Polednak AP. Trends in U.S. urban black infant mortality, by degree of residential segregation. American Journal of Public Health. 1996;86:723-726.
This article examines associations between residential segregation and urban black infant mortality rates. The authors found that white infant mortality rates were unrelated to the segregation index. The segregation index was a significant predictor of black infant mortality, even when another variable-the black poverty rate-was included in the model. The black poverty rate and rate of unmarried black mothers were highly correlated with the segregation index. When the authors included all three variables in the model, the only significant variable was the rate of unmarried black mothers.
Thirteen of the 19 areas with black infant mortality rates exceeding 20 deaths per 1,000 live births were located the Middle Atlantic and East North Central regions, which included several hypersegregated areas. Black infant mortality rates were lowest in the west, which also had the least residential segregation. The authors note that black/white segregation could affect infant mortality through concentrations of poverty or lower quality of life for blacks and whites living within these isolated communities. The relationship between unmarried mothers and the infant mortality rate, the authors note, may be attributable to social factors such as unemployment and to nutritional and health care factors. The higher infant mortality rate in hypersegregated areas may be associated with the concentration of poverty, poorer neighborhood quality (e.g., high-density housing, crime, noise, psychological stresses), and higher prevalence of specific risk factors (e.g., maternal medical-nutritional factors, education, reproductive patterns, smoking, and drug use).
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