Comparing proxy and formal measures of county-level racial isolation in race-stratified models: A case study in Tennessee, 2005-2014.
Comparing proxy and formal measures of county-level racial isolation in race-stratified models: A case study in Tennessee, 2005-2014.
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DOI：
10.1016/j.ssmph.2022.101146
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发表时间：
2022-09
影响因子：
4.7
通讯作者：
Whiteside, Martin
中科院分区：
文献类型：
--
作者：
Oka, Masayoshi;Williams, Faustine;Whiteside, Martin
本研究的目的是了解县级种族隔离的代理措施（基于种族构成）是否会产生与县级种族隔离的正式措施（来自隔离指数P*）相似的结果。居住在美国田纳西州的诊断为非浸润性或浸润性乳腺癌的白人（非西班牙裔白人）和黑人（非西班牙裔黑人或非裔美国人）妇女被视为研究人群。个体水平变量来自田纳西州癌症登记处2005年至2014年期间的数据（46,983名白人女性和7,967名黑人女性），县级变量来自2005 - 2009年和2010-2014年期间的美国社区调查数据（95个县）。以乳腺癌状况（非侵入性与侵入性）作为感兴趣的二元结局，按种族分别进行了一系列多水平logistic回归分析。在控制了个人层面的社会人口统计学特征后，县级白人隔离的代理测量和县级家庭收入中位数与乳腺癌状况无关，但县级白人隔离的正式测量与白人妇女患浸润性乳腺癌的几率较低有关。另一方面，县级黑人隔离的代理和正式措施都与乳腺癌状况无关，但县级家庭收入中位数与黑人妇女患浸润性乳腺癌的几率较低有关。这些结果表明，使用种族隔离的代理和正式措施可能会产生不同的结果，种族分层分析将有助于理解种族隔离对白人和黑人的不同影响。虽然在未来的研究中需要更详细的检查，但讨论了这些发现背后的可能解释和原因。县级的白人隔离可能对白人妇女有保护作用。县级的黑人隔离可能对黑人妇女没有影响。县一级的种族隔离可能对种族产生不同的影响。测量可能对居住隔离和健康的研究很重要。
The purpose of this study was to understand whether proxy measures of county-level racial isolation (based on racial compositions) would yield similar results as the formal measures of county-level racial isolation (derived from the isolation index of P*). White (non-Hispanic White) and Black (non-Hispanic Black or African American) women residing in the State of Tennessee, USA, and diagnosed with a non-invasive or invasive breast cancer were considered as the study population. Individual-level variables were obtained from the Tennessee Cancer Registry data for the period between 2005 and 2014 (46,983 White women and 7,967 Black women), and county-level variables were obtained from the American Community Survey data for the periods of 2005–2009 and 2010–2014 (95 counties). Using breast cancer condition (non-invasive versus invasive) as the binary outcome of interest, a series of multilevel logistic regression analyses was conducted separately by race. After controlling for individual-level socio-demographic characteristics, proxy measure of county-level White isolation and county-level median household income were not associated with breast cancer condition, but formal measure of county-level White isolation was associated with lower odds of having an invasive breast cancer among White women. On the other hand, neither proxy nor formal measure of county-level Black isolation was associated with breast cancer condition, but county-level median household income was associated with lower odds of having an invasive breast cancer among Black women. These results suggest that using a proxy and formal measure of racial isolation may yield different results, and race-stratified analyses would be helpful for understanding a differential effect of racial isolation on Whites and Blacks. While more detailed examinations are needed in future studies, possible explanations on and reasons behind these findings are discussed. County-level White isolation may have a protective effect on White women. County-level Black isolation may have no effect on Black women. County-level racial isolation may have differential effects on races. Measurement may matters for a study of residential segregation and health.
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