Racial/ethnic segregation and health disparities: Future directions and opportunities

Abstract

Health researchers have investigated the association between racial segregation and racial health disparities with multilevel approaches. This study systematically reviews these multilevel studies and identifies broad trends and potential directions for future research on racial segregation and health disparities in the US. After searching databases including CINAHL and MEDLINE, we systematically reviewed 66 articles published between 2003 and 2019 and found four major gaps in racial/ethnic segregation and health disparities: (a) the concept of segregation was rarely operationalized at the neighborhood level, (b) except for the evenness and exposure dimension, other dimensions of segregation are overlooked, (c) little attention was paid to the segregation between whites and non‐black minorities, particularly Hispanics and Asians, and (d) mental health outcomes were largely absent. Future directions and opportunities include: First, other segregation dimensions should be explored. Second, the spatial scales for segregation measures should be clarified. Third, the theoretical frameworks for black and non‐black minorities should be tested. Fourth, mental health, substance use, and the use of mental health care should be examined. Fifth, the long‐term health effect of segregation has to be investigated, and finally, other competing explanations for why segregation matters at the neighborhood level should be answered.

Racial/Ethnic Residential Segregation and the First Wave of SARS-CoV-2 Infection Rates: A Spatial Analysis of Four U.S. Cities

“…Overall, these results track well with previous studies on racial/ethnic residential segregation and health outcomes that demonstrate notable disparities in health where racial/ethnic segregated communities and cities are more likely to experience poor health outcomes ( Williams and Collins 2001 ; Yang, Park, and Matthews 2020 ). This includes the more limited work on infectious diseases specifically ( Acevedo-Garcia 2000 , 2001 ).…”

Relationship between Residential Segregation, Later-Life Cognition, and Incident Dementia across Race/Ethnicity

“…An important contribution of our study is that we examined multiple segregation indices in a diverse neighborhood. Dissimilarity has been proposed as an indicator of inequitable distribution of resources [27]. The exposure indices-interaction and isolation-are thought to at least partly reflect mechanisms reliant on social contact, such as support from one's social network, adoption of health-related behaviors [50] or exposure to stressors, such as discrimination [51,52].…”

“…These indices may more adequately capture benefits of social contact, corresponding to the social cohesion pathways. Measures along the clustering dimension, such as dissimilarity, might better capture inequitable access to resources [27]. The nascent literature regarding residential segregation and cognition lacks comparative examination across multiple indices-in other words, we are not yet sure which of these indices are most important for cognitive health.…”

Improving Sexual Health in U.S. Rural Communities: Reducing the Impact of Stigma

“…Place clearly matters when it comes to health status [111]. Although it may have taken the COVID-19 pandemic to focus national attention on the challenges facing public health in rural areas, the unfortunate truth is that many rural communities have long-struggled with disparate health outcomes.…”