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1.
medRxiv ; 2024 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-38947046

RESUMO

IMPORTANCE: Disparities in cognition, including dementia occurrence, persist between White and Black older adults, and are possibly influenced by early educational differences stemming from structural racism. However, the relationship between school racial segregation and later-life cognition remains underexplored. OBJECTIVE: To investigate the association between childhood contextual exposure to school racial segregation and cognitive outcomes in later life. DESIGN SETTING AND PARTICIPANTS: Data from 16,625 non-Hispanic White (hereafter, White) and 3,335 non-Hispanic Black (hereafter, Black) Americans aged 65 or older were analyzed from the Health and Retirement Study. EXPOSURES: State-level White-Black dissimilarity index for public elementary schools in the late 1960s (range: 0-100) was used to measure school segregation. States were categorized into high segregation (383.6) and low segregation (<83.6) based on the top quintile. MAIN OUTCOMES AND MEASURES: Cognitive scores, cognitive impairment (with or without dementia), and dementia were assessed using the Telephone Interview for Cognitive Status (TICS) and proxy assessment. Multilevel regression analyses were conducted, adjusting for demographic covariates, socioeconomic status, and health factors. Stratified analyses by race were performed. RESULTS: The mean (SD) age of participants was 78.5 (5.7) years, and 11,208 (56.2%) were female. Participants exposed to high segregation exhibited lower cognitive scores (12.6 vs. 13.6; P<0.001) and higher prevalence of cognitive impairment (50.8% vs 41.4%; P<0.001) and dementia (26.0% vs. 19.5%; P<0.001), compared to those with low segregation exposure. Multilevel analyses revealed a significant negative association between school segregation and later-life cognitive even after adjusting sequentially for potential confounders, and these associations were stronger among Black than White participants. Notably, in the fully adjusted model, Black participants exposed to high segregation displayed significantly lower cognitive scores (-0.51; 95% CI: -0.94, -0.09) and higher likelihood of cognitive impairment (adjusted Odds Ratio [aOR]: 1.45, 95% CI: 1.22, 1.72) and dementia (aOR: 1.31, 95% CI: 1.06, 1.63). CONCLUSIONS AND RELEVANCE: Our study underscores that childhood exposure to state-level school segregation is associated with late-life cognition, especially for Black Americans. Given the rising trend of school segregation in the US, educational policies aimed at reducing segregation are crucial to address health inequities. Clinicians can leverage patients' early-life educational circumstances to promote screening, prevention, and management of cognitive disorders.

2.
Proc Natl Acad Sci U S A ; 121(28): e2401661121, 2024 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-38950373

RESUMO

In US cities, neighborhoods have long been racially segregated. However, people do not spend all their time in their neighborhoods, and the consequences of residential segregation may be tempered by the contact people have with other racial groups as they traverse the city daily. We examine the extent to which people's regular travel throughout the city is to places "beyond their comfort zone" (BCZ), i.e., to neighborhoods of racial composition different from their own-and why. Based on travel patterns observed in more than 7.2 million devices in the 100 largest US cities, we find that the average trip is to a neighborhood less than half as racially different from the home neighborhood as it could have been given the city. Travel to grocery stores is least likely to be BCZ; travel to gyms and parks, most likely; however, differences are greatest across cities. For the first ~10 km people travel from home, neighborhoods become increasingly more BCZ for every km traveled; beyond that point, whether neighborhoods do so depends strongly on the city. Patterns are substantively similar before and after COVID-19. Our findings suggest that policies encouraging more 15-min travel-that is, to amenities closer to the home-may inadvertently discourage BCZ movement. In addition, promoting use of certain "third places" such as restaurants, bars, and gyms, may help temper the effects of residential segregation, though how much it might do so depends on city-specific conditions.


