Association Between Changes in Racial Residential Segregation and Trends in Racial Disparities in Early Mortality in 220 Metropolitan Areas, 2001-2018.

IF 3.2 3区 医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Racial and Ethnic Health Disparities Pub Date : 2024-12-01 Epub Date: 2023-10-19 DOI:10.1007/s40615-023-01830-z
Michael Siegel, Madeline Rieders, Hannah Rieders, Leighla Dergham, Rohan Iyer
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Abstract

Introduction: Racial residential segregation has been shown to affect the absolute levels of racial disparities in a wide variety of health outcomes in the USA but it is not known whether changes in segregation also influence these racial health disparities. This study examines the relationship between changes in racial residential segregation over four decades (1980-2020) and trends in racial disparities in early mortality (under age 65) rates among non-Hispanic Black and non-Hispanic White persons across a wide range of health outcomes in 220 metropolitan statistical areas (MSAs) during the period 2001-2018.

Methods: Using the CDC WONDER Underlying Cause of Death database, we derived annual estimates of race-specific death rates and rate ratios for each MSA. We used latent trajectory analysis to examine the relationship between the level of segregation and changes in segregation over time in an MSA and trends in death rate disparities in that MSA.

Results: The trajectory analysis resulted in a linear, three group model in which trajectory Groups 1 and 2 had decreasing trends in the ratios of Black to White death rates over time while in Group 3, the disparity remained almost constant over time. Increases in the level of segregation in an MSA from 1980 to 2000 were significantly associated with the likelihood that the MSA was in Group 3 and experienced no improvement in racial health disparities in mortality over time.

Conclusion: This paper provides new evidence that changes in segregation are related to trends in racial health disparities in mortality rates over time.

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2001-2018年220个大都市地区种族居住隔离的变化与早期死亡率种族差异趋势之间的关系。
引言:种族居住隔离已被证明会影响美国各种健康结果中种族差异的绝对水平,但尚不清楚隔离的变化是否也会影响这些种族健康差异。本研究调查了2001-2018年期间220个大都市统计区(MSAs)的各种健康结果中,40年来(1980-2020年)种族居住隔离的变化与非西班牙裔黑人和非西班裔白人早期死亡率(65岁以下)种族差异趋势之间的关系死因数据库,我们得出了每个MSA的特定种族死亡率和比率的年度估计值。我们使用潜在轨迹分析来检验MSA中的分离水平和分离随时间的变化与该MSA中死亡率差异趋势之间的关系。结果:轨迹分析产生了一个线性的三组模型,其中轨迹组1和2的黑人与白人死亡率随时间呈下降趋势,而在轨迹组3中,随着时间的推移,这种差距几乎保持不变。从1980年到2000年,MSA中种族隔离程度的增加与MSA属于第3组的可能性显著相关,并且随着时间的推移,死亡率的种族健康差异没有改善。结论:本文提供了新的证据,证明种族隔离的变化与死亡率随时间变化的种族健康差异趋势有关。
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来源期刊
Journal of Racial and Ethnic Health Disparities
Journal of Racial and Ethnic Health Disparities PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
7.30
自引率
5.10%
发文量
263
期刊介绍: Journal of Racial and Ethnic Health Disparities reports on the scholarly progress of work to understand, address, and ultimately eliminate health disparities based on race and ethnicity. Efforts to explore underlying causes of health disparities and to describe interventions that have been undertaken to address racial and ethnic health disparities are featured. Promising studies that are ongoing or studies that have longer term data are welcome, as are studies that serve as lessons for best practices in eliminating health disparities. Original research, systematic reviews, and commentaries presenting the state-of-the-art thinking on problems centered on health disparities will be considered for publication. We particularly encourage review articles that generate innovative and testable ideas, and constructive discussions and/or critiques of health disparities.Because the Journal of Racial and Ethnic Health Disparities receives a large number of submissions, about 30% of submissions to the Journal are sent out for full peer review.
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