Dataset Information

Relationship of Racial Residential Segregation to Newly Diagnosed Cases of HIV among Black Heterosexuals in US Metropolitan Areas, 2008-2015.

ABSTRACT: Social science and public health literature has framed residential segregation as a potent structural determinant of the higher HIV burden among black heterosexuals, but empirical evidence has been limited. The purpose of this study is to test, for the first time, the association between racial segregation and newly diagnosed heterosexually acquired HIV cases among black adults and adolescents in 95 large US metropolitan statistical areas (MSAs) in 2008-2015. We operationalized racial segregation (the main exposure) using Massey and Denton's isolation index for black residents; the outcome was the rate of newly diagnosed HIV cases per 10,000 black adult heterosexuals. We tested the relationship of segregation to this outcome using multilevel multivariate models of longitudinal (2008-2015) MSA-level data, controlling for potential confounders and time. All covariates were lagged by 1 year and centered on baseline values. We preliminarily explored mediation of the focal relationship by inequalities in education, employment, and poverty rates. Segregation was positively associated with the outcome: a one standard deviation decrease in baseline isolation was associated with a 16.2% reduction in the rate of new HIV diagnoses; one standard deviation reduction in isolation over time was associated with 4.6% decrease in the outcome. Exploratory mediation analyses suggest that black/white socioeconomic inequality may mediate the relationship between segregation and HIV. Our study suggests that residential segregation may be a distal determinant of HIV among black heterosexuals. The findings further emphasize the need to address segregation as part of a comprehensive strategy to reduce racial inequities in HIV.

SUBMITTER: Ibragimov U

PROVIDER: S-EPMC6904685 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Relationship of Racial Residential Segregation to Newly Diagnosed Cases of HIV among Black Heterosexuals in US Metropolitan Areas, 2008-2015.

Ibragimov Umedjon U Beane Stephanie S Adimora Adaora A AA Friedman Samuel R SR Williams Leslie L Tempalski Barbara B Stall Ron R Wingood Gina G Hall H Irene HI Johnson Anna Satcher AS Cooper Hannah L F HLF

Journal of urban health : bulletin of the New York Academy of Medicine 20191201 6

Social science and public health literature has framed residential segregation as a potent structural determinant of the higher HIV burden among black heterosexuals, but empirical evidence has been limited. The purpose of this study is to test, for the first time, the association between racial segregation and newly diagnosed heterosexually acquired HIV cases among black adults and adolescents in 95 large US metropolitan statistical areas (MSAs) in 2008-2015. We operationalized racial segregatio ...[more]

PMID: 30182249

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Project description:ImportanceThe continued harm of Black individuals in the US by law enforcement officers calls for reform of both law enforcement officers and structural racism embedded in communities.ObjectiveTo examine the association between county characteristics and racial and ethnic disparities in legal intervention injuries.Design, setting, and participantsThis retrospective, cross-sectional study was conducted among 27 671 patients presenting to California hospitals from January 1, 2016, to December 31, 2019, with legal intervention injuries (defined as any injury sustained as a result of an encounter with any law enforcement officer) as identified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes.Main outcomes and measuresLegal intervention injuries were classified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision external cause of injury code Y35. Expected injury counts were calculated for each county by multiplying statewide median rates of injury per capita for each age-racial and ethnic group, and then observed to expected injury ratios were measured. The association between county injury ratio, percentage of Black individuals, and residential segregation (measured using an index of dissimilarity) was modeled, stratifying by race and ethnicity.ResultsA total of 27 671 patients (24 159 male patients [87.3%]; 1734 Asian and Pacific Islander [6.3%], 5049 Black [18.2%], 11 250 Hispanic [40.7%], and 9638 White [34.8%]; mean [SD] age, 34.2 [12.5] years) presented with legal intervention injuries in California from 2016 to 2019. Observed to expected injury ratios ranged from 0 to 7 for Black residents and from 0 to 5 for White residents. High observed to expected injury ratios for Black residents (408 observed vs 60 expected; ratio = 7) were clustered around San Francisco Bay Area counties and corresponded with a higher proportion of Black residents. High observed to expected injury ratios for White residents (57 observed vs 11 expected; ratio = 5) clustered around rural northern California counties and corresponded with higher mean percentage of residents with income below the federal poverty level and fewer urban areas.Conclusions and relevanceThis study suggests that residential segregation may be associated with increased legal intervention injury rates for Black residents of California counties with a large percentage of Black residents. Reform efforts to address racial and ethnic disparities in these injuries should carefully consider and address the legacy of discriminatory policies that has led to segregated communities in California and the United States.

Project description:ObjectiveWe examined the distribution of heat risk-related land cover (HRRLC) characteristics across racial/ethnic groups and degrees of residential segregation.MethodsBlock group-level tree canopy and impervious surface estimates were derived from the 2001 National Land Cover Dataset for densely populated urban areas of the United States and Puerto Rico, and linked to demographic characteristics from the 2000 Census. Racial/ethnic groups in a given block group were considered to live in HRRLC if at least half their population experienced the absence of tree canopy and at least half of the ground was covered by impervious surface (roofs, driveways, sidewalks, roads). Residential segregation was characterized for metropolitan areas in the United States and Puerto Rico using the multigroup dissimilarity index.ResultsAfter adjustment for ecoregion and precipitation, holding segregation level constant, non-Hispanic blacks were 52% more likely (95% CI: 37%, 69%), non-Hispanic Asians 32% more likely (95% CI: 18%, 47%), and Hispanics 21% more likely (95% CI: 8%, 35%) to live in HRRLC conditions compared with non-Hispanic whites. Within each racial/ethnic group, HRRLC conditions increased with increasing degrees of metropolitan area-level segregation. Further adjustment for home ownership and poverty did not substantially alter these results, but adjustment for population density and metropolitan area population attenuated the segregation effects, suggesting a mediating or confounding role.ConclusionsLand cover was associated with segregation within each racial/ethnic group, which may be explained partly by the concentration of racial/ethnic minorities into densely populated neighborhoods within larger, more segregated cities. In anticipation of greater frequency and duration of extreme heat events, climate change adaptation strategies, such as planting trees in urban areas, should explicitly incorporate an environmental justice framework that addresses racial/ethnic disparities in HRRLC.

Dataset Information

Relationship of Racial Residential Segregation to Newly Diagnosed Cases of HIV among Black Heterosexuals in US Metropolitan Areas, 2008-2015.

Publications

Relationship of Racial Residential Segregation to Newly Diagnosed Cases of HIV among Black Heterosexuals in US Metropolitan Areas, 2008-2015.

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