This ecologic study examined the association of mortality with selected socioeconomic indicators among blacks and whites under the age of 65 in 267 US metropolitan areas. The socioeconomic indicators were drawn from census and vital statistics data and included median income, income inequality, percentage of the population that was black and residential segregation. The primary aim of the analysis was to operationalize the concept of institutional racism in public health. Age-adjusted mortality was 81% higher in blacks compared to whites and median household income was 40% lower. Inequality, as measured by the Gini coefficient, was greater within the black than within the white population (0.45 vs. .40; p < .001). The variables were all independently and significantly related to mortality (p < .01; R2=0.74). Income inequality for the total population was significantly correlated with mortality (Gini vs. Mortality, r=0.33). Residential segregation was significantly related to mortality and income inequality for blacks (r=0.38, both relationships); among whites, however, segregation was modestly correlated with mortality (r=0.19) and uncorrelated with income inequality. Regional analyses demonstrated that the association of segregation with mortality was much more pronounced in the South and in areas with a larger black population. Ecologic studies of the relationships among social factors and population health can measure attributes of the social context that may be relevant for population health, providing the basis for imputing macro-level relationships. Through group comparisons these studies offer support to the role of social forces.
Learning Objectives: 1. To understand the relationship between mortality and socioecomonic factors in black and whites.
Keywords: Social Inequalities, Ethnicity
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.