Segregation and mortality: The deadly effects of racism?

Elevated rates of mortality for African Americans compared to whites, coupled with the persistence of high levels of racial residential segregation, have directed attention to the structural manifestations of racism as potentially important pathogens for health. Using national mortality and census data for 1990 and a measure of black social isolation from whites, we examine the association between residential segregation and mortality in 107 major U.S. cities. Our analyses revealed that black social isolation tended to predict higher rates of mortality for African American males and females, although the strength of the association varied by cause of death. Socioeconomic deprivation explained a modest part of this association for black males but not for black females. Our analyses also found that a positive association between social isolation and mortality was more pronounced, for both blacks and whites, in cities that were also high on the index of dissimilarity. These findings highlight the need for research to identify the specific mechanisms and processes that link residential environments to adverse changes in health status.