Concentrated poverty, racial segregation, and health: an analysis of metropolitan areas

Individual poverty has long been linked to poor health. With the increased importance of the social determinants of health, the literature on neighborhood effects has attempted to explain the independent effect on health of the ecological environment of daily life in order to lessen persistent health inequalities. Extant research on the topic of neighborhood effects has fallen short in addressing the problem of selection bias. This study overcomes this with a multilevel design modelling individual health outcomes aggregated at the metropolitan level as a function of metropolitan level poverty, poverty concentration, and segregation, controlling for individual and household level characteristics. I further compute spatial equivalents for poverty concentration and segregation at the metro level. The results suggest the spatial arrangement of poverty, at a set level of aspatial concentration, worsens health for lower income individuals. The aspatial measure of segregation, at a set level of spatial arrangement of race and ethnicity, worsens health for Hispanics, and Native Americans. Importantly, the study uncovers some profound differences in the two sets of aspatial and explicitly spatial metro level measures: what they measure, how they interact, and the implications for their use.Ph.D.Includes bibliographical referencesIncludes vit