Assessing How Level of Segregation Affects Social Determinants of Health of African Americans in U.S. 500 Cities

This study assessed racial disparities in associations between four levels of residential segregation and five social determinants of health (SDH). The data for this study was drawn from 500-City Health Dashboard that aggregated a variety of health indicators in 2018. Those 500 cities were ranked according to their levels of segregation. Next, the associations between four segregation gradients and five different community indicators were tested including (1) absenteeism, (2) children in poverty, (3) high school graduation, (4) limited access healthy foods, and (5) unemployment. All analyses were stratified by race. The total population of this data is 103,020,800, which accounts for one-third of the total U.S. populations. Among nine regions, 69% of cities in the East South-Central region have a high white/black segregation. On the other hand, the Pacific region has the lowest level of segregation. Consistent with literature, African Americans are still at a higher risk than white people to experience school absenteeism (6.1% higher), poverty (28.8% higher), educational attainment (4.9% lower), and unemployment (8.4% higher). However, unlike the literature, the study did not find any statistically significant disparities in access to healthy foods associated with level of segregation. The study concludes with suggestions to mitigate these adverse effects due to segregation policy against African Americans. The findings also encourage local departments to use 500-City Health Dashboard and our analytic methods to facilitate decision making and implement citywide, cross-sector initiatives.