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Public health monitoring of privilege and deprivation with the index of concentration at the extremes

Author

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  • Krieger, N.
  • Waterman, P.D.
  • Spasojevic, J.
  • Li, W.
  • Maduro, G.
  • Van Wye, G.

Abstract

Objectives. We evaluated use of the Index of Concentration at the Extremes (ICE) for public health monitoring. Methods.We used New York City data centered around 2010 to assess cross-sectional associations at the census tract and community district levels, for (1) diverse ICE measures plus the US poverty rate, with (2) infant mortality, premature mortality (before age 65 years), and diabetes mortality. Results. Point estimates for rate ratios were consistently greatest for the novel ICE that jointly measured extreme concentrations of income and race/ethnicity. For example, the census tract-level rate ratio for infant mortality comparing the bottom versus top quintile for an ICE contrasting low-income Black versus high-income White equaled 2.93 (95% confidence interval [CI] = 2.11, 4.09), but was 2.19 (95% CI = 1.59, 3.02) for low versus high income, 2.77 (95% CI = 2.02, 3.81) for Black versus White, and 1.56 (95% CI = 1.19, 2.04) for census tracts with greater than or equal to 30% versus less than 10% below poverty. Conclusions. The ICE may be a useful metric for public health monitoring, as it simultaneously captures extremes of privilege and deprivation and can jointly measure economic and racial/ethnic segregation.

Suggested Citation

  • Krieger, N. & Waterman, P.D. & Spasojevic, J. & Li, W. & Maduro, G. & Van Wye, G., 2016. "Public health monitoring of privilege and deprivation with the index of concentration at the extremes," American Journal of Public Health, American Public Health Association, vol. 106(2), pages 256-263.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.302955_2
    DOI: 10.2105/AJPH.2015.302955
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    2. Jeffers, Noelene K. & Berger, Blair O. & Marea, Christina X. & Gemmill, Alison, 2023. "Investigating the impact of structural racism on black birthing people - associations between racialized economic segregation, incarceration inequality, and severe maternal morbidity," Social Science & Medicine, Elsevier, vol. 317(C).
    3. Marilyn D. Thomas & Eli K. Michaels & Sean Darling-Hammond & Thu T. Nguyen & M. Maria Glymour & Eric Vittinghoff, 2020. "Whites’ County-Level Racial Bias, COVID-19 Rates, and Racial Inequities in the United States," IJERPH, MDPI, vol. 17(22), pages 1-19, November.
    4. Jahn, Jaquelyn L. & Chen, Jarvis T. & Agénor, Madina & Krieger, Nancy, 2020. "County-level jail incarceration and preterm birth among non-Hispanic Black and white U.S. women, 1999–2015," Social Science & Medicine, Elsevier, vol. 250(C).
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    6. Wen Fan & Liying Luo, 2020. "Understanding Trends in the Concentration of Infant Mortality Among Disadvantaged White and Black Mothers in the United States, 1983–2013: A Decomposition Analysis," Demography, Springer;Population Association of America (PAA), vol. 57(3), pages 979-1005, June.
    7. Veni Kandasamy & Ashley H Hirai & Jay S Kaufman & Arthur R James & Milton Kotelchuck, 2020. "Regional variation in Black infant mortality: The contribution of contextual factors," PLOS ONE, Public Library of Science, vol. 15(8), pages 1-15, August.
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    11. 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.
    12. Joan A. Casey & Peter James & Lara Cushing & Bill M. Jesdale & Rachel Morello-Frosch, 2017. "Race, Ethnicity, Income Concentration and 10-Year Change in Urban Greenness in the United States," IJERPH, MDPI, vol. 14(12), pages 1-15, December.
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    14. Miller, Charlotte E. & Vasan, Ramachandran S., 2021. "The southern rural health and mortality penalty: A review of regional health inequities in the United States," Social Science & Medicine, Elsevier, vol. 268(C).
    15. 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.
    16. 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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