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Ethnicity and Mortality in the United States: Individual and Community Correlates
LeClere, Felicia, Richard G. Rogers, and Kimberley Peters, 1997. Social Forces,
76:169–198. †
It has been suggested in the past that the higher mortality rates experienced by
non–whites is a result of social disadvantages. However, this theory does not completely explain the
age–specific mortality differentials between African Americans and whites and is directly contradicted
by the observed differences in mortality rates between Hispanics and non–Hispanics. The authors of this
paper consider the effect of racial discrimination, with particular reference to residential segregation,
which may reinforce social isolation and economic segregation. The paper attempted to evaluate if
neighborhood characteristics, in general, and more specifically, social and economic correlates of
residential segregation, have a significant impact on mortality.
The authors examined the effect of selective neighbourhood characteristics on overall
mortality for men and women. Residential segregation can produce poor mortality outcomes for all persons,
rather then just ethnic sub–populations. This study wanted to identify the pathways and processes that
can impact mortality differently depending on place of residence. The age–specific patterns of
mortality for men were examined. These results were re–estimated to see if neighbourhood
characteristics are most critical for particular age groups.
The study uses data from the entire U.S. It is based on the National Health Interview
Survey (NHIS), the National Health Interview Survey – National Death Index (NHIS–NDI) and the
1990 Census of Population.
Residential segregation was measured by the proportion of a community that was African
American or Hispanic. The following neighborhood characteristics were examined: median family income, female
headship rates (i.e. households headed by a female family member), poverty rates, educational attainment,
linguistic isolation and migration.
The results suggest that residential segregation influences individual mortality in
opposite ways for African Americans and Mexican Americans and that the effects are larger for men than for
women. It was found that neighborhoods with low income and high concentrations of African Americans increase
the likelihood of death for all residents and partially explain the ethnic differential in mortality.
However, the variable neighborhood characteristics did not act as dramatically on the risk of death among
Mexican Americans as it did for African Americans.
In general, none of the individual–level correlates of mortality were modified by
the introduction of neighborhood characteristics, except for the relative risk associated with living in
concentrated African American communities. The direct effects of age, education, family income and marital
status on mortality risk were not explained, even in part, by their association with place of residence. It
was also found that neighborhood linguistic isolation and mobility did not affect mortality risk. The idea of
selective migration argues that those in poor health are more likely to move into poor and disadvantaged
areas and, because of their health are more likely to die. This was partially eliminated as an alternative
hypothesis. This was through a discussion, rather than formal testing.
The mechanisms that affected mortality and ethnic mortality differentials differed
between men and women. For men, the results suggested neighborhood income and ethnic concentration directly
affect mortality risk for all ethnic groups and that these mechanisms explain the ethnic differentials.
Indeed, the ethnic differential in mortality between non–Hispanic white and African American men is
only fully accounted for in models that include the concentration of African Americans as a co–variate.
These effects were found to be especially important among young and middle–aged men.
The causal mechanisms linking ethnic minority concentration to poor mortality for women
were less clear. Women of all educational levels were found to be protected by the educational attainment of
neighbors. This effect appeared to be independent of the ethnic mix in the neighborhood or median income. The
paper also suggests that ethnic residential segregation may affect women's mortality by its association with
high levels of female headship. This may be a result of physical and financial stress.
This study confirms previous findings that show that individual social and economic
characteristics are important determinants of ethnic differentials in mortality. Individual characteristics
were robustly related to mortality but the community was also found to affect individual mortality risk. This
suggests that mortality analyses that ignore individual traits or the effects of local conditions will be
distorted.
The paper acknowledges that this research ignores individual and contextual mechanisms
that intervene between ethnicity, socio–economic status and mortality. The authors propose that this
research is merely a first step in developing a greater understanding of the factors affecting mortality.
They suggest that better measurement at the individual, family and community level would lead to more
comprehensive mortality models based on an integrated conceptual framework. They also suggest that mortality
analyses should be expanded to different sub–populations, types of neighborhoods, and specific causes
of death.
† This study is based on data from the United States.