Residential Segregation, Health-Promoting Organizations, and Health Outcomes

生活在种族隔离社区的人往往病得更重，死得更早。然而，造成这些不良健康结果的原因尚不清楚。本研究探讨社区隔离、健康促进组织的存在与居民健康结果之间的关系。卫生保健提供者、超市、健身房和其他促进健康的组织在社区活力和居民的健康和福祉方面发挥着重要作用。该项目追踪了这些类型的组织在不同类型的城市地区的传播。该研究还调查了健康促进组织的可用性如何影响家庭对卫生保健服务的使用和满意度。该研究促进了对隔离与公共卫生之间关系的理解，为公共卫生和城市规划的决策和干预提供了信息。本研究分为两部分，考察了：1)城市社区组织和服务提供者的分布；2)这种分布如何影响居民的健康相关结果。首先，研究人员使用来自美国人口普查局和疾病控制中心（CDC）的有限微观数据，检查了1990年至2020年期间美国大都市地区健康促进社区组织的分布情况。纵向方法可以分析社区组成的变化与健康促进组织的数量之间的关系。其次，该研究使用了来自全国儿童健康调查的有限调查数据，并与社区层面的背景数据相结合，分析了家庭如何使用医疗保健服务，这与他们在社区中可获得的服务有何关系，以及这如何影响他们对医疗服务提供者的满意度和整体健康。该奖项反映了美国国家科学基金会的法定使命，并通过使用基金会的知识价值和更广泛的影响审查标准进行评估，被认为值得支持。

People who live in segregated neighborhoods are often sicker and die younger. Yet, the reasons for these poor health outcomes are not well understood. This study examines the relationships among neighborhood segregation, the presence of health-promoting organizations, and the health outcomes of residents. Health care providers, supermarkets, gyms, and other health-promoting organizations play an important role in community vitality, and the health and well-being of residents. This project traces the spread of these types of organizations across different types of urban areas over time. The research also examines how the availability of health-promoting organizations affect families’ use of and satisfaction with health care services. The study advances understanding of the relationship between segregation and public health, informing decision-making and interventions in public health and city planning.This two-part study examines: 1) the distribution of community organizations and service providers across urban neighborhoods; and 2) how that distribution affects residents’ health-related outcomes. First, using restricted micro-data from the United States Census Bureau and Centers for Disease Control (CDC), researchers examine the distribution of health-promoting community organizations over time across neighborhoods in metropolitan areas in the U.S. from 1990 to 2020. A longitudinal approach enables analysis of how changes in neighborhood composition relate to the number of health-promoting organizations over time. Second, the study uses restricted survey data from the National Survey of Children’s Health paired with neighborhood-level contextual data to analyze how families use health care services, how that is patterned by what is available to them in their communities, and how this impacts satisfaction with their health provider and overall health.This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the Foundation's intellectual merit and broader impacts review criteria.