title: Place, not race: disparities dissipate in southwest Baltimore when blacks and whites live under similar conditions.
abstract: Much of the current health disparities literature fails to account for the fact that the nation is largely segregated, leaving racial groups exposed to different health risks and with variable access to health services based on where they live. We sought to determine if racial health disparities typically reported in national studies remain the same when black and white Americans live in integrated settings. Focusing on a racially integrated, low-income neighborhood of Southwest Baltimore, Maryland, we found that nationally reported disparities in hypertension, diabetes, obesity among women, and use of health services either vanished or substantially narrowed. The sole exception was smoking: We found that white residents were more likely than black residents to smoke, underscoring the higher rates of ill health in whites in the Baltimore sample than seen in national data. As a result, we concluded that racial differences in social environments explain a meaningful portion of disparities typically found in national data. We further concluded that when social factors are equalized, racial disparities are minimized. Policies aimed solely at health behavior change, biological differences among racial groups, or increased access to health care are limited in their ability to close racial disparities in health. Such policies must address the differing resources of neighborhoods and must aim to improve the underlying conditions of health for all.
authors: Center for Health Disparities Solutions and the William C. and Nancy F. Richardson Professor in Health Policy at the Johns Hopkins Bloomberg School of Public Health, in Baltimore, Maryland, USA.
authors: Thomas
authors: T
authors: LaVeist
authors: Keshia
authors: K
authors: Pollack
authors: Roland
authors: R
authors: Thorpe
authors: Ruth
authors: R
authors: Fesahazion
authors: Darrell
authors: D
authors: Gaskin
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore; D044383:Black People / Q000706:statistics & numerical data*; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006306:Health Surveys; D054625:Healthcare Disparities / Q000208:ethnology*; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology; D012111:Residence Characteristics; D012907:Smoking / Q000208:ethnology; D012931:Social Environment; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult; D001741:Black or African American