Relationship between premature mortality and socioeconomic factors in black and white populations of US metropolitan areas

Cooper, Richard S.; Kennelly, Joan F.; Durazo‐Arvizu, Ramón; Oh, Hyunjoo; Kaplan, George A.; Lynch, John

doi:10.1016/s0033-3549(04)50074-2

Cited by 100 publications

(44 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Much research into the causes of racial disparity in health in the United States has focused on individual attributes. 44,48,56 However, there is a growing recognition of the importance of contextual characteristics in local health disparities. 44,46,57,58 As David Williams has written: “Effective effort to reduce racial disparities in health status should seriously grapple with … targeting interventions not only at individuals but also at the geographic context within which they live.” 46 …”

Section: Discussionmentioning

confidence: 99%

Small-Area Racial Disparity in Stroke Mortality

Tassone

Waller²,

Casper³

2009

Epidemiology

View full text Add to dashboard Cite

Background In the United States, excess burden of stroke mortality has persisted among African Americans compared with whites despite declines in stroke mortality for both groups. New insights may be gleaned by examining local, small-area patterns in racial disparities in stroke. Methods The study population includes all non-Hispanic African Americans and non-Hispanic whites aged 35 to 64 in the southeastern United States during 1999 to 2002. We assessed county-level numbers of stroke deaths and population estimates in a Bayesian spatial hierarchical modeling framework allowing for inclusion of potential covariates (poverty and rurality), and generating county-specific model-based estimates of both absolute and relative racial disparity. The resulting estimates of race-specific stroke death rates, relative racial disparity, and absolute racial disparity were expressed in maps. Results After adjustment for age, poverty, and rurality, county-level estimates of relative racial disparity ranged from 2.3 to 3.3 and estimates of absolute racial disparity ranged from 19 to 45 excess deaths per 100,000. For both racial groups, stroke death rates were higher in rural areas and with increasing poverty. High relative racial disparity was concentrated primarily in the eastern portion of the region and large absolute racial disparity was concentrated primarily in the western portion. Conclusions The results highlight the pervasiveness and magnitude of substantial local racial disparities in stroke mortality in the southeast.

show abstract

Section: Discussionmentioning

confidence: 99%

Small-Area Racial Disparity in Stroke Mortality

Tassone

Waller²,

Casper³

2009

Epidemiology

View full text Add to dashboard Cite

show abstract

“…Age differences across studies may also play a role, particularly if among older populations mortality selection is operating to cull Blacks such that only hearty Blacks had survived to participate in the sample. Since mortality selection may be especially operative in predominantly Black neighborhoods, 9, 11 this could explain the apparent protective effect of racial composition with CVD mortality seen in previous studies of adults ages 65 and older.…”

Section: Discussionmentioning

confidence: 98%

Neighborhood-Level Racial/Ethnic Residential Segregation and Incident Cardiovascular Disease

Kershaw¹,

et al. 2015

View full text Add to dashboard Cite

Background Previous research suggests neighborhood-level racial/ethnic residential segregation is linked to health, but it has not been studied prospectively in relation to cardiovascular disease (CVD). Methods and Results Participants were 1,595 non-Hispanic Black, 2,345 non-Hispanic White, and 1,289 Hispanic adults from the Multi-Ethnic Study of Atherosclerosis free of CVD at baseline (ages 45-84). Own-group racial/ethnic residential segregation was assessed using the Gi∗ statistic, a measure of how the neighborhood racial/ethnic composition deviates from surrounding counties’ racial/ethnic composition. Multivariable Cox proportional hazards modeling was used to estimate hazard ratios (HR) for incident CVD (first definite angina, probable angina followed by revascularization, myocardial infarction, resuscitated cardiac arrest, CHD death, stroke, or stroke death) over 10.2 median years of follow-up. Among Blacks, each standard deviation increase in Black segregation was associated with a 12% higher hazard of developing CVD after adjusting for demographics (95% Confidence Interval (CI): 1.02, 1.22). This association persisted after adjustment for neighborhood-level characteristics, individual socioeconomic position, and CVD risk factors (HR: 1.12; 95% CI: 1.02, 1.23). For Whites, higher White segregation was associated with lower CVD risk after adjusting for demographics (HR: 0.88; 95% CI: 0.81, 0.96), but not after further adjustment for neighborhood characteristics. Segregation was not associated with CVD risk among Hispanics. Similar results were obtained after adjusting for time-varying segregation and covariates. Conclusions The association of residential segregation with cardiovascular risk varies according to race/ethnicity. Further work is needed to better characterize the individual- and neighborhood-level pathways linking segregation to CVD risk.

