Much of the current health disparities literature fails to account for the fact that the nation is largely segregated, leaving racial groups exposed to different health risks and with variable access to health services based on where they live. We sought to determine if racial health disparities typically reported in national studies remain the same when black and white Americans live in integrated settings. Focusing on a racially integrated, low-income neighborhood of Southwest Baltimore, Maryland, we found that nationally reported disparities in hypertension, diabetes, obesity among women, and use of health services either vanished or substantially narrowed. The sole exception was smoking: We found that white residents were more likely than black residents to smoke, underscoring the higher rates of ill health in whites in the Baltimore sample than seen in national data. As a result, we concluded that racial differences in social environments explain a meaningful portion of disparities typically found in national data. We further concluded that when social factors are equalized, racial disparities are minimized. Policies aimed solely at health behavior change, biological differences among racial groups, or increased access to health care are limited in their ability to close racial disparities in health. Such policies must address the differing resources of neighborhoods and must aim to improve the underlying conditions of health for all.

Background National data do not account for race differences in health risks resulting from racial segregation or the correlation between race and socioeconomic status. Therefore, these data may inaccurately attribute differences in obesity to race rather than differing social context. The goal of this study was to investigate whether race disparities in obesity among women persist in a community of black people and white people living in the same social context with similar income. Methods Race disparities in obesity were examined among black women and white women living in the same social context with similar income, using the data from the Exploring Health Disparities in Integrated Communities-SWB (EHDIC-SWB) study, and these estimates were compared to national data (National Health Interview Survey) to determine if race disparities in obesity were attenuated among women in EHDIC-SWB. Obesity was based on participants’ self-reported height and weight. Logistic regression was used to examine the association between race and obesity. Results In the national sample, black women exhibited greater odds of being obese (OR 1.99, 95% CI 1.71 to 2.32) than white women after controlling for covariates. In the EHDIC-SWB sample, black women had similar odds of being obese (OR 1.25, 95% CI 0.90 to 1.75) as compared to white women, after adjusting for covariates. Conclusions There are no race disparities in obesity among poor, urban women sharing the same social context. Developing policies that focus on modifying social aspects of the environment may reduce disparities in obesity among low-income women living in urban communities.

The weathering hypothesis, an explanation for race disparities in the USA, asserts that the health of African Americans begin to deteriorate prematurely compared to whites as a consequence of long-term exposure to social and environmental risk factors. Using data from 2000-2009 National Health Interview Surveys (NHIS), we sought to describe differences in age-related health outcomes in 619,130 African Americans and whites. Outcome measures included hypertension, diabetes, stroke, and cardiovascular disease. Using a mixed models approach to age-period-cohort analysis, we calculated age- and race-specific prevalence rates that accounted for the complex sampling design of NHIS. African Americans exhibited higher prevalence rates of hypertension, diabetes, and stroke than whites across all age groups. Consistent with the weathering hypothesis, African Americans exhibited equivalent prevalence rates for these three conditions 10 years earlier than whites. This suggests that African Americans are acquiring age-related conditions prematurely compared to whites.

Objectives National estimates of race differences in alcohol use suggest that whites are more likely to be current and binge users of alcohol. These findings fail to account for race differences in the social and environmental context where people live. This study aims to determine whether race disparities persist in alcohol use among individuals who share similar social and environmental conditions. Methods We compared race disparities between individuals living in a low-income racially integrated urban community without race differences in socioeconomic status (EHDIC-SWB) to individuals from the National Health Interview Survey (NHIS-2003) to determine if race disparities in alcohol use were attenuated in the integrated environment. Results In the NHIS-2003 sample, compared to whites, African Americans had lower odds of being a current drinker (OR=0.56, 95% CI=0.49–0.64) and binge drinker (OR=0.68, 95% CI= 0.58–0.80) independent of covariates. However in the EHDIC-SWB sample, African Americans had similar odds of being a current drinker (OR=0.94, 95% CI=0.67–1.33) and binge drinker (OR=1.02, 95% CI=0.77–1.35) compared to whites. Conclusions Among individuals who share similar social and environmental risk exposures, race group differences in alcohol use patterns are similar.

This article explores the effects of being raised by married parents during childhood on health and well-being in adolescence and young adulthood in a longitudinal sample of African Americans. This study aims to address the following three questions: Does childhood with married patients lead to better health and well-being during adolescence? Does childhood with married patients lead to better health and well-being in young adulthood? Do the health effects of childhood with married patients differ for male and female? The authors found modest direct effects of childhood exposure to marriage on health for females. Having at least some childhood marriage exposure was also associated with several positive health behaviors. There is modest evidence that marriage bestows health benefits for children and that these benefits endure into young adulthood.