Racial residential segregation: A fundamental cause of racial disparities in health

Abstract

Racial residential segregation is a fundamental cause of racial disparities in health. The physical separation of the races by enforced residence in certain areas is an institutional mechanism of racism that was designed to protect whites from social interaction with blacks. Despite the absence of supportive legal statutes, the degree of residential segregation remains extremely high for most African Americans in the United States. The authors review evidence that suggests that segregation is a primary cause of racial differences in socioeconomic status (SES) by determining access to education and employment opportunities. SES in turn remains a fundamental cause of racial differences in health. Segregation also creates conditions inimical to health in the social and physical environment. The authors conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences.

The National Institute on Aging Health Disparities Research Framework

“…10 Other exposures such as poverty, crime and violence could influence the health of some populations disproportionately and may be related to structural factors that are geographic and political. 11,12 In this case, residential segregation that limits opportunities for social mobility constrains some population groups to risky physical environments. 13 Immigrant population groups present a unique case, as many immigrants have a healthier profile on entering the United States.…”

Not Near Enough: Racial and Ethnic Disparities in Access to Nearby Behavioral Health Care and Primary Care

“…For instance, literature suggests that neighborhoodlevel factors such as a large percentage of minority populations or limited social cohesion (e.g., getting along with neighbors, depending on neighbors for emergencies) are associated with limited access to primary care services. [67][68][69] These challenges are exacerbated by workforce training factors such as the shortage of medical graduates practicing in underserved areas such as medically underserved areas and provider shortage areas and the inadequate supply of primary care practitioners. 70 In our study, neighborhoods lacking primary care providers were not evaluated.…”

Residential segregation, dividing walls and mental health: a population-based record linkage study

“…One such characteristic, residential segregation, is acknowledged to be a fundamental determinant of physical ill health associated with risk of cancer, heart disease, obesity, low birth weight and increased infant mortality. [1][2][3][4] The mechanisms underlying these associations are not well understood, but segregation is likely to play a significant role in determining access to resources such as education, employment, transport and healthcare which are all associated with health outcomes. 5 Segregated areas are also associated with high rates of antisocial behaviour and crime prompted by intergroup contact, especially in the form of hate crime, sectarianism and crimes for financial gain.…”