show abstract

“…Despite an extensive literature examining the association between racial residential segregation and health outcomes, studies of neighborhood racial composition are relatively sparse and those that exist rarely examine mediating factors. Interestingly, while ecological studies of large areas (e.g., states, counties) have generally demonstrated a positive correlation between the percentage of blacks in the area and mortality rates (Bird, 1995; Cooper et al, 2001; Deaton & Lubotsky, 2003; McLaughlin & Stokes, 2002), studies of smaller areas, and multi-level studies using individual-level outcomes, have had mixed results. Studies of New York City have demonstrated lower mortality for elderly blacks, Hispanics, and whites living in neighborhoods with higher proportions of their respective racial group (Fang et al, 1998; Inagami et al, 2006), but worse self-reported health status for blacks who live in neighborhoods with a greater proportion of black residents (White & Borrell, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Several studies demonstrate that higher proportions of blacks in a geographic area are associated with higher mortality (Bird, 1995; Cooper et al, 2001; Deaton & Lubotsky, 2003; McLaughlin & Stokes, 2002) and worse self-reported health status (White & Borrell, 2006), often for both blacks and whites. However, many of these studies do not adjust for other individual or area-level sociodemographic characteristics, limiting the insight into independent effects of racial composition.…”

Section: Introductionmentioning

confidence: 99%

Neighborhood racial composition, social capital and black all-cause mortality in Philadelphia

Hutchinson

Putt

Dean

et al. 2009

Social Science & Medicine

View full text Add to dashboard Cite

Neighborhood characteristics such as racial composition and social capital have been widely linked to health outcomes, but the direction of the relationship between these characteristics and health of minority populations is controversial. Given this uncertainty, we examined the relationship between neighborhood racial composition, social capital, and black all-cause mortality between 1997 and 2000 in 68 Philadelphia neighborhoods. Data from the U.S. Census, the Philadelphia Health Management Corporation’s 2004 Southeast Pennsylvania Community Health Survey, and city vital statistics were linked by census tract and then aggregated into neighborhoods, which served as the unit of analysis. Neighborhood social capital was measured by a summative score of respondent assessments of: the livability of their community, the likelihood of neighbors helping one another, their sense of belonging, and the trustworthiness of their neighbors. After adjustment for the sociodemographic characteristics of neighborhood residents, black age-adjusted all-cause mortality was significantly higher in neighborhoods that had lower proportion of black residents. Neighborhood social capital was also associated with lower black mortality, with the strongest relationship seen for neighborhoods in the top half of social capital scores. There was a significant interaction between racial composition and social capital, so that the effect of social capital on mortality was greatest in neighborhoods with a higher proportion of black residents and the effect of racial composition was greatest in neighborhoods with high social capital. These results demonstrate that age-adjusted all-cause black mortality is lowest in mostly black neighborhoods with high levels of social capital in Philadelphia.

show abstract

Relationship between premature mortality and socioeconomic factors in black and white populations of US metropolitan areas

Cited by 100 publications

References 30 publications

Small-Area Racial Disparity in Stroke Mortality

Small-Area Racial Disparity in Stroke Mortality

Neighborhood-Level Racial/Ethnic Residential Segregation and Incident Cardiovascular Disease

Neighborhood racial composition, social capital and black all-cause mortality in Philadelphia

Contact Info

Product

Resources

About