Summary 3
Weekly Topic: “Housing Experiment to Inform How Housing and Neighborhood Factors Influence Health and Health Equity”
Paper Reviewed:
Lee, Min-Ah, and Kenneth F. Ferraro. “Neighborhood Residential Segregation and Physical Health among Hispanic Americans: Good, Bad, or Benign?” Journal of Health and Social Behavior, SAGE Publications. 31 May 2007.
This week’s guest speaker was Dr. Theresa Osypuk and she came to campus to talk about how housing and neighborhood factors affect and influence health and health equity. She talked about how neighborhoods of low ses are negatively impacted, how extensive residential segregation within large American cities exists, and how there are things that can bring about change to those affected. As she mentioned in the seminar, the geography of opportunity is identified as the neighborhoods of high opportunity and individuals placed in these contexts are seen as far more likely to succeed than those in neighborhoods of low opportunity. A really large geographic variability exists and because of it, there is at least a 14 year gap of life expectancy within different county areas. Just like Los Angeles, New York is heavily segregated. In both of these large American cities, you will find the majority of Whites, living next door to each other, in affluent areas while those of minority races, such as Hispanics and Blacks, live in areas of lower socioeconomic status and high rates of poverty. Due to social, economic, and housing policies, there is a huge racial residential segregation; within this divide, there are outstanding differences of neighborhood quality + opportunity, socioeconomic advancement + affordability, social determinants of health, and health care. Because of such racial residential segregation, minorities have worse health in which they consequently suffer from low mortality rates, infectious diseases, CVD, mental health, obesity, environmental toxicants, etc. The guest speaker also talked about the “double jeopardy,” in which people are subjected to low opportunities because of both residential segregation and race. Those who experience high rates of segregation, in addition to their race factor (aka double jeopardy), are both Blacks and Latinos. Dr. Theresa Osypuk also mentioned a study, called ‘Moving to Opportunity for Fair Housing Voucher Experiment,’ in which a housing policy was seen as having potential to improve segregation, opportunity, and health equity for some. Such social experiment was conducted by the United States Department of Housing & Urban Development and it included a violently neighborhood relocation to participants involved.
The paper the I reviewed this week, Neighborhood Residential Segregation and Physical Health among Hispanic Americans: Good, Bad, or Benign?, seeks to find a link between ecological characteristics and residential segregation with health indicators among Hispanic Americans. It has been reasonable to presume that segregation is detrimental and harmful to the health of minority populations, but findings from many well-known and well-executed studies in the past have not supported such a conclusion. There could be many reasons for such inconsistency in findings about residential segregation and health— which may include the comparison of different ethnic and racial groups, geographic variability, and varying scientