Racial disparities in self-rated health at older ages: what difference does the neighborhood make?
OBJECTIVE
Racial differences in self-rated health at older ages are well documented. African Americans consistently report poorer health, even when education, income, and other health status indicators are controlled. The extent to which neighborhood-level characteristics mediate this association remains largely unexplored. We ask whether neighborhood social and economic resources help to explain the self-reported health differential between African Americans and Whites.


METHODS
Using the 1990 Decennial Census, the 1994-1995 Project on Human Development in Chicago Neighborhoods-Community Survey, and selected years of the 1991-2000 Metropolitan Chicago Information Center-Metro Survey, we examine the impact of neighborhood structure and social organization on self-rated health for a sample of Chicago residents aged 55 and older (N = 636). We use multilevel modeling techniques to examine both individual and neighborhood-level covariates.


RESULTS
Findings indicate that affluence, a neighborhood structural resource, contributes positively to self-rated health and attenuates the association between race and self-rated health. When the level of affluence in a community is low, residential stability is negatively related to health. Collective efficacy, a measure of neighborhood social resources, is not associated with health for this older population.


CONCLUSIONS
Analyses incorporating individual and neighborhood-level contextual indicators may further our understanding of the complex association between sociodemographic factors and health.
Department of Health Studies, University of Chicago, 5841 S. Maryland Ave., MC 2007, Chicago, IL 60637, USA. kcagney@health.bsd.uchicago.edu
Kathleen A
KA
Cagney
Christopher R
CR
Browning
Ming
M
Wen
D000367:Age Factors; D000368:Aged; D003710:Demography; D005006:Ethnicity; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D012111:Residence Characteristics; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires