Mapping Segregation Across the US.
A new study conducted by Northwestern Medicine reveals that Black residents residing in highly segregated neighborhoods experience significantly shortened life expectancies.
The study, which is the first of its kind to analyze life expectancy at the neighborhood level, found that individuals living in highly segregated areas have, on average, four years less life expectancy compared to those in less segregated predominantly white neighborhoods.
The research sheds light on the role of residential segregation in contributing to racial health inequities based on geographical location. In addition to shorter lifespans, the study discovered that residents in more segregated areas were more likely to lack a college education, live below the federal poverty line, and face unemployment. These characteristics reflect the social determinants of health, which play a vital role in overall well-being.
Dr. Sadiya Khan, the corresponding study author and an associate professor of cardiology and epidemiology at Northwestern University Feinberg School of Medicine, emphasized the impact of one’s residential area, stating, “A common phrase is ‘your zip code is more important than your genetic code.’
“At a broader level, we’ve learned much about the health consequences of adverse social determinants of health, but we were trying to better understand on a local level what the implications of racial segregation are on life expectancy.”
The analysis of the study was published today in JAMA Health Forum.
While previous research has examined life expectancy among racially segregated populations on a state or county level, this study provides insight into the specific impact of segregation at the neighborhood level. The findings underscore the enduring influence of residential segregation perpetuated by discriminatory housing practices like redlining, which result in related socioeconomic disadvantages that must be analyzed within the context of neighborhoods.
The study encompassed 63,694 census tracts across the United States, finding that the national average life expectancy stands at 78 years old. However, predominantly Black neighborhoods with high racial segregation exhibited an average life expectancy of 75 years, significantly lower than the average of 79 years in neighborhoods with low racial segregation.
Moreover, the study revealed that residents in highly segregated areas had higher percentages of individuals lacking a college education, living below the federal poverty line, and experiencing unemployment compared to less segregated neighborhoods.
The study model did not incorporate factors such as access to healthcare, housing stability, and environmental pollution. However, the authors acknowledged that these elements are related to structural racism and likely impact the association between segregation and life expectancy.
Dr. Khan explained, “While the mechanisms by which neighborhood segregation may contribute to differences in life expectancy are many, we sought to focus on key socioeconomic factors that are likely attributable to redlining and downstream differences by neighborhood in economic investment and resources in communities, which all have downstream consequences on health. These factors explained more than half of the differences in life expectancy across neighborhoods in our analysis.”
The senior author, Kiarri Kershaw, an associate professor of epidemiology at Feinberg, highlighted the importance of addressing the circumstances in which people live rather than solely focusing on individual-level interventions.
The author added, “The solution is less about the decision of where people live and more about changing the circumstances in which they live.”
The study’s findings hold the potential to inform policy decisions aimed at improving overall health in the United States.
Dr. Khan stressed the need for equity in terms of educational opportunities, employment, and a healthy environment at the local level where people are born, live, and grow.
Efforts such as the Bronzeville initiative, which provides local care and economic opportunities for residents of the Bronzeville neighborhood in Chicago, and the Northwestern Scholars program, which increases access and successful matriculation of underrepresented students from Chicago Public Schools to top-tier colleges and universities, exemplify local solutions to address these challenges.
According to Dr. Clyde Yancy, who serves as the vice dean for diversity and inclusion and chief of cardiology at Feinberg, addressing local challenges necessitates tailored solutions. He emphasizes that no single intervention can fundamentally alter risks at the neighborhood level. While public health advocacy plays a role, Dr. Yancy stresses the immense value of economic opportunities and high-quality education in bringing about positive change.
Source: 10.1001/jamahealthforum.2023.1805
Image Credit: Getty