Does Integration Produce Equity? A Longitudinal Study of Neighborhood Conditions and Racial Health Inequality

Courtney Boen, University of North Carolina at Chapel Hill

Research identifies racial residential segregation as a fundamental determinant of racial health disparities, but whether neighborhood economic conditions and neighborhood racial composition operate through similar or unique mechanisms to affect health remains unknown. Using hierarchical modeling strategies and longitudinal data, this study examines how the economic and racial characteristics of neighborhoods relate to markers of physiological functioning as individuals age. Results indicate that, after adjusting for neighborhood economic conditions, the associations between neighborhood racial composition and physical functioning vary by race and level of segregation. Whereas increased levels of neighborhood racial diversity are associated with better outcomes for Whites, neighborhood racial heterogeneity is associated with worse outcomes for Blacks. Conversely, net of economic conditions, high levels of residential segregation are associated with higher levels physiological dysregulation for Whites but lower levels of dysregulation for Blacks. Additional analyses suggest that psychosocial factors—including exposure to racial discrimination—may mediate these associations.