 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Amani Nuru-Jeter, MPH, Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, 2380 Edgehill Rd., Cleveland Heights, OH 44106, 240-350-8821, anjeter@jhsph.edu
Background: This paper examines the role of race and racial residential segregation on the income inequality/mortality relationship. The current income inequality literature has been criticized for failing to directly address the role of race/ethnicity in the relationship between income inequality and population health. This paper examines whether the observed income inequality effect is independent of race or dependent on race specific effects? Previous works state that the literature would benefit from a better understanding of the effects of income inequality between racial groups.36 Further, they add that future research should focus on where people live and suggest that the effect of income inequality on social disintegration may be mediated by racial residential segregation.9,26-27
Methods: This is a cross-sectional ecological study of metropolitan areas in the US (N=107). Metropolitan areas were selected using two criteria: 1) a population > 100,000; and 2) at least 10% African-American. Data for this study come from the US Census Bureau and the National Center for Health Statistics. Ordinary least squares regression was used to conduct race-specific analysis to assess both the direct and indirect effects of race on the income inequality/mortality relationship. Structural equation modeling techniques (i.e., cross-lagged causal modeling, path analysis, and latent variable SEM) were used to examine residential segregation and concentrated poverty as mediators in the pathway to health. Results: Income inequality is protective of mortality rates for both the total sample and for whites (p<.05). Among African-Americans, income inequality is a positive predictor of mortality rates (p<.05). Racial concentration and residential segregation moderate the effect of income inequality on mortality (p<.05). Residential segregation mediates the income inequality/mortality relationship; and the pathway to health varies by racial group.
Conclusions: The experience of income inequality and residential segregation is not the same across racial groups. Race and racial residential segregation confound the income inequality/mortality relationship. Future studies seeking to explore the effects of income inequality on population health should specifically account for the confounding role of race and residential segregation; and should consider that income inequality may be an indicator for other social processes such as racial residential segregation.
Learning Objectives:
Keywords: Mortality,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.