Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Journal of Urban Health
Published in: Journal of Urban Health 1/2008

01-01-2008

Exploring Health Disparities in Integrated Communities: Overview of the EHDIC Study

Authors: Thomas LaVeist, PhD, Roland Thorpe Jr., Terra Bowen-Reid, John Jackson, Tiffany Gary, Darrell Gaskin, Dorothy Browne

Published in: Journal of Urban Health | Issue 1/2008

Login to get access

Abstract

Progress in understanding the nature of health disparities requires data that are race-comparative while overcoming confounding between race, socioeconomic status, and segregation. The Exploring Health Disparities in Integrated Communities (EHDIC) study is a multisite cohort study that will address these confounders by examining the nature of health disparities within racially integrated communities without racial disparities in socioeconomic status. Data consisted of a structured questionnaire and blood pressure measurements collected from a sample of the adult population (age 18 and older) of two racially integrated contiguous census tracts. This manuscript reports on baseline results from the first EHDIC site, a low-income urban community in southwest Baltimore, Maryland (EHDIC-SWB). In the adjusted models, African Americans had lower rates of smoking and fair or poor self-rated health than whites, but no race differences in obesity, drinking, or physical inactivity. Our findings indicate that accounting for race differences in exposure to social conditions reduces or eliminates some health-related disparities. Moreover, these findings suggest that solutions to the seemingly intractable health disparities problem that target social determinants may be effective, especially those factors that are confounded with racial segregation. Future research in the area of health disparities should seek ways to account for confounding from SES and segregation.
Literature
1.
Ferraro KF, Farmer MM. Double jeopardy, aging as leveler, or persistent health inequality? A longitudinal analysis of white and black Americans. J Gerontol B Psychol Sci Soc Sci. 1996;51(6):S319–S328.PubMed
2.
Ferraro KF, Farmer MM, Wybraniec JA. Health trajectories: long-term dynamics among black and white adults. J Health Soc Behav. 1997;38(1):38–54.PubMedCrossRef
3.
Miles TP, Bernard MA. Morbidity, disability, and health status of black American elderly: a new look at the oldest-old. J Am Geriatr Soc. 1992;40(10):1047–1054.PubMed
4.
Smith JP, Kington R. Demographic and economic correlates of health in old age. Demography. 1997;34(1):159–170.PubMedCrossRef
5.
Sudano JJ, Baker DW. Explaining U.S. racial/ethnic disparites in health declines and mortality in late middle age: the roles of socioeconomic status, health behaviors, and health insurance. Soc Sci Med. 2006;62:909–922.PubMedCrossRef
6.
LaVeist TA, Bowie JV, Cooley-Quille M. Minority health status in adulthood: the middle years of life. Health Care Financ Rev. 2000;21(4):9–21.PubMed
7.
Farmer MM, Ferraro KF. Are racial disparities in health conditional on socioeconomic status? Soc Sci Med. 2005;60:191–204.PubMedCrossRef
8.
LaVeist TA, Arthur M, Morgan A, et al. The cardiac access longitudinal study. A study of access to invasive cardiology among African American and white patients. J Am Coll Cardiol. 2003;41(7):1159–1166.PubMedCrossRef
9.
Williams DR. Race and health: basic questions, emerging directions. Ann Epidemiol. 1997;7(5):322–333.PubMedCrossRef
10.
Kochanek KD, Maurer JD, Rosenberg HM. Why did black life expectancy decline from 1984 through 1989 in the United States? Am J Public Health. 1994;84(6):938–944.PubMed
11.
Jackson JS, Brown TN, Williams DR, Torres M, Sellers SL, Brown K. Racism and the physical and mental health status of African Americans: a thirteen year national panel study. Ethn Dis. 1996;6(1–2):132–147.PubMed
12.
