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Measures of local segregation for monitoring health inequities by local health departments

Author

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  • Krieger, N.
  • Waterman, P.D.
  • Batra, N.
  • Murphy, J.S.
  • Dooley, D.P.
  • Shah, S.N.

Abstract

Objectives. To assess the use of local measures of segregation for monitoring health inequities by local health departments. Methods. We analyzed preterm birth and premature mortality (death before the age of 65 years) rates for Boston, Massachusetts, for 2010 to 2012, using the Index of Concentration at the Extremes (ICE) and the poverty rate at both the census tract and neighborhood level. Results. For premature mortality at the census tract level, the rate ratios comparing the worst-off and best-off terciles were 1.58 (95% confidence interval [CI] = 1.36, 1.83) for the ICE for income, 1.66 (95% CI = 1.43, 1.93) for the ICE for race/ethnicity, and 1.63 (95% CI = 1.40, 1.90) for the ICE combining income and race/ethnicity, as compared with 1.47 (95% CI = 1.27, 1.71) for the poverty measure. Results for the ICE and poverty measures were more similar for preterm births than for premature mortality. Conclusions. The ICE, a measure of social spatial polarization, may be useful for analyzing health inequities at the local level. Public Health Implications. Local health departments in US cities can meaningfully use the ICE to monitor health inequities associated with racialized economic segregation.

Suggested Citation

  • Krieger, N. & Waterman, P.D. & Batra, N. & Murphy, J.S. & Dooley, D.P. & Shah, S.N., 2017. "Measures of local segregation for monitoring health inequities by local health departments," American Journal of Public Health, American Public Health Association, vol. 107(6), pages 903-906.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2017.303713_3
    DOI: 10.2105/AJPH.2017.303713
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    1. Kelvin C. Fong & Maayan Yitshak-Sade & Kevin J. Lane & M. Patricia Fabian & Itai Kloog & Joel D. Schwartz & Brent A. Coull & Petros Koutrakis & Jaime E. Hart & Francine Laden & Antonella Zanobetti, 2020. "Racial Disparities in Associations between Neighborhood Demographic Polarization and Birth Weight," IJERPH, MDPI, vol. 17(9), pages 1-11, April.
    2. Maayan Yitshak-Sade & M. Patricia Fabian & Kevin J. Lane & Jaime E. Hart & Joel D. Schwartz & Francine Laden & Peter James & Kelvin C. Fong & Itai Kloog & Antonella Zanobetti, 2020. "Estimating the Combined Effects of Natural and Built Environmental Exposures on Birthweight among Urban Residents in Massachusetts," IJERPH, MDPI, vol. 17(23), pages 1-16, November.
    3. Joseph Gibbons & Tse-Chuan Yang & Elizabeth Brault & Michael Barton, 2020. "Evaluating Residential Segregation’s Relation to the Clustering of Poor Health across American Cities," IJERPH, MDPI, vol. 17(11), pages 1-18, June.
    4. Anders Larrabee Sonderlund & Mia Charifson & Antoinette Schoenthaler & Traci Carson & Natasha J Williams, 2022. "Racialized economic segregation and health outcomes: A systematic review of studies that use the Index of Concentration at the Extremes for race, income, and their interaction," PLOS ONE, Public Library of Science, vol. 17(1), pages 1-27, January.
    5. Charvonne N. Holliday & Kristin Bevilacqua & Karen Trister Grace & Langan Denhard & Arshdeep Kaur & Janice Miller & Michele R. Decker, 2021. "Examining the Neighborhood Attributes of Recently Housed Partner Violence Survivors in Rapid Rehousing," IJERPH, MDPI, vol. 18(8), pages 1-22, April.
    6. Maayan Yitshak-Sade & Kevin J Lane & M Patricia Fabian & Itai Kloog & Jaime E Hart & Brigette Davis & Kelvin C Fong & Joel D Schwartz & Francine Laden & Antonella Zanobetti, 2020. "Race or racial segregation? Modification of the PM2.5 and cardiovascular mortality association," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-12, July.
    7. Angel G. Ortiz & Daniel Wiese & Kristen A. Sorice & Minhhuyen Nguyen & Evelyn T. González & Kevin A. Henry & Shannon M. Lynch, 2020. "Liver Cancer Incidence and Area-Level Geographic Disparities in Pennsylvania—A Geo-Additive Approach," IJERPH, MDPI, vol. 17(20), pages 1-20, October.
    8. Laura A. Rodriguez-Villamizar & Diana Marín & Juan Gabriel Piñeros-Jiménez & Oscar Alberto Rojas-Sánchez & Jesus Serrano-Lomelin & Victor Herrera, 2023. "Intraurban Geographic and Socioeconomic Inequalities of Mortality in Four Cities in Colombia," IJERPH, MDPI, vol. 20(2), pages 1-19, January.

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