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Racial disparities in context: A multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts

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  • Subramanian, S.V.
  • Chen, J.T.
  • Rehkopf, D.H.
  • Waterman, P.D.
  • Krieger, N.

Abstract

Objectives. We analyzed neighborhood heterogeneity in associations among mortality, race/ethnicity, and area poverty. Methods. We performed a multilevel statistical analysis of Massachusetts all-cause mortality data for the period 1989 through 1991 (n = 142836 deaths), modeled as 79813 cells (deaths and denominators cross-tabulated by age, gender, and race/ethnicity) at level 1 nested within 5532 block groups at level 2 within 1307 census tracts (CTs) at level 3. We also characterized CTs by percentage of the population living below poverty level. Results. Neighborhood variation in mortality across CTs and block groups was not accounted for by these areas' age, gender, and racial/ethnic composition. Neighborhood variation in mortality was much greater for the Black population than for the White population, largely because of CT-level variation in poverty rates. Conclusions. Neighborhood heterogeneity in the relationship between mortality and race/ethnicity in Massachusetts is statistically significant and is closely related to CT-level variation in poverty.

Suggested Citation

  • Subramanian, S.V. & Chen, J.T. & Rehkopf, D.H. & Waterman, P.D. & Krieger, N., 2005. "Racial disparities in context: A multilevel analysis of neighborhood variations in poverty and excess mortality among black populations in Massachusetts," American Journal of Public Health, American Public Health Association, vol. 95(2), pages 260-265.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2003.034132_8
    DOI: 10.2105/AJPH.2003.034132
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    1. Scribner, Richard Allen & Theall, Katherine P. & Simonsen, Neal R. & Mason, Karen E. & Yu, Qingzhao, 2009. "Misspecification of the effect of race in fixed effects models of health inequalities," Social Science & Medicine, Elsevier, vol. 69(11), pages 1584-1591, December.
    2. Subramanian, S.V. & Elwert, Felix & Christakis, Nicholas, 2008. "Widowhood and mortality among the elderly: The modifying role of neighborhood concentration of widowed individuals," Social Science & Medicine, Elsevier, vol. 66(4), pages 873-884, February.
    3. Dustin T. Duncan & Jared Aldstadt & John Whalen & Kellee White & Márcia C. Castro & David R. Williams, 2012. "Space, race, and poverty: Spatial inequalities in walkable neighborhood amenities?," Demographic Research, Max Planck Institute for Demographic Research, Rostock, Germany, vol. 26(17), pages 409-448.
    4. Michael Reibel, 2007. "Geographic Information Systems and Spatial Data Processing in Demography: a Review," Population Research and Policy Review, Springer;Southern Demographic Association (SDA), vol. 26(5), pages 601-618, December.
    5. Bethany M. Wood & Catherine Cubbin & Esmeralda J. Rubalcava Hernandez & Diana M. DiNitto & Shetal Vohra-Gupta & Philip Baiden & Elizabeth J. Mueller, 2023. "The Price of Growing Up in a Low-Income Neighborhood: A Scoping Review of Associated Depressive Symptoms and Other Mood Disorders among Children and Adolescents," IJERPH, MDPI, vol. 20(19), pages 1-25, October.
    6. Shell, Alyssa Marie & Peek, M. Kristen & Eschbach, Karl, 2013. "Neighborhood Hispanic composition and depressive symptoms among Mexican-descent residents of Texas City, Texas," Social Science & Medicine, Elsevier, vol. 99(C), pages 56-63.
    7. Arcaya, Mariana C. & Tucker-Seeley, Reginald D. & Kim, Rockli & Schnake-Mahl, Alina & So, Marvin & Subramanian, S.V., 2016. "Research on neighborhood effects on health in the United States: A systematic review of study characteristics," Social Science & Medicine, Elsevier, vol. 168(C), pages 16-29.
    8. Bjornstrom, Eileen E.S., 2011. "The neighborhood context of relative position, trust, and self-rated health," Social Science & Medicine, Elsevier, vol. 73(1), pages 42-49, July.
    9. Andrea Fleisch Marcus & Alex H Illescas & Bernadette C Hohl & Adana A M Llanos, 2017. "Relationships between social isolation, neighborhood poverty, and cancer mortality in a population-based study of US adults," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-13, March.
    10. Peter Congdon, 2010. "A Multilevel Model for Comorbid Outcomes: Obesity and Diabetes in the US," IJERPH, MDPI, vol. 7(2), pages 1-20, January.

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