The Place We Live, the Health We Have

A Multi-Level, Life Course Perspective on the Effects of Residential Segregation and Neighborhood Poverty on Health and Racial Health Disparities

by D. Phuong Do

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Although our choices and behaviors are inherently expressed at the individual level, they are often influenced and constrained by the larger social and economic context to which we are exposed. Consequently, place can play an influential role in shaping our culture, our lifestyle, our behavior, and our aspirations in life. The author investigates the relationship between metropolitan-level segregation measures and individual-level health outcomes; distinguishes between transient and persistent exposure to individual and neighborhood poverty in estimating individual and neighborhood poverty effects on health and racial health disparities; and estimates the causal impact of neighborhood disadvantage on health. Racial and economic segregation detrimentally affects the health of blacks, even after adjustment of individual socioeconomic factors, but its effects on health for whites are either neutral or beneficial. However, multiple-year measurements of individual-level and neighborhood-level socioeconomic factors lead to substantial reduction in the magnitude of the black/white health gap.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Data

  • Chapter Three

    Residential Segregation and Health

  • Chapter Four

    Dynamics of Income and Neighborhood Context on Health and Racial Health Disparities

  • Chapter Five

    Neighborhood Poverty and Health: Context or Composition?

  • Chapter Six

    Summary and Policy Implications

Research conducted by

This document was submitted as a dissertation in September 2006 in partial fulfillment of the requirements of the doctoral degree in public policy analysis at the Pardee RAND Graduate School. The faculty committee that supervised and approved the dissertation consisted of Brian K. Finch (Chair), Richard J. Buddin, and Nicole Lurie.

This report is part of the RAND Corporation Dissertation series. Pardee RAND dissertations are produced by graduate fellows of the Pardee RAND Graduate School, the world's leading producer of Ph.D.'s in policy analysis. The dissertations are supervised, reviewed, and approved by a Pardee RAND faculty committee overseeing each dissertation.

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