Black-white differences in infant mortality in 38 standard metropolitan statistical areas.

Abstract

Infrodudion ResultsThe US Black-White difference in the infant mortality rate has persisted. Lower rates have been reported for Blacks in the West than in the other three US census regions.' This report examines the Black-White difference in infant mortality rate in 38 large standard metropolitan statistical areas (SMSAs), including several in California, in relation to socioeconomic status indicators and an index of residential segregation. Residential segregation may be associated with such factors as the availability and quality of prenatal and postnatal medical care, which may influence infant mortality independent of differences in socioeconomic status. The segregation index and the BlackWhite difference in poverty prevalence for the 38 SMSAs were significantly correlated (r = .573, P < .001), but this correlation does not indicate strong collinearity, and both variables were included in multiple regression analysis (Table 1). The segregation index was the only statistically significant independent predictor of the Black-White difference in infant mortality rate among the SMSAs, and the only independent variable selected in stepwise regression (not shown). Only for Blacks was the segregation index a statistically significant independent predictor of infant mortality rate in multiple regression analysis (data not shown). MetlodsChicago had the highest segregation index (i.e., .878) and, a Black-White difference in poverty prevalence (i.e., 28.8%) that was higher than the average (i.e., 18.3%), the Black-White difference in infant mortality was also large (i.e., 13.38 per 1000; 95% CL = 12.39 and 14.17).

Exploring Health Disparities in Integrated Communities: Overview of the EHDIC Study

“…And, several studies have demonstrated that African-American communities were more likely to be targeted for tobacco consumption compared to white communities. 36,37 Other studies have demonstrated a link between segregation and health disparities across a variety of unrelated health outcomes, such as infant mortality, 29,39,40 adult mortality, 30,[41][42][43] tuberculosis, 38,44 and hospital admissions. 45 However, segregation has not been well studied as a potential source of confounding, but it is potentially a substantial problem, which can lead to erroneous conclusions about the etiology of racial disparities in health.…”

Residential Segregation and Latino, Black and White Mortality in New York City

“…2 Many studies have shown that black mortality rates are higher in metropolitan areas with high levels of segregation as compared to areas with lower levels of segregation. [3][4][5][6][7][8][9][10][11] The adverse effects on health are felt to occur through poorer residential area quality and its effects on health behaviors and health care, independent of individual and/or area level socioeconomic status (SES). 2 The studies cited above used various measures to define segregation, ranging from population composition 6,7,11,12 to more formally defined measures.…”

“…2 The studies cited above used various measures to define segregation, ranging from population composition 6,7,11,12 to more formally defined measures. [3][4][5][8][9][10] Though the use of population composition as a proxy for segregation is neither technically nor conceptually the same as the formal constructs, the studies that used population composition as a measure of segregation 6,7,11 have also found that black mortality rates are higher in areas with a high proportion of blacks. The segregation literature, [3][4][5][6][7][8][9][10] for the most part, has used large geographical areas as the unit of analysis or has compared smaller areas across a broad geography but generally not focused on the local impacts of segregation that result in areas with both low and high residential race/ethnic minority concentrations within a metropolitan area.…”

Where You Live Matters to Your Health

“…All residential segregation, although most dramatically in the African American community, has been shown to result in racial disparities in socioeconomic status and has been linked to health outcomes such as all-cause mortality [18,19], premature mortality [20], infant mortality [21,22] and tuberculosis [23].…”