Assuntos
COVID-19 , Características de Residência , Humanos , COVID-19/epidemiologia , Características da Vizinhança , Cidades , Viagem/estatística & dados numéricos , Estados Unidos , Segregação Social , SARS-CoV-2 , Grupos Raciais/estatística & dados numéricos
3.
Soc Sci Res ; 121: 103025, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38871434

RESUMO

Today, black-owned banks are important financial resources challenging economic exclusion. Nevertheless, they do not associate strongly with building black wealth. Some scholars argue this signals black-owned banks are ornamental, or ineffective responses to legacies of economic exclusion in black segregated neighborhoods. To engage these critiques, I draw on the dialectical theoretical frames of cultural assets and structural deficits to examine the effectiveness of black-owned banks during the subprime lending boom-a period when bank practices exploiting a history of economic exclusion in black segregated neighborhoods intensify. Specifically, I analyze administrative data from the Federal Deposit Insurance Corporation (FDIC) and the Home Mortgage Disclosure Act (HMDA) to assess whether black-owned banks associate with access to mortgage credit when the subprime lending boom peaks in 2006. Using propensity score matching with inverse probability weighting, I find black-owned banks do not associate with mortgage originations in 2006; but neighborhoods with black-owned banks receive fewer subprime mortgage loans, compared to matched ones without them. As such, black-owned banks appear to effectively shield black segregated neighborhoods from the time period's predation. Overall, findings imply black-owned banks support protective credit markets during periods of intensifying economic exclusion and exploitation.

4.
Artigo em Inglês | MEDLINE | ID: mdl-38421509

RESUMO

INTRODUCTION: Most studies of the relationship between racial segregation and racial health disparities have focused on residential segregation. School-based racial segregation is an additional form of segregation that may be associated with racial disparities in health. This study examines the relationship between both residential segregation and school segregation and racial health disparities among non-Hispanic Black compared to non-Hispanic White persons at the county level in the United States. It also examines the relationship between changes in residential and school segregation and subsequent trajectories in a variety of racial health disparities across the life course. METHODS: Using the CDC WONDER Multiple Case of Death database, we derived an annual estimate of race-specific death rates and rate ratios for each county during the period 2000-2020. We then examined the relationship between baseline levels of residential and school segregation in 1991 as well as changes between 1991-2000 and the trajectories of the observed racial health disparities between 2000 and 2020. We used latent trajectory analysis to identify counties with similar patterns of residential and school segregation over time and to identify counties with similar trajectories in each racial health disparity. Outcomes included life expectancy, early mortality (prior to age 65), infant mortality, firearm homicide, total homicide, and teenage pregnancy rates. RESULTS: During the period 1991-2020, racial residential segregation remained essentially unchanged among the 1051 counties in our sample; however, racial school segregation increased during this period. Increases in school segregation from 1991 to 2000 were associated with higher racial disparities in each of the health outcomes during the period 2000-2020 and with less progress in reducing these disparities. CONCLUSION: This paper provides new evidence that school segregation is an independent predictor of racial health disparities and that reducing school segregation-even in the face of high residential segregation-could have a long-term impact on reducing racial health disparities. Furthermore, it suggests that the health consequences of residential segregation have not been eliminated from our society but are now being exacerbated by a new factor: school-based segregation. Throughout this paper, changes in school-based segregation not only show up as a consistent significant predictor of greater racial disparities throughout the life course, but at times, an even stronger predictor of health inequity than residential segregation.

5.
Health Place ; 83: 103089, 2023 09.
Artigo em Inglês | MEDLINE | ID: mdl-37557002

RESUMO

This scoping review summarized findings and key measures from U.S.-based studies that 1) examined associations between geographic indicators of structural racism (e.g., redlining, racial segregation) and access to food retailers (e.g., supermarkets, convenience stores) or 2) documented disparities in access by neighborhood racial/ethnic composition. In 2022, relevant scientific literature was reviewed using Covidence software. Independent reviewers examined 13,069 citations; 163 citations advanced to the full-text review stage and 70 were selected for inclusion. Twenty-one studies (30%) linked one or more indicator of structural racism to food retailer access while 49 (70%) solely examined differences in access by neighborhood racial/ethnic composition. All studies featuring indicators of structural racism reported significant findings; however, indicators varied across studies making it difficult to make direct comparisons. Key indicators of structural racism in the food access literature included redlining (n = 3), gentrification (n = 3), and racial segregation (n = 4). Many U.S.-based studies have evaluated food retailer access by neighborhood racial/ethnic composition. Moving forward, studies should model indicators of structural racism and determine their influence on geographic access to large and small food retailers.


