Does place explain racial health disparities? Quantifying the contribution of residential context to the Black/white health gap in the United States
Does place explain racial health disparities? Quantifying the contribution of residential context to the Black/white health gap in the United States
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DOI：
10.1016/j.socscimed.2008.06.018
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发表时间：
2008-10-01
影响因子：
5.4
通讯作者：
Lurie, Nicole
中科院分区：
文献类型：
--
作者：
Do, D. Phuong;Finch, Brian Karl;Lurie, Nicole
尽管在过去的世纪里，美国的发病率和死亡率普遍下降，但黑人在健康方面的劣势一直是美国健康问题中一个令人困惑的组成部分。研究集中在已确立的个人层面的健康决定因素，如社会经济地位和健康行为，已无法完全解释这些差异。最近的研究开始关注其他因素，如种族主义、歧视和隔离。邻里环境的变化，社会人口组成，社会方面，和建成的环境，已被假定为种族差异的一个额外的解释，但很少有人试图量化其整体贡献的黑色/白色健康差距。这种分析是试图通过利用美国国家健康访谈调查（NHIS）（1989-1994）的数据，结合确定居民的同一块内和跨NHIS调查横截面的方法，以产生一个估计的地方效应解释健康差距。我们的研究结果表明，控制一个单一的时间点测量的居住环境的结果在一个大约15-76%的黑人/白色的差异，自我评价的健康，以前未占个人水平的控制。居住环境对解释黑人/白色自评健康差距的贡献因年龄和性别而异，因此对差异的背景解释随年龄而下降，女性中似乎较小。(C)2008爱思唯尔有限公司保留所有权利。
The persistence of the black health disadvantage has been a Puzzling component of health in the United States in spite of general declines in rates of morbidity and mortality over the past century. Studies that have focused on well-established individual-level determinants of health such as socio-economic status and health behaviors have been unable to fully explain these disparities. Recent research has begun to focus on other factors such as racism, discrimination, and segregation. Variation in neighborhood context-socio-demographic composition, social aspects, and built environment-has been postulated as an additional explanation for racial disparities, but few attempts have been made to quantify its overall contribution to the black/white health gap. This analysis is an attempt to generate an estimate of place effects on explaining health disparities by utilizing data from the U.S. National Health Interview Survey (NHIS) (1989-1994), combined with a methodology for identifying residents of the same blocks both within and across NHIS survey cross-sections. Our results indicate that controlling for a single point-in-time measure of residential context results in a roughly 15-76% reduction of the black/white disparities in self-rated health that were previously unaccounted for by individual-level controls. The contribution of residential context toward explaining the black/white self-rated health gap varies by both age and gender such that contextual explanations of disparities decline with age and appear to be smaller among females. (C) 2008 Elsevier Ltd. All rights reserved.