Objectives This study seeks to determine the role of neighborhood poverty and racial composition on race disparities in diabetes prevalence. Methods Using data from the 1999–2004 National Health and Nutrition Examination Survey (NHANES) and 2000 U.S. Census, we estimate the impact of individual race and poverty and neighborhood racial composition and poverty concentration on the odds of having diabetes. Results We found a race-poverty-place gradient for diabetes prevalence for blacks and poor whites. The odds of having diabetes was higher for blacks compared to whites. Individual poverty increased the odds of having diabetes for both whites and blacks. Living in a poor neighborhood increased the odds of having diabetes for blacks and poor whites. Conclusions To address race disparities in diabetes, policymakers should address problems created by concentrated poverty, e.g., lack of access to reasonably priced fruits and vegetables, recreational facilities, and health care services, and high crime rates, and greater exposures to environmental toxins. Housing and development policies in urban areas should avoid creating high poverty neighborhoods.

Introduction This article presents an integrative review of the literature examining the relationship between racial discrimination and adverse birth outcomes. Methods Searches for research studies published from 2009 to 2015 were conducted using PubMed, CINAHL, Scopus, PsycINFO, Web of Science, and Embase. Articles were assessed for potential inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) 2009 framework. Results Fifteen studies met criteria for review. The majority of the studies found a significant relationship between racial discrimination and low birth weight, preterm birth, and small for gestational age. Each of the studies that examined more proximal variables related to birth outcomes such as entry into prenatal care, employment opportunities, neighborhood characteristics, or inflammatory markers found significant associations between the specific variables examined and racial discrimination. Participants in qualitative studies discussed experiences of institutional racism with regard to several components of prenatal care including access and quality of care. Discussion Racial discrimination is a significant risk factor for adverse birth outcomes. To best understand the mechanisms by which racial discrimination impacts birth outcomes, and to inform the development of effective interventions that eliminate its harmful effects on health, longitudinal research that incorporates comprehensive measures of racial discrimination is needed. Health care providers must fully acknowledge and address the psychosocial factors that impact health outcomes in minority racial/ethnic women.

Background Food store availability may determine the quality of food consumed by residents. Neighborhood racial residential segregation, poverty, and urbanicity independently affect food store availability, but the interactions among them has not been studied. Purpose To examine availability of supermarkets, grocery stores, and convenience stores in US census tracts according to neighborhood racial/ethnic composition, poverty, and urbanicity. Methods Data from 2000 US Census and 2001 InfoUSA food store data were combined and multivariate negative binomial regression models employed. Results As neighborhood poverty increased, supermarket availability decreased and grocery and convenience stores increased, regardless of race/ethnicity. At equal levels of poverty, black census tracts had the fewest supermarkets, white tracts had the most, and integrated tracts were intermediate. Hispanic census tracts had the most grocery stores at all levels of poverty. In rural census tracts, neither racial composition nor level of poverty predicted supermarket availability. Conclusions Neighborhood racial composition and neighborhood poverty are independently associated with food store availability. Poor predominantly black neighborhoods face a double jeopardy with the most limited access to quality food and should be prioritized for interventions. These associations are not seen in rural areas which suggest that interventions should not be universal but developed locally.

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