Assuntos
Racismo , Segregação Social , Estados Unidos , Humanos , Racismo Sistêmico , Alimentos , Segregação Residencial
6.
Artigo em Inglês | MEDLINE | ID: mdl-37368191

RESUMO

INTRODUCTION: The food environment influences the availability and affordability of food options for consumers in a given neighborhood. However, disparities in access to healthy food options exist, affecting Black and low-income communities disproportionately. This study investigated whether racial segregation predicted the spatial distribution of supermarkets and grocery stores better than socioeconomic factors or vice versa in Cleveland, Ohio. METHOD: The outcome measure was the count of supermarket and grocery stores in each census tract in Cleveland. They were combined with US census bureau data as covariates. We fitted four Bayesian spatial models. The first model was a baseline model with no covariates. The second model accounted for racial segregation alone. The third model looked at only socioeconomic factors, and the final model combined both racial and socioeconomic factors. RESULTS: Overall model performance was better in the model that considered only racial segregation as a predictor of supermarkets and grocery stores (DIC = 476.29). There was 13% decrease in the number of stores for a census tract with a higher majority of Black people compared to areas with a lower number of Black people. Model 3 that considered only socioeconomic factors was less predictive of the retail outlets (DIC = 484.80). CONCLUSIONS: These findings lead to the conclusion that structural racism evidenced in policies like residential segregation has a significant influence on the spatial distribution of food retail in the city of Cleveland.

7.
J Law Med Ethics ; 51(1): 77-82, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37226753

RESUMO

The Supreme Court's decision in New York State Rifle & Pistol Association Inc. v. Bruen undermines the ability of cities and states to regulate firearms safety. Nonetheless, we remain hopeful that firearm violence can decline even after the Bruen decision. Several promising public health approaches have gained broader adoption in recent years. This essay examines the key drivers of community firearm violence and reviews promising strategies to reverse those conditions, including community violence intervention (CVI) programs and place-based and structural interventions.


Assuntos
Epidemias , Armas de Fogo , Violência com Arma de Fogo , New York/epidemiologia , Violência com Arma de Fogo/prevenção & controle , Decisões da Suprema Corte
8.
Lancet Reg Health Am ; 20: 100468, 2023 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-36992707

RESUMO

Background: Preventing HIV infection remains a critically important tool in the continuing fight against HIV/AIDS. The primary aim is to evaluate the effect and interactions between a composite area-level social determinants of health measure and an area-level measure of residential segregation on the risk of HIV/AIDS in U.S. Veterans. Methods: Using the individual-level patient data from the U.S. Department of Veterans Affairs, we constructed a case-control study of veterans living with HIV/AIDS (VLWH) and age-, sex assigned at birth- and index date-matched controls. We geocoded patient's residential address to ascertain their neighborhood and linked their information to two measures of neighborhood-level disadvantage: area deprivation index (ADI) and isolation index (ISOL). We used logistic regression to estimate the odds ratio (OR) and 95% confidence interval (CI) for comparing VLWH with matched controls. We performed analyses for the entire U.S. and separately for each U.S. Census division. Findings: Overall, living in minority-segregated neighborhoods was associated with a higher risk of HIV (OR: 1.88 (95% CI: 1.79-1.97) while living in higher ADI neighborhoods was associated with a lower risk of HIV (OR: 0.88; 95% CI: 0.84-0.92). The association between living in a higher ADI neighborhood and HIV was inconsistent across divisions, while living in minority-segregated neighborhoods was consistently associated with increased risk across all divisions. In the interaction model, individuals from low ADI and high ISOL neighborhoods had a higher risk of HIV in three divisions: East South Central; West South Central, and Pacific. Interpretation: Our results suggest that residential segregation may prevent people in disadvantaged neighborhoods from protecting themselves from HIV independent from access to health care. There is the need to advance knowledge about the neighborhood-level social-structural factors that influence HIV vulnerability toward developing interventions needed to achieve the goal of ending the HIV epidemic. Funding: US National Cancer Institute.

