighborhood built environment make a difference in children’s development? Building the research agenda to create evidence for place-based children’s policy. Acad Pediatr. 2016; 16: 10–19.

    Article  PubMed  Google Scholar 

  70. 70

    Newman L, Baum F, Javanparast S, O’Rourke K, Carlon. Addressing social determinants of health inequities through settings: a rapid review. Health Promot Int. 2015; 30(S2): ii26–ii43.

    Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Nancy Krieger.

Ethics declarations

Funding

This work was supported by the McLennan Family Fund—Dean’s Challenge Grant Program on “Race, Ethnicity and Health” of the Harvard T.H. Chan School of Public Health (Boston, MA, USA). The funder had no role in the design of the study or in the collection, analysis, and interpretation of the data, or in the writing of the manuscript.

Electronic Supplementary Material

Below is the link to the electronic supplementary material.

ESM 1

(PDF 735 kb)

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Krieger, N., Feldman, J.M., Waterman, P.D. et al. Local Residential Segregation Matters: Stronger Association of Census Tract Compared to Conventional City-Level Measures with Fatal and Non-Fatal Assaults (Total and Firearm Related), Using the Index of Concentration at the Extremes (ICE) for Racial, Economic, and Racialized Economic Segregation, Massachusetts (US), 1995–2010. J Urban Health 94, 244–258 (2017). https://doi.org/10.1007/s11524-016-0116-z

Download citation

Keywords

  • Assault
  • Economic segregation
  • Income inequality
  • Index of Concentration at the Extremes
  • Firearm
  • Health inequities
  • Racial inequality
  • Racial segregation
  • Spatial polarization
  • Violence