Racial Disparities in Context: A Multilevel Analysis of Neighborhood Variations in Poverty and Excess Mortality Among Black Populations in Massachusetts

作者：S. V. Subramanian, Jarvis T. Chen, David H. Rehkopf, Pamela D. Waterman, Nancy R Krieger · 发表于：American Journal of Public Health · 年份：2005 · DOI：10.2105/ajph.2003.034132 · 被引用次数：158 · 研究领域：Health disparities and outcomes、Urban, Neighborhood, and Segregation Studies、Insurance, Mortality, Demography, Risk Management

OBJECTIVES: We analyzed neighborhood heterogeneity in associations among mortality, race/ethnicity, and area poverty. METHODS: We performed a multilevel statistical analysis of Massachusetts all-cause mortality data for the period 1989 through 1991 (n=142836 deaths), modeled as 79813 cells (deaths and denominators cross-tabulated by age, gender, and race/ethnicity) at level 1 nested within 5532 block groups at level 2 within 1307 census tracts (CTs) at level 3. We also characterized CTs by percentage of the population living below poverty level. RESULTS: Neighborhood variation in mortality across CTs and block groups was not accounted for by these areas' age, gender, and racial/ethnic composition. Neighborhood variation in mortality was much greater for the Black population than for the White population, largely because of CT-level variation in poverty rates. CONCLUSIONS: Neighborhood heterogeneity in the relationship between mortality and race/ethnicity in Massachusetts is statistically significant and is closely related to CT-level variation in poverty.