9.
J Adolesc Health ; 72(1): 27-35, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-35985915

RESUMO

PURPOSE: Suicide is an ongoing public health crisis among youth and adolescents, and few studies have investigated the spatial patterning in the United States among this subpopulation. Potential precursors to suicide in this vulnerable group are also on the rise, including nonfatal self-injury. METHODS: This study uses emergency department data, death certificates, and violent death reporting system data for North Carolina from 2009 to 2018 to investigate spatial clusters of self-injury and suicide. RESULTS: Findings show that the demographic characteristics of individuals committing fatal and nonfatal self-injury are quite different. Self-injury and completed suicides exhibited different geographical patterns. Area-level measures like micropolitan status and measures of racial and income segregation predicted the presence of high-risk suicide clusters. Suicides among Native Americans and veteran status/military personnel also were associated with higher risk suicide clusters. DISCUSSION: Future interventions should target these specific high-risk locations for immediate reductions in adolescent and youth suicides.


Assuntos
Suicídio , Adolescente , Adulto Jovem , Humanos , Estados Unidos , Homicídio , North Carolina/epidemiologia , Causas de Morte , Vigilância da População
10.
J Race Ethn City ; 3(1): 70-94, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35992214

RESUMO

Housing discrimination and racial segregation have a long history in the United States. The 1930's Home Owners' Loan Corporation (HOLC) "residential security maps," recently digitized, have become a popular visualization of Depression era mortgage lending risk patterns across American cities. Numerous housing policies have since been instituted, including the Home Mortgage Disclosure Act (HMDA), but mortgage lending bias persists. The degree to which detailed spatial patterns of bias have persisted or changed along with urban change is not well understood. We compare historic HOLC grades and contemporary levels of mortgage lending bias using spatially detailed HMDA data. We further examine the relationship between HOLC risk grades and contemporary racial and ethnic settlement patterns. Results suggest that historical mortgage lending risk categorizations and settlement patterns are associated with contemporary mortgage lending bias and racial and ethnic settlement patterns. Concerted and deliberate efforts will be needed to change these patterns.

11.
Circulation ; 146(3): 211-228, 2022 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-35861764

RESUMO

BACKGROUND: Black adults experience a disproportionately higher burden of cardiovascular risk factors and disease in comparison with White adults in the United States. Less is known about how sex-based disparities in cardiovascular mortality between these groups have changed on a national scale over the past 20 years, particularly across geographic determinants of health and residential racial segregation. METHODS: We used CDC WONDER (Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research) to identify Black and White adults age ≥25 years in the United States from 1999 to 2019. We calculated annual age-adjusted cardiovascular mortality rates (per 100 000) for Black and White women and men, as well as absolute rate differences and rate ratios to compare the mortality gap between these groups. We also examined patterns by US census region, rural versus urban residence, and degree of neighborhood segregation. RESULTS: From 1999 to 2019, age-adjusted mortality rates declined overall for both Black and White adults. There was a decline in age-adjusted cardiovascular mortality among Black (602.1 to 351.8 per 100 000 population) and White women (447.0 to 267.5), and the absolute rate difference (ARD) between these groups decreased over time (1999: ARD, 155.1 [95% CI, 149.9-160.3]; 2019: ARD, 84.3 [95% CI, 81.2-87.4]). These patterns were similar for Black (824.1 to 526.3 per 100 000) and White men (637.5 to 396.0; 1999: ARD, 186.6 [95% CI, 178.6-194.6]; 2019: ARD, 130.3 [95% CI, 125.6-135.0]). Despite this progress, cardiovascular mortality in 2019 was higher for Black women (rate ratio, 1.32 [95% CI, 1.30-1.33])- especially in the younger (age <65 years) subgroup (rate ratio, 2.28 [95% CI, 2.23-2.32])-as well as for Black men (rate ratio, 1.33 [95% CI, 1.32-1.34]), compared with their respective White counterparts. There was regional variation in cardiovascular mortality patterns, and the Black-White gap differed across rural and urban areas. Cardiovascular mortality rates among Black women and men were consistently higher in communities with high levels of racial segregation compared with those with low to moderate levels. CONCLUSIONS: During the past 2 decades, age-adjusted cardiovascular mortality declined significantly for Black and White adults in the United States, as did the absolute difference in death rates between these groups. Despite this progress, Black women and men continue to experience higher cardiovascular mortality rates than their White counterparts.


