title: Metropolitan governance, residential segregation, and mortality among African Americans.
abstract: OBJECTIVE
  This study tested the hypothesis that the degree to which local government is metropolitanized is associated with mortality rates for African Americans and with residential segregation, which has itself previously been shown to be positively associated with mortality among African Americans.
  
  
  METHODS
  One hundred fourteen US standard metropolitan statistical areas were examined. The primary dependent variable was the age-adjusted, race- and sex-specific all-cause mortality rate, averaged for 1990 and 1991. The 2 primary independent variables were residential segregation, as measured by the index of dissimilarity, and metropolitanization of government, as measured by the central city's elasticity score.
  
  
  RESULTS
  Mortality rates for male and female African Americans were lower in metropolitan statistical areas with more metropolitanized local governments and lower levels of residential segregation. Mortality for male and female Whites was not associated in either direction with residential segregation. White male mortality showed no association with level of metropolitanization, but lower White female mortality rates were associated with less metropolitanization.
  
  
  CONCLUSIONS
  This study suggests the need for further research into whether policy changes in areas not traditionally thought of as "health policy" areas can improve the health of urban minorities.
authors.affiliation: Department of Community and Preventive Medicine, School of Medicine and Dentistry, University of Rochester, NY, USA.
authors.forename: K D
authors.initials: KD
authors.lastname: Hart
authors.forename: S J
authors.initials: SJ
authors.lastname: Kunitz
authors.forename: R R
authors.initials: RR
authors.lastname: Sell
authors.forename: D B
authors.initials: DB
authors.lastname: Mukamel
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006801:Humans; D009111:Local Government; D008297:Male; D009026:Mortality; D011203:Poverty; D011287:Prejudice; D012044:Regression Analysis; D012111:Residence Characteristics; D014481:United States / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*; D044465:White People / Q000706:statistics & numerical data