Race, Class, Gender & Diversity

The Contribution of Health Care and Other Interventions to Black-White Disparities in Life Expectancy, 1980-2007

The Contribution of Health Care and Other Interventions to Black-White Disparities in Life Expectancy, 1980-2007
Population Research and Policy Review, Vol. 33, no. 1 (Feb 2014), pp. 97-126. doi: 10.1007/s11113-013-9309-2

Elo, I.T., H. Beltran-Sanchez, and J. Macinko
02/01/2014

Black–white mortality disparities remain sizable in the United States. In this study, we use the concept of avoidable/amenable mortality to estimate cause-of-death contributions to the difference in life expectancy between whites and blacks by gender in the United States in 1980, 1993, and 2007. We begin with a review of the concept of “avoidable mortality” and results of prior studies using this cause-of-death classification. We then present the results of our empirical analyses. We classified causes of death as amenable to medical care, sensitive to public health policies and health behaviors, ischemic heart disease, suicide, HIV/AIDS, and all other causes combined. We used vital statistics data on deaths and Census Bureau population estimates and standard demographic decomposition techniques. In 2007, causes of death amenable to medical care continued to account for close to 2 years of the racial difference in life expectancy among men (2.08) and women (1.85). Causes amenable to public health interventions made a larger contribution to the racial difference in life expectancy among men (1.17 years) than women (0.08 years). The contribution of HIV/AIDS substantially widened the racial difference among both men (1.08 years) and women (0.42 years) in 1993, but its contribution declined over time. Despite progress observed over the time period studied, a substantial portion of black–white disparities in mortality could be reduced given more equitable access to medical care and health interventions.

Spatial Segmentation and the Black Middle Class

Spatial Segmentation and the Black Middle Class
American Journal of Sociology, Vol. 119 no. 4, pp. 903-54. The University of Chicago

Sharkey, P.
01/01/2014

Ethnographic studies of the black middle class focus attention on the ways in which residential environments condition the experiences of different segments of the black class structure. This study places these arguments in a larger demographic context by providing a national analysis of neighborhood inequality and spatial inequality of different racial and ethnic groups in urban America. The findings show that there has been no change over time in the degree to which majority-black neighborhoods are surrounded by spatial disadvantage. Predominantly black neighborhoods, regardless of socioeconomic composition, continue to be spatially linked with areas of severe disadvantage. However, there has been substantial change in the degree to which middle- and upper-income African-American households have separated themselves from highly disadvantaged neighborhoods. These changes are driven primarily by the growing segment of middle- and upper-income African-Americans living in neighborhoods in which they are not the majority group, both in central cities and in suburbs.

Mobility and the Metropolis

Mobility and the Metropolis
Washington, D.C.: The Economic Mobility Project, An Initiative of The Pew Charitable Trusts

Graham, B., and P. Sharkey
12/03/2013

In a 2011 public opinion poll, The Pew Charitable Trusts asked Americans how important they thought a number of factors were in determining whether people in the United States get ahead or fall behind economically. More than 80 percent of respondents identified factors such as hard work, ambition, and access to education as key drivers of upward mobility, while less than half viewed growing up in a good neighborhood as an important factor. On the contrary, respondents strongly agreed that a young person with drive, ambition, and creativity growing up in a poor neighborhood is more likely to get ahead economically than someone growing up in a more affluent neighborhood who lacks those attributes.

Contrary to these perceptions, however, evidence is building that location actually matters a great deal and that Americans’ economic mobility prospects vary by state, locality, and even neighborhood.

For example, a 2009 Pew study indicated that a person who experienced high neighborhood poverty throughout childhood had a much higher risk of moving down the economic ladder as an adult. Other recent research examining mobility among metropolitan areas, including nearby towns and rural areas, showed that economic mobility varied widely across these localities. And, in a 2012, first-of-its-kind analysis of Americans’ economic mobility at the state level, Pew found that a number of states, primarily in the Mideast and New England regions, had higher mobility than the national average, and other states, primarily in the South, had lower mobility. 

This report adds to the growing body of research as it examines economic mobility across 96 U.S. metropolitan areas and the role of place in Americans’ prospects of moving up or down the economic ladder. It also offers insight on why and how location matters. Although a host of factors, such as state and local policies and labor market conditions, could influence mobility, this analysis considers one: neighborhood economic segregation, or the degree to which the poor and the wealthy live apart from each other. To begin to answer this question, Pew commissioned original research that, using three longitudinal data sets, measures differences in economic mobility across American metro areas over the last generation and identifies above-average-, average-, and below-average-mobility areas. The analysis then looks at whether metro areas’ rates of economic segregation are related to their rates of economic mobility.

Race and neighborhoods in the 21st century: What does segregation mean today?