Assuntos
Doenças Cardiovasculares , População Branca , Adulto , Negro ou Afro-Americano , Idoso , População Negra , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/mortalidade , Feminino , Humanos , Masculino , Fatores Raciais , Características de Residência , Segregação Social , Estados Unidos/epidemiologia
12.
BMC Public Health ; 22(1): 1044, 2022 05 25.
Artigo em Inglês | MEDLINE | ID: mdl-35614426

RESUMO

BACKGROUND: COVID-19 infection has disproportionately affected socially disadvantaged neighborhoods. Despite this disproportionate burden of infection, these neighborhoods have also lagged in COVID-19 vaccinations. To date, we have little understanding of the ways that various types of social conditions intersect to explain the complex causes of lower COVID-19 vaccination rates in neighborhoods. METHODS: We used configurational comparative methods (CCMs) to study COVID-19 vaccination rates in Philadelphia by neighborhood (proxied by zip code tabulation areas). Specifically, we identified neighborhoods where COVID-19 vaccination rates (per 10,000) were persistently low from March 2021 - May 2021. We then assessed how different combinations of social conditions (pathways) uniquely distinguished neighborhoods with persistently low vaccination rates from the other neighborhoods in the city. Social conditions included measures of economic inequities, racial segregation, education, overcrowding, service employment, public transit use, health insurance and limited English proficiency. RESULTS: Two factors consistently distinguished neighborhoods with persistently low COVID-19 vaccination rates from the others: college education and concentrated racial privilege. Two factor values together - low college education AND low/medium concentrated racial privilege - identified persistently low COVID-19 vaccination rates in neighborhoods, with high consistency (0.92) and high coverage (0.86). Different values for education and concentrated racial privilege - medium/high college education OR high concentrated racial privilege - were each sufficient by themselves to explain neighborhoods where COVID-19 vaccination rates were not persistently low, likewise with high consistency (0.93) and high coverage (0.97). CONCLUSIONS: Pairing CCMs with geospatial mapping can help identify complex relationships between social conditions linked to low COVID-19 vaccination rates. Understanding how neighborhood conditions combine to create inequities in communities could inform the design of interventions tailored to address COVID-19 vaccination disparities.


Assuntos
COVID-19 , Segregação Social , COVID-19/epidemiologia , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Humanos , Philadelphia/epidemiologia , Características de Residência , Vacinação
13.
Demography ; 59(2): 433-459, 2022 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-35129609

RESUMO

Patterns of household mobility across neighborhoods reproduce patterns of racial segregation at the metropolitan level. Substantial literature across the social sciences has explored the scale and predictors of household mobility as well as changes in metropolitan residential segregation over time. This study unifies these two strands of inquiry by connecting the sorting of households across neighborhoods to aggregate changes in segregation levels. Using discrete choice models of intrametropolitan mobility and restricted decennial census and American Community Survey data for 1960-2014, I model the correlates of household mobility and identify the counterfactual scenarios under which lower segregation levels can be achieved. The results show that even though the mobility flows of the White, Black, Hispanic, and Asian populations across census tracts have become more similar over time, U.S. metropolitan areas are far from experiencing large drops in segregation.


