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sy9 - V iewpoint Racial Residential Segregation A...

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Viewpoint 404 Public Health Reports / September–October 2001 / Volume 116 SYNOPSIS Racial residential segregation is a fundamental cause of racial disparities in health. The physical separation of the races by enforced residence in certain areas is an institutional mecha- nism of racism that was de- signed to protect whites from social interaction with blacks. Despite the absence of support- ive legal statutes, the degree of residential segregation remains extremely high for most African Americans in the United States. The authors review evidence that suggests that segregation is a primary cause of racial differ- ences in socioeconomic status (SES) by determining access to education and employment opportunities. SES in turn remains a fundamental cause of racial differences in health. Segregation also creates condi- tions inimical to health in the social and physical environment. The authors conclude that effective efforts to eliminate racial disparities in health must seriously confront segregation and its pervasive consequences. Racial Residential Segregation: A Fundamental Cause of Racial Disparities in Health a Department of Sociology and Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI b Department of Sociology, University of Texas at Austin, Austin, TX Address correspondence to David R. Williams, PhD, MPH, Institute for Social Research, Univ. of Michigan, PO Box 1248, Ann Arbor, MI 48106-1248; tel. 734-936-0649; fax 734-647-6972; e-mail <[email protected]>. Preparation of this article was supported by grants MH59575 and MH57425 from the National Institute of Mental Health and by the John D. and Catherine T. MacArthur Foundation Research Network on Socioeconomic Status and Health. The authors thank Scott Wyatt for research assistance and Kathleen Boyle for preparing the manuscript. © 2001 Association of Schools of Public Health David R. Williams, PhD, MPH a Chiquita Collins, PhD b
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Racial Residential Segregation 405 Public Health Reports / September–October 2001 / Volume 116 Racial disparities are large and pervasive across mul- tiple indicators of health status. Mortality data for the United States reveal that, compared to the white popu- lation, African Americans/blacks have an elevated death rate for 8 of the 10 leading causes of death. 1 Especially disconcerting is evidence revealing that black-white disparities in health have not narrowed over time. For example, age-adjusted all-cause mortal- ity for African Americans was one and a half times as high as that of whites in 1998, identical to what it was in 1950. 1 Moreover, the black:white ratios of mortality from coronary heart disease, cancer, diabetes, and cir- rhosis of the liver were larger in the late 1990s than in 1950. 2 In the case of infant mortality, the black:white ratio increased from 1.6 in 1950 to 2.4 in 1998.
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