Race and neighborhoods in the 21st century: What does segregation mean today?
Regional Science and Urban Economics (2013), http://dx.doi.org/10.1016/j.regsciurbeco.2013.09.006

De la Roca, Jorge, Ingrid Gould Ellen and Katherine M. O'Regan.
09/14/2013

Noting the decline in segregation between blacks and whites over the past several decades, some recent work argues that racial segregation is no longer a concern in the 21st century. In response, this paper revisits some of the concerns that John Quigley raised about racial segregation and neighborhoods to assess their relevance today. We note that while segregation levels between blacks and whites have certainly declined, they remain quite high; Hispanic and Asian segregation have meanwhile remained unchanged. Further, our analysis shows that the neighborhood environments of minorities continue to be highly unequal to those enjoyed by whites. Blacks and Hispanics continue to live among more disadvantaged neighbors, to have access to lower performing schools, and to be exposed to more violent crime. Further, these differences are amplified in more segregated metropolitan areas.

Learning in Place: Immigrant Spatial and Temporal Strategies for Occupational Advancement

Learning in Place: Immigrant Spatial and Temporal Strategies for Occupational Advancement
Economic Geography. 89 (1): 53-75.

Iskander, N., C. Riordan, & N. Lowe.
09/06/2013

Studies of low-wage workers have long recognized the role of space in mediating access to employment. Significantly less attention has been paid to the ways in which space informs workers' ability to develop the attributes that would make them more employable. In this article, we address this gap through an examination of how immigrant workers use the relative spatial organization of residence and production to cultivate the skills that enable them to shift out of low-wage occupations. We also argue that workers' spatial job market strategies have an important, but often overlooked, temporal aspect: workers use space over time not only to shape their access to jobs but also to create breathing room for learning skills that enable them to improve their employment trajectories over the long term. Drawing on a multiyear ethnographic study of Mexican immigrants in downtown Philadelphia, we show that immigrant workers used the functional proximity among the restaurant industry, small-scale residential construction work pertaining to housing renovation, and the neighborhoods where they lived to develop skill sets that enabled them to shift into higher-wage construction jobs. In essence, these workers knitted together two seemingly separate industries, such that they could use their employment time in one for learning in and about the other. Our study suggests that interventions that curtail immigrants' mobility may have implications that are far more serious than limiting immediate access to jobs: these measures may undercut immigrants' strategies for developing the skills required for long-term occupational mobility and advancement.

Not Just for Poor Kids: The Impact of Universal Free School Breakfast on Meal Participation and Student Outcomes

Not Just for Poor Kids: The Impact of Universal Free School Breakfast on Meal Participation and Student Outcomes
Economics of Education Review, 36: 88-107

Leos-Urbel, J., Schwartz, A. E., Weinstein, M., & Corcoran, S.
06/18/2013

This paper examines the impact of the implementation of a universal free school breakfast policy on meals program participation, attendance, and academic achievement. In 2003, New York City made school breakfast free for all students regardless of income, while increasing the price of lunch for those ineligible for meal subsidies. Using a difference-indifference estimation strategy, we derive plausibly causal estimates of the policy’s impact by exploiting within and between group variation in school meal pricing before and after the policy change. Our estimates suggest that the policy resulted in small increases in breakfast participation both for students who experienced a decrease in the price of breakfast and for free-lunch eligible students who experienced no price change. The latter suggests that universal provision may alter behavior through mechanisms other than price, highlighting the potential merits of universal provision over targeted services. We find limited evidence of policy impacts on academic outcomes.

Why Do Higher Income Households Move Into Low Income Neighborhoods: Pioneering or Thrift?

Why Do Higher Income Households Move Into Low Income Neighborhoods: Pioneering or Thrift?
Urban Studies, September 2013; vol. 50, 12: pp. 2478-2495.

Ellen, Ingrid, Katherine O’Regan and Keren Horn
05/01/2013

This paper offers several hypotheses about which US higher-income households choose to move into low-income neighbourhoods and why. It first explores whether the probability that a household moves into a relatively low-income neighbourhood (an RLIN move) varies with predicted household and metropolitan area characteristics. Secondly, it estimates a residential choice model to examine the housing and neighbourhood preferences of the households making such moves. Thirdly, it explores responses to survey questions about residential choices. Evidence is found that, in the US, households who place less value on neighbourhood services and those who face greater constraints on their choices are more likely to make an RLIN move. No evidence is found that households making RLIN moves are choosing neighbourhoods that are more accessible to employment. Rather, it is found that households making RLIN moves appear to place less weight on neighbourhood amenities than other households and more weight on housing costs.

Non-academic factors associated with dropping out of high school: Adolescent problem behaviors

Non-academic factors associated with dropping out of high school: Adolescent problem behaviors
Journal of the Society for Social Work Research. Vol. 4, No. 2 (2013) (pp. 58-75).