Assuntos
Dessegregação , Segregação Social , População Negra , Hispânico ou Latino , Humanos , Características de Residência , Estados Unidos , População Urbana , População Branca
14.
West J Nurs Res ; 44(1): 5-14, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34378455

RESUMO

Prior studies of neighborhood racial segregation and intrauterine growth have not accounted for confounding factors in early life. We used the Life-Course Influences on Fetal Environment Study of births to Black women in metropolitan Detroit, 2009-2011, (N = 1,408) to examine whether health and social conditions in childhood and adulthood confound or modify the association of neighborhood segregation (addresses during pregnancy geocoded to census tract racial composition) and gestational age-adjusted birthweight. Before adjusting for covariates, women living in a predominantly (≥75%) Black neighborhood gave birth to 47.3 grams (95% CI: -99.0, 4.4) lighter infants, on average, compared with women living in <75% Black neighborhoods. This association was confounded by adulthood (age at delivery, parity, neighborhood deprivation) and childhood (parental education, neighborhood racial composition) factors and modified by adulthood socioeconomic position. These findings underscore the complex relationship between neighborhood racial segregation and birth outcomes, which would be enhanced through a life course framework.


Assuntos
Negro ou Afro-Americano , Segregação Social , Adulto , População Negra , Feminino , Desenvolvimento Fetal , Humanos , Lactente , Gravidez , Características de Residência , Fatores Socioeconômicos
15.
J Gerontol B Psychol Sci Soc Sci ; 77(6): 1132-1143, 2022 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34137853

RESUMO

OBJECTIVES: Residential segregation is one of the fundamental features of health disparities in the United States. Yet little research has examined how living in segregated metropolitan areas is related to cognitive function and cognitive decline with age. We examined the association between segregation at the metropolitan statistical area (MSA) level and trajectories of age-related cognitive function. METHOD: Using data from Black and White older adults in the REasons for Geographic and Racial Differences in Stroke study (n = 18,913), we employed linear growth curve models to examine how living in racially segregated MSAs at baseline, measured by the degree of non-Hispanic Black (NHB) isolation and NHB dissimilarity, was associated with trajectories of age-related cognitive function and how the associations varied by race and education. RESULTS: Living in MSAs with greater levels of isolation was associated with lower cognitive function (b = -0.093, p < .05) but was not associated with rates of change in cognitive decline with age. No effects of living in isolated MSAs were found for those with at least a high school education, but older adults with less than a high school education had lower cognitive function in MSAs with greater isolation (b = -0.274, p < .05). The degree of dissimilarity was not associated with cognitive function. The association between segregation and cognitive function did not vary by race. DISCUSSION: Metropolitan segregation was associated with lower cognitive function among older adults, especially for those with lower education living in racially isolated MSAs. This suggests complex associations between individual socioeconomic status, place, and cognitive health.


Assuntos
Segregação Social , Acidente Vascular Cerebral , Negro ou Afro-Americano/psicologia , Idoso , Cognição , Humanos , Fatores Raciais , Características de Residência , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Branca
16.
Sociol Educ ; 95(2): 110-132, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38882469

RESUMO

Most U.S. students attend racially segregated schools. To understand this pattern, I employ a survey experiment with New York City families actively choosing schools and investigate whether they express racialized school preferences. I find school racial composition heterogeneously affects white, black, Latinx, and Asian parents' and students' willingness to attend schools. Independent of characteristics potentially correlated with race, white and Asian families preferred white schools over black and Latinx schools, Latinx families preferred Latinx schools over black schools, and black families preferred black schools over white schools. Results, importantly, demonstrate that racial composition has larger effects on white and Latinx parents' preferences compared with white and Latinx students and smaller effects on black parents compared with black students. To ensure results were not an artifact of experimental conditions, I validate findings using administrative data on New York City families' actual school choices in 2013. Both analyses establish that families express heterogenous racialized school preferences.

17.
Proc Natl Acad Sci U S A ; 118(46)2021 11 16.
Artigo em Inglês | MEDLINE | ID: mdl-34764221

RESUMO

We estimate a measure of segregation, experienced isolation, that captures individuals' exposure to diverse others in the places they visit over the course of their days. Using Global Positioning System (GPS) data collected from smartphones, we measure experienced isolation by race. We find that the isolation individuals experience is substantially lower than standard residential isolation measures would suggest but that experienced isolation and residential isolation are highly correlated across cities. Experienced isolation is lower relative to residential isolation in denser, wealthier, more educated cities with high levels of public transit use and is also negatively correlated with income mobility.


