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Luisa Franzini, PhD1, Margaret Caughy, PhD1, William Spears, PhD2, and Maria Eugenia Fernandez-Esquer, PhD1. (1) University of Texas School of Public Health, 1200 Herman Pressler, Houston, TX 77030, 713 500 9487, lfranzini@sph.uth.tmc.edu, (2) San Antonio Regional Campus, University of Texas School of Public Health, 7703 Floyd Curl Drive, Mail Code 7976, San Antonio, TX 78284
Racial/ethnic disparities in health outcomes are due to several economic and social factors. This paper explores the role of the neighborhood of residence in explaining racial/ethnic disparities in self-rated health in a diverse set of neighborhoods in Texas. We develop and test a comprehensive model to explain the relationships between neighborhood of residence SES, multiple dimensions of neighborhood social and physical characteristics, individual race/ethnicity SES and demographic factors to individual health outcomes. Data were drawn from surveys obtained using a multistage probability sample in low/medium income “neighborhoods”, defined as census block groups, in the Houston area and in Lower Rio Grande Valley. The sample of 3,171 individuals represents 100 census block groups. Neighborhood social and physical characteristics were modeled as latent variables and multilevel structural equation models were used to estimate the relationships between neighborhood SES, neighborhood social and physical characteristics, individual race/ethnicity (white, Hispanic, and African-American), income to needs ratio, age, and sex and individual self-rated health. The results indicate that racial/ethnic disparities in self-rated health are explained by neighborhood of residence impoverishment (neighborhood poverty rate, unemployment rate, vacant housing rate, and proportion of households with children under the age of 5 which were single-headed). Social and physical characteristics of neighborhoods (collective efficacy, social capital measured by trust and norms of reciprocity, social and physical disorder, social processes pertaining to children, availability of play resources, and neighborhood climate characterized by heightened fear and racism) are determined by neighborhood structural factors and mediate the effects of neighborhood impoverishment on individual self-rated health. Individual factors, such as age, sex, and income to needs ratio remain strong predictors of self-rated health. The results of this study contribute to our understanding of how different neighborhood characteristics mediate the effect of race/ethnicity on individual health status.
Learning Objectives:
Keywords: Community, Health
Presenting author's disclosure statement:
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.