Death and taxes: Examining the racial inequality in premature death across neighborhoods.

Legacies of residential segregation have led to deep inequities felt in communities of color across the nation and have been established as a fundamental cause of health disparities. Historical practices such as the redlining of majority Black neighborhoods in cities have led to long term consequences on these communities, including concentrated poverty and disadvantage. Research shows a strong connection between living in a poor neighborhood and poorer health outcomes, including early death, but questions remain about what characteristics of poor neighborhoods drive these disparities. We combined data from the American Community Survey with administrative data from Pittsburgh, Pennsylvania to examine the difference in premature death in Black and white neighborhoods (N = 87) using measures of socioeconomic disadvantage and less commonly studied neighborhood features including vacancy, tax delinquency, and property sales and conditions. Results suggest that features of abandonment, particularly the percent of tax delinquent properties in a neighborhood, may capture an important structural difference between majority Black and majority white neighborhoods with impacts beyond socioeconomic disadvantage on community health. We discuss implications of these findings for research and practice.

Neighborhood Social and Environmental Factors and Asthma Among Children Living in Low-Income Neighborhoods: The Importance of Informal Social Control.

Despite the knowledge that children in low-income neighborhoods are particularly vulnerable to asthma, few studies of child asthma focus on variation among low-income neighborhoods. We examined the relationship between child asthma and features associated with neighborhood poverty including safety, social cohesion, informal social control, collective efficacy, and disorder, across a sample of children from low-income neighborhoods (N = 3010; 2005-2007). Results show that the relationship between asthma and poverty is accounted for by family-level characteristics, but informal social control remains significantly and positively related to asthma after accounting for family-level characteristics. We discuss the importance of neighborhood environmental features for children's asthma.

Barrios, ghettos, and residential racial composition: Examining the racial makeup of neighborhood profiles and their relationship to self-rated health.

Racial/ethnic disparities in self-rated health persist and according to the social determinants of health framework, may be partially explained by residential context. The relationship between neighborhood factors and self-rated health has been examined in isolation but a more holistic approach is needed to understand how these factors may cluster together and how these neighborhood typologies relate to health. To address this gap, we conducted a latent profile analysis using data from the Chicago Community Adult Health Study (CCAHS; N = 2969 respondents in 342 neighborhood clusters) to identify neighborhood profiles, examined differences in neighborhood characteristics among the identified typologies and tested their relationship to self-rated health. Results indicated four distinct classes of neighborhoods that vary significantly on most neighborhood-level social determinants of health and can be defined by racial/ethnic composition and class. Residents in Hispanic, majority black disadvantaged, and majority black non-poor neighborhoods all had significantly poorer self-rated health when compared to majority white neighborhoods. The difference between black non-poor and white neighborhoods in self-rated health was not significant when controlling for individual race/ethnicity. The results indicate that neighborhood factors do cluster by race and class of the neighborhood and that this clustering is related to poorer self-rated health.

Using Concept Mapping to Explore and Engage Parent and Youth Residents of an Economically Underserved Minority Community around Children's Asthma.

BACKGROUND: Asthma continues to disproportionately impact children living in economically underserved urban neighborhoods, and contributes to persistent racial and economic disparities in health. Furthermore, asthma is often exacerbated by the presence of social and environmental factors that are prevalent in, and sometimes particular to, these communities. OBJECTIVES: The present study uses a community-based participatory research (CBPR) approach to explore and define the experience and issues around children's asthma in an economically underserved community. These findings will be used to inform the design of a community intervention. METHODS: Through a community and academic partnership called Healthy Living, Healthy Learning, Healthy Lives (HL3), we engaged neighborhood youth and adult residents (N = 21) in a concept mapping activity to identify triggers and health care-related factors that influence children with asthma. RESULTS: Findings highlight that the most important triggers of asthma included indoor and outdoor irritants and allergens, as well as violence and fear-related emotions. The most important factors perceived to influence the care of asthma included medical relievers such as asthma medication, appliances such as a humidifier, and supports for asthma like the school nurse. Differences between adults and youth perceptions of factors triggering and influencing asthma are highlighted. CONCLUSIONS: Engaging community residents as experts provided a deeper understanding of the issues around children's asthma in the community, which can contribute to the design of a more effective intervention.

Mapping the Racial Inequality in Place: Using Youth Perceptions to Identify Unequal Exposure to Neighborhood Environmental Hazards.

Black youth are more likely than white youth to grow up in poor, segregated neighborhoods. This racial inequality in the neighborhood environments of black youth increases their contact with hazardous neighborhood environmental features including violence and toxic exposures that contribute to racial inequality in youth health and well-being. While the concept of neighborhood effects has been studied at length by social scientists, this work has not been as frequently situated within an environmental justice (EJ) paradigm. The present study used youth perceptions gained from in-depth interviews with youth from one Pittsburgh, Pennsylvania neighborhood to identify neighborhood environmental health hazards. We then mapped these youth-identified features to examine how they are spatially and racially distributed across the city. Our results suggest that the intersection of race and poverty, neighborhood disorder, housing abandonment, and crime were salient issues for youth. The maps show support for the youths' assertions that the environments of black and white individuals across the city of Pittsburgh differ in noteworthy ways. This multi-lens, mixed-method analysis was designed to challenge some of the assumptions we make about addressing environmental inequality using youths' own opinions on the issue to drive our inquiry.

Neighborhood poverty and children's exposure to danger: Examining gender differences in impacts of the Moving to Opportunity experiment.

The Moving to Opportunity (MTO) program offered public housing residents in distressed communities a chance to move to low-poverty neighborhoods. The present study examined whether the resulting decline in neighborhood poverty led to lower levels of exposure to danger among children and youth ages 8-19years old (n=4606), and specifically, if there was a gender difference that matched the pattern of more beneficial program effects for girls and more adverse affects for boys. The study goes beyond previous research by using fixed effects to control for family factors that may influence moving behavior and confound estimates of gender differences in program impacts. Results showed that children experienced a decline in exposure to danger, with one key gender difference. Models based on brother-sister comparisons indicated that MTO had a more beneficial impact on exposure to drug activity for females than males. The findings suggest that neighborhood poverty is tied to children's exposure to danger. Moreover, exposure to drug activity may help explain the gender differences in impacts on children's mental health and risky behavior.