Assuntos
Sistemas de Informação Geográfica/estatística & dados numéricos , Características de Residência/estatística & dados numéricos , População Urbana/estatística & dados numéricos , Cidades/estatística & dados numéricos , Humanos , Segregação Social , Fatores Socioeconômicos , Estados Unidos
18.
Artigo em Inglês | MEDLINE | ID: mdl-34574655

RESUMO

Racial segregation has been identified as a predictor for the burden of cancer in several different metropolitan areas across the United States. This ecological study tested relationships between racial segregation and liver cancer mortality across several different metropolitan statistical areas in Wisconsin. Tract-level liver cancer mortality rates were calculated using cases from 2003-2012. Hotspot analysis was conducted and segregation scores in high, low, and baseline mortality tracts were compared using ANOVA. Spatial regression analysis was done, controlling for socioeconomic advantage and rurality. Black isolation scores were significantly higher in high-mortality tracts compared to baseline and low-mortality tracts, but stratification by metropolitan areas found this relationship was driven by two of the five metropolitan areas. Hispanic isolation was predictive for higher mortality in regression analysis, but this effect was not found across all metropolitan areas. This study showed associations between liver cancer mortality and racial segregation but also found that this relationship was not generalizable to all metropolitan areas in the study area.


Assuntos
Neoplasias Hepáticas , Segregação Social , Negro ou Afro-Americano , Humanos , Características de Residência , Fatores Socioeconômicos , Estados Unidos/epidemiologia , População Urbana , População Branca
19.
J Urban Health ; 98(5): 676-686, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34264475

RESUMO

The obesity rate in Chicago has increased up to more than 30% in the last two decades. Obesity is a major problem in Chicago, where 36% of the city's high school students and 61% of adults in the metropolitan area are overweight or obese. Simultaneously, Chicago remains highly segregated by race-a phenomenon that begs for spatial analysis of health. Extant work exploring associations between the food retail environment and obesity has provided mixed findings, and virtually, none of this work has been done with the effects of the interaction between racial segregation and the food retail environment on obesity, where obesity rates are among the highest in the segregation area for the city defined by racial segregation. This study explores whether being overweight or obese is associated with urban food environments, such as access to different types of food retail outlets, and how its associations interact with racial factors, at the community level. This study uses the 2016-2018 data from the Healthy Chicago Survey to investigate the spatial variations in obesity and their association with food environments in Chicago. Also, this study examines the moderating effects of racial segregation on associations between obesity and access to food retail outlets. Using spatial statistics and regression models with interaction terms, this study assesses how the urban food environment can interact with racial segregation to explain the spatial distribution of obesity. The results indicate that the obesity population is highly concentrated in the African American community. In Chicago, each additional convenience store in a community is associated with a 0.42% increase in the obesity rate. Fast food restaurant access is predictive of a greater obesity rate, and grocery store access is predictive of less obesity rate in a community with a higher percentage of African American population. Findings can be used to promote equitable access to food retail outlets, which may help reduce broader health inequities in Chicago.


Assuntos
Desigualdades de Saúde , Segregação Social , Adulto , Chicago/epidemiologia , Comércio , Fast Foods , Abastecimento de Alimentos , Humanos , Obesidade/epidemiologia , Características de Residência , Restaurantes , Análise Espacial
20.
Front Sociol ; 6: 598911, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34150903

RESUMO

In recent decades, the city of Detroit has experienced the greatest population loss of any major American city. Applying Event History Analysis methodology to a large dataset containing information on all properties in Detroit between 2002 and 2013, I examine how Property Tax Foreclosure spatially perpetuated itself in Detroit, finding evidence that the number of past but recent Property Tax Foreclosures in a localized area significantly predicts the likelihood of a future foreclosure. I extrapolate these findings to mathematical simulations and find evidence that suggests that initial Property Tax Foreclosures played a significant role in cascading many later on. Finally, building off past research that suggests neighborhood blight disproportionally affects white residential preferences and patterns, I perform an empirical analysis that examines how the initial distribution of Property Tax Foreclosures in Detroit neighborhoods played some role in determining how those neighborhoods have experienced racial demographic change.

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