Spatial Context and Health Inequity: Reconfiguring Race, Place, and Poverty

Abstract

Intimate connections among race, place, and poverty are increasingly featured in the health disparities literature. However, few models exist that can guide our understanding of these interconnections. We build on the Chicago School of Sociology’s contributions in urban research and one of its contemporary elaborations, often described as the “neighborhood effects approach,” to propose a three-axis model of health inequity. This model, in alignment with Chicago School theory, postulates a dynamic and adaptive relationship between spatial context and health inequity. Compositional axes of race and poverty form the foundation of the model. These compositional axes then intersect with a third axis of place to compose the built and social environment planes. We develop this model to provide conceptual guidance for clinical, policy, and public health researchers who aim to examine how these three features, taken together, have important implications for urban health.

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Acknowledgements

This manuscript was supported by the Chicago Center for Diabetes Translation Research (CCDTR), NIDDK grant P30DK092949. E. Tung was also supported by the AHRQ Patient-Centered Outcomes Research (PCOR) Institutional Mentored Career Development Program (K12), AHRQ grant 5K12HS023007. E. Tung takes full responsibility for the integrity of this manuscript.

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Respective author contributions are as follows: Manuscript concept and design: E. Tung and M. Chin. Drafting of the manuscript: E. Tung and M. Chin. Critical revision of the manuscript for important intellectual content: All authors. Administrative, technical, or material support: M. Chin. Supervision: M. Chin and M. Peek. Final approval of the version to be published: All authors.

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Correspondence to Elizabeth L. Tung.

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Tung, E.L., Cagney, K.A., Peek, M.E. et al. Spatial Context and Health Inequity: Reconfiguring Race, Place, and Poverty. J Urban Health 94, 757–763 (2017). https://doi.org/10.1007/s11524-017-0210-x

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Keywords

  • Health inequity
  • Health disparities
  • Racial and ethnic disparities
  • Chronic disease
  • Place
  • Neighborhood effects
  • Urban sociology