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- Title
Measures of Local Segregation for Monitoring Health Inequities by Local Health Departments.
- Authors
Krieger, Nancy; Waterman, Pamela D.; Batra, Neelesh; Murphy, Johnna S.; Dooley, Daniel P.; Shah, Snehal N.
- Abstract
Objectives. To assess the use of local measures of segregation for monitoring health inequities by local health departments. Methods. We analyzed preterm birth and premature mortality (death before the age of 65 years) rates for Boston, Massachusetts, for 2010 to 2012, using the Index of Concentration at the Extremes (ICE) and the poverty rate at both the census tract and neighborhood level. Results. For premature mortality at the census tract level, the rate ratios comparing the worst-off and best-off terciles were 1.58 (95% confidence interval [CI] = 1.36, 1.83) for the ICE for income, 1.66 (95% CI = 1.43,1.93) for the ICE for race/ethnicity, and 1.63 (95% CI = 1.40,1.90) for the ICE combining income and race/ethnicity, as compared with 1.47 (95% CI = 1.27, 1.71) for the poverty measure. Results for the ICE and poverty measures were more similar for preterm births than for premature mortality. Conclusions. The ICE, a measure of social spatial polarization, may be useful for analyzing health inequities at the local level. Public Health Implications. Local health departments in US cities can meaningfully use the ICE to monitor health inequities associated with racialized economic segregation.
- Subjects
BOSTON (Mass.); MASSACHUSETTS; HEALTH equity; HEALTH boards; RACE discrimination in medical care; PREMATURE labor; ETHNIC discrimination; EARLY death; POVERTY rate; ECONOMICS; HEALTH status indicators; CONFIDENCE intervals; HEALTH services accessibility; INCOME; PREMATURE infants; LONGITUDINAL method; MORTALITY; POVERTY; RACE; SOCIOECONOMIC factors; ODDS ratio
- Publication
American Journal of Public Health, 2017, Vol 107, Issue 6, p903
- ISSN
0090-0036
- Publication type
Article
- DOI
10.2105/AJPH.2017.303713