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Residential segregation and the epidemiology of infectious diseases


  • Acevedo-Garcia, Dolores


Several empirical studies have documented the effects of residential segregation on health inequalities between the US African-American and white populations. However, the majority of such studies have not explained the pathways that link residential segregation and specific health outcomes. This paper presents a conceptual framework of the role that residential segregation may play in the epidemiology of tuberculosis (TB) and other infectious diseases. This is an important issue given the concentration of TB cases among US racial/ethnic minorities and the increasing gap in the incidence of infectious diseases between minorities and the white majority. Segregation may have an indirect effect on the transmission of TB because of its negative impact on the quality of neighborhood environment in segregated communities. Segregation concentrates poverty, overcrowded and dilapidated housing and social disintegration in minority areas, and results in limited access to health care. Furthermore, two dimensions of residential segregation (isolation and concentration) may have direct effects on TB transmission. The isolation of minorities confines TB to segregated areas and prevents transmission to the rest of the population. High-density levels in minority areas increase the probability of transmission within the segregated group. In order to operationalize the above pathways, health researchers may rely on the segregation literature, which has conceptualized various dimensions of residential segregation and proposed ways to measure them. The indirect pathways that link segregation and TB can be captured through exposure indices, which quantify the concentration of risk factors for TB for various racial and ethnic groups. The direct pathways can be captured through the isolation index (which is a proxy for the degree of interaction between the segregated group and the rest of the population) and two proposed measures of density (which are proxies for the likelihood of transmission within the segregated group and from the segregated group to the rest of the population).

Suggested Citation

  • Acevedo-Garcia, Dolores, 2000. "Residential segregation and the epidemiology of infectious diseases," Social Science & Medicine, Elsevier, vol. 51(8), pages 1143-1161, October.
  • Handle: RePEc:eee:socmed:v:51:y:2000:i:8:p:1143-1161

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    Cited by:

    1. Grady, Sue C., 2006. "Racial disparities in low birthweight and the contribution of residential segregation: A multilevel analysis," Social Science & Medicine, Elsevier, vol. 63(12), pages 3013-3029, December.
    2. James J. Feigenbaum & Christopher Muller & Elizabeth Wrigley-Field, 2019. "Regional and Racial Inequality in Infectious Disease Mortality in U.S. Cities, 1900–1948," Demography, Springer;Population Association of America (PAA), vol. 56(4), pages 1371-1388, August.
    3. Bécares, Laia & Cormack, Donna & Harris, Ricci, 2013. "Ethnic density and area deprivation: Neighbourhood effects on Māori health and racial discrimination in Aotearoa/New Zealand," Social Science & Medicine, Elsevier, vol. 88(C), pages 76-82.
    4. Prentice, Julia C., 2006. "Neighborhood effects on primary care access in Los Angeles," Social Science & Medicine, Elsevier, vol. 62(5), pages 1291-1303, March.
    5. 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.
    6. Nicole Bohme Carnegie & Martina Morris, 2012. "Size Matters: Concurrency and the Epidemic Potential of HIV in Small Networks," PLOS ONE, Public Library of Science, vol. 7(8), pages 1-6, August.
    7. Beck, Audrey N. & Finch, Brian K. & Lin, Shih-Fan & Hummer, Robert A. & Masters, Ryan K., 2014. "Racial disparities in self-rated health: Trends, explanatory factors, and the changing role of socio-demographics," Social Science & Medicine, Elsevier, vol. 104(C), pages 163-177.
    8. Lutfi, Khaleeq & Trepka, Mary Jo & Fennie, Kristopher P. & Ibanez, Gladys & Gladwin, Hugh, 2015. "Racial residential segregation and risky sexual behavior among non-Hispanic blacks, 2006–2010," Social Science & Medicine, Elsevier, vol. 140(C), pages 95-103.
    9. Malia Jones & Anne Pebley, 2014. "Redefining Neighborhoods Using Common Destinations: Social Characteristics of Activity Spaces and Home Census Tracts Compared," Demography, Springer;Population Association of America (PAA), vol. 51(3), pages 727-752, June.
    10. Viruell-Fuentes, Edna A. & Miranda, Patricia Y. & Abdulrahim, Sawsan, 2012. "More than culture: Structural racism, intersectionality theory, and immigrant health," Social Science & Medicine, Elsevier, vol. 75(12), pages 2099-2106.
    11. Ziersch, Anna & Due, Clemence, 2018. "A mixed methods systematic review of studies examining the relationship between housing and health for people from refugee and asylum seeking backgrounds," Social Science & Medicine, Elsevier, vol. 213(C), pages 199-219.
    12. Logan, Trevon D. & Parman, John M., 2018. "Segregation and mortality over time and space," Social Science & Medicine, Elsevier, vol. 199(C), pages 77-86.
    13. Joseph Gibbons & Robert Malouf & Brian Spitzberg & Lourdes Martinez & Bruce Appleyard & Caroline Thompson & Atsushi Nara & Ming-Hsiang Tsou, 2019. "Twitter-based measures of neighborhood sentiment as predictors of residential population health," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-19, July.
    14. Peter Congdon & Patsy Lloyd, 2011. "Toxocara infection in the United States: the relevance of poverty, geography and demography as risk factors, and implications for estimating county prevalence," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 56(1), pages 15-24, February.
    15. Do, D. Phuong & Wang, Lu & Elliott, Michael R., 2013. "Investigating the relationship between neighborhood poverty and mortality risk: A marginal structural modeling approach," Social Science & Medicine, Elsevier, vol. 91(C), pages 58-66.
    16. Do, D. Phuong & Dubowitz, Tamara & Bird, Chloe E. & Lurie, Nicole & Escarce, Jose J. & Finch, Brian K., 2007. "Neighborhood context and ethnicity differences in body mass index: A multilevel analysis using the NHANES III survey (1988-1994)," Economics & Human Biology, Elsevier, vol. 5(2), pages 179-203, July.


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