Residential segregation: A key connector between race and environmental health disparities

Our study seeks to determine the role that residential segregation plays in driving the distribution of ecologic salutogens (i.e., factors that promote health) and pathogens (i.e., factors that impede health) in neighborhoods across the nation, ultimately driving health disparities in diverse populations. Currently, there is considerable debate concerning specific mechanisms culminating in a “health disparity”. Limited research purports that residential segregation is a critical starting point to gain better insight into the origins and persistence of environmental health disparities and may be part of the causal pathway leading to health disparities in exposure risks. In this study we aim to determine the variability in the distribution of salutogens and pathogens across levels of residential racial segregation. This cross-sectional study uses county-level data to describe the distribution of salutogenic (i.e., number of schools, health facilities, banks, religious institutions, and social/community service facilities) and pathogenic ( i.e., number of fast food places, gas stations, liquor stores, pawn shops, owned vs. rented housing, waste treatment facilities) determinants of health on a national scale. The dissimilarity index (D) was used to measure residential segregation for whites, blacks, and Hispanics. We found that a disproportionate amount of salutogens were present in white neighborhoods, while black and Hispanic neighborhoods housed a disproportionate number of pathogens. Highly racially segregated neighborhoods shoulder a disproportionate burden of pathogenic exposures and these exposure disparities may modify risk factors for adverse health outcomes. Furthermore, we found that pathogenic exposures were especially pronounced in high poverty and highly segregated neighborhoods.