Hawkins, R. L., Jaccard, J., & Needle, E.
04/02/2013

This study uses a social capital and collective socialization lens to examine nonacademic factors in middle school that predict students’ failure to complete high school, and focuses on youth who engage in adolescent problem behaviors of smoking cigarettes, sexual intercourse, delinquency, marijuana use, and alcohol use. Our area of interest was the extent to which these variables were predictive of dropping out of high school measured 6 years later and beyond the traditional variables of school performance and school engagement, which are the target of many dropout prevention programs. Analyses use data from the National Longitudinal Study of Adolescent Health to follow a nationally representative sample of children from middle school through the end of the high-school years. Results indicate that engaging in regular smoking and sexual activity during middle-school years predict high-school dropout independent of school performance during middle school. Acts of delinquency during middle school in the context of poverty (i.e., mothers’ receipt of welfare was proxy for poverty) are also predictive of high-school dropout. These findings suggest the importance of factors that reach beyond school performance and school engagement as possible targets for dropout prevention programs.

Stuck in Place: Urban Neighborhoods and the End of Progress toward Racial Equality

Stuck in Place: Urban Neighborhoods and the End of Progress toward Racial Equality
University of Chicago Press

Sharkey, P.
04/01/2013

In the 1960s, many believed that the civil rights movement’s successes would foster a new era of racial equality in America. Four decades later, the degree of racial inequality has barely changed. To understand what went wrong, Patrick Sharkey argues that we have to understand what has happened to African American communities over the last several decades. In Stuck in Place, Sharkey describes how political decisions and social policies have led to severe disinvestment from black neighborhoods, persistent segregation, declining economic opportunities, and a growing link between African American communities and the criminal justice system.

As a result, neighborhood inequality that existed in the 1970s has been passed down to the current generation of African Americans. Some of the most persistent forms of racial inequality, such as gaps in income and test scores, can only be explained by considering the neighborhoods in which black and white families have lived over multiple generations. This multigenerational nature of neighborhood inequality also means that a new kind of urban policy is necessary for our nation’s cities. Sharkey argues for urban policies that have the potential to create transformative and sustained changes in urban communities and the families that live within them, and he outlines a durable urban policy agenda to move in that direction.

 

Winner of the Mirra Komarovsky Book Award, Eastern Sociological Society.

Winner of The American Publishers Award for Professional and Scholarly Excellence (PROSE Award) in Sociology and Social Work. ​

Race/Ethnicity-Specific Associations of Urinary Phthalates with Childhood Body Mass in a Nationally Representative Sample

Race/Ethnicity-Specific Associations of Urinary Phthalates with Childhood Body Mass in a Nationally Representative Sample
Environmental Health Perspectives. 121:501-506.

Trasande, Leonardo, Teresa M Attina, S Sathyanarayana, Adam J Spanier, Jan Blustein.
04/01/2013

Background: Phthalates have antiandrogenic effects and may disrupt lipid and carbohydrate metabolism. Racial/ethnic subpopulations have been documented to have varying urinary phthalate concentrations and prevalences of childhood obesity.

Objective: We examined associations between urinary phthalate metabolites and body mass outcomes in a nationally representative sample of U.S. children and adolescents.

Methods: We performed stratified and whole-sample cross-sectional analyses of 2,884 children 6–19 years of age who participated in the 2003–2008 National Health and Nutrition Examination Survey. Multivariable linear and logistic analyses of body mass index z-score, overweight, and obesity were performed against molar concentrations of low-molecular-weight (LMW), high-molecular-weight (HMW), and di-2-ethylhexylphthalate (DEHP) metabolites, controlling for sex, television watching, caregiver education, caloric intake, poverty–income ratio, race/ethnicity, serum cotinine, and age group. We used sensitivity analysis to examine robustness of results to removing sample weighting, normalizing phthalate concentrations for molecular weight, and examining different dietary intake covariates.

Results: In stratified, multivariable models, each log unit (roughly 3-fold) increase in LMW metabolites was associated with 21% and 22% increases in odds (95% CI: 1.05–1.39 and 1.07–1.39, respectively) of overweight and obesity, and a 0.090-SD unit increase in BMI z-score (95% CI: 0.003–0.18), among non-Hispanic blacks. Significant associations were not identified in any other racial/ethnic subgroup or in the study sample as a whole after controlling for potential confounders, associations were not significant for HMW or DEHP metabolites, and results did not change substantially with sensitivity analysis.

Conclusions: We identified a race/ethnicity–specific association of phthalates with childhood obesity in a nationally representative sample. Further study is needed to corroborate the association and evaluate genetic/epigenomic predisposition and/or increased phthalate exposure as possible explanations for differences among racial/ethnic subgroups.

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