Ng-Mak DS, Dohrenwend BP, Abraido-Lanza AF, Turner JB. A further analysis of race differences in the National Longitudinal Mortality Study. Am J Public Health. 1999;89(11):1748–1751.PubMed
13.
Williams DR. Race/ethnicity and socioeconomic status: measurement and methodological issues. Int J Health Serv. 1996;26(3):483–505.PubMedCrossRef
14.
Lillie-Blanton M, Parsons PE, Gayle H, Dievler A. Racial differences in health: not just black and white, but shades of gray. Annu Rev Public Health. 1996;17:411–448.PubMed
15.
Williams DR, Collins C. U.S. socioeconomic and racial differences in health: patterns and explanations. Annu Rev Sociology. 1995;21:349.CrossRef
16.
LaVeist TA. On the study of race, racism, and health: a shift from description to explanation. Int J Health Serv. 2000;30(1):217–219.PubMedCrossRef
17.
LaVeist TA. Disentangling race and socioeconomic status: a key to understanding health inequalities. J Urban Health. 2005;82(2 Suppl 3):iii26–iii34.PubMed
18.
Braveman PA, Cubbin C, Egerter S, et al. Socioeconomic status in health research: one size does not fit all. JAMA. 2005;294:2879–2888.PubMedCrossRef
19.
Hayward MD, Crimmins EM, Miles TP, Yang Y. The significance of socioeconomic status in explaining the racial gap in chronic health conditions. Sociol Rev. 2000;65:910–930.CrossRef
20.
Kilbourne AM, Switzer G, Hyman K, Crowley-Matoka M, Fine MJ. Advancing health disparities research within the health care system: a conceptual framework. Am J Public Health. 2006;96(12):2113–2121.PubMedCrossRef
21.
LaVeist TA. Data sources for aging research on racial and ethnic groups. Gerontologist. 1995;35(3):328–339.PubMed
22.
LaVeist TA, Thorpe RJ Jr, Mance G, Jackson J. Overcoming confounding of race with socioeconomic status and segregation to explore race disparities in smoking. Journal of Addiction. In Press.
23.
LaVeist TA. Racial segregation and longevity among African Americans: an individual-level analysis. Health Serv Res. 2003;38(6 Pt 2):1719–1733.PubMedCrossRef
24.
Kaufman JS, Cooper RS, McGee DL. Socioeconomic status and health in blacks and whites: the problem of residual confounding and the resiliency of race. Epidemiology. 1997;8(6):621–628.PubMedCrossRef
25.
Krieger N, Williams DR, Moss NE. Measuring social class in U.S. public health research: concepts, methodologies, and guidelines. Annu Rev Public Health. 1997;18:341–378.PubMedCrossRef
26.
Navarro V. Race or class or race and class: growing mortality differentials in the United States. Int J Health Serv. 1991;21(2):229–235.PubMedCrossRef
27.
Navarro V. Race or class versus race and class: mortality differentials in the United States. Lancet. 1990;336(8725):1238–1240.PubMedCrossRef
28.
LaVeist TA. Beyond dummy variables and sample selection: what health services researchers ought to know about race as a variable. Health Serv Res. 1994;29(1):1–16.PubMed
29.
Laveist TA. Segregation, poverty, and empowerment: health consequences for African Americans. Milbank Q. 1993;71(1):41–64.PubMedCrossRef
30.
Collins CA, Williams DR. Segregation and mortality: the deadly effects of racism? Sociological Forum. 1999;14:495–523.CrossRef
31.
Williams DR, Collins C. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001;116(5):404–416.PubMed
32.
Morland K, Wing S, Diez Roux A, Poole C. Neighborhood characteristics associated with the location of food stores and food service places. Am J Prev Med. 2002;22(1):23–29.PubMedCrossRef
33.
LaVeist TA, Wallace JM Jr. Health risk and inequitable distribution of liquor stores in African American neighborhood. Soc Sci Med. 2000;51(4):613–617.PubMedCrossRef
34.
Lillie-Blanton M, Anthony JC, Schuster CR. Probing the meaning of racial/ethnic group comparisons in crack cocaine smoking. JAMA. 1993;269(8):993–997.PubMedCrossRef
35.
Morrison RS, Wallenstein S, Natale DK, Senzel RS, Huang LL. “We don’t carry that”—failure of pharmacies in predominantly nonwhite neighborhoods to stock opioid analgesics. N Engl J Med. 2000;342(14):1023–1026.PubMedCrossRef
36.
Luke D, Esmundo E, Bloom Y. Smoke signs: patterns of tobacco billboard advertising in a metropolitan region. Tob Control. 2000;9(1):16–23.PubMedCrossRef
37.
Balbach ED, Gasior RJ, Barbeau EM. R.J. Reynolds’ targeting of African Americans: 1988–2000. Am J Public Health. 2003;93(5):822–827.PubMed
38.
Acevedo-Garcia D. Residential segregation and the epidemiology of infectious diseases. Soc Sci Med. 2000;51(8):1143–1161.PubMedCrossRef
39.
LaVeist TA. Linking residential segregation and the infant mortality race disparity. Sociol Soc Res. 1989;73:90–94.
40.
Yankauer A. The relationship of fetal and infant mortality to residential segregation. Am Sociol Rev. 1950;15:644–648.CrossRef
41.
Polednak AP. Black-white differences in infant mortality in 38 standard metropolitan statistical areas. Am J Public Health. 1991;81(11):1480–1482.PubMed
42.
Fang J, Madhavan S, Bosworth W, Alderman MH. Residential segregation and mortality in New York City. Soc Sci Med. 1998;47(4):469–476.PubMedCrossRef
43.
Jackson SA, Anderson RT, Johnson NJ, Sorlie PD. The relation of residential segregation to all-cause mortality: a study in black and white. Am J Public Health. 2000;90(4):615–617.PubMed
44.
Acevedo-Garcia D. Zip code-level risk factors for tuberculosis: neighborhood environment and residential segregation in New Jersey, 1985–1992. Am J Public Health. 2001;91(5):734–741.PubMedCrossRef
45.
Hart KD. Racial segregation and ambulatory care-sensitive admissions. Health Aff (Millwood). 1997;16(1):224–225; author reply 225.CrossRef
46.
Gary TL, Stark SA, Laveist TA. Neighborhood characteristics and mental health among African Americans and whites living in a racially integrated urban community. Health Place. 2007;13(2):569–575.PubMedCrossRef
47.
Casagrande SS, Gary TL, LaVeist TA, Gaskin J, Cooper LA. Perceived discrimination and adherence to medical care in a racially integrated community. J Gen Intern Med. 2007;22(3):389–395.PubMedCrossRef
48.
National Center for Health Statistics. 2003 National Health Interview Survey Adult Core. 2004.
49.
National Center for Health Statistics. 2003 National Health Interview Survey Description. 2004.
50.
51.
Bullard RD. Solid waste sites and the black Houston community. Sociol Inq. 1983;53(2–3):273–288.PubMedCrossRef
52.
National Institute on Drug Abuse. National Household Survey on Drug Abuse: Main Findings 1988. Washington, DC: U.S. Department of Health and Human Services Publication ADM 90-1692. 1990.
53.
Massey D, Denton N. American Apartheid: Segregation and the Making of the Underclass. Boston: Harvard University Press; 1998.
54.
Oliver M, Shapiro T. Black Wealth/White Wealth: A New Perspective on Racial Inequality. United Kingdom: Routledge; 1995.
55.
Shapiro T. The Hidden cost of Being African American: How Wealth Perpetuates Inequality. USA: Oxford University Press; 2005.
Metadata
Title
Exploring Health Disparities in Integrated Communities: Overview of the EHDIC Study
Authors
Thomas LaVeist, PhD
Roland Thorpe Jr.
Terra Bowen-Reid
John Jackson
Tiffany Gary
Darrell Gaskin
Dorothy Browne
Publication date
01-01-2008
Publisher
Springer US
Published in
Journal of Urban Health / Issue 1/2008
Print ISSN: 1099-3460
Electronic ISSN: 1468-2869
DOI
https://doi.org/10.1007/s11524-007-9226-y

Other articles of this Issue 1/2008

Journal of Urban Health 1/2008 Go to the issue

OriginalPaper

Mercury Exposure in Young Children Living in New York City

OriginalPaper

Externalizing Behaviors among Children of HIV Seropositive Former and Current Drug Users: Parent Support Network Factors as Social Ecological Risks

OriginalPaper

Incarceration and Sexually Transmitted Infections: A Neighborhood Perspective

OriginalPaper

Urbanicity and Methods of Suicide: A Nationwide Population-based Study

Literature in Brief

Child and Adolescent Health

Acknowledgments

Peer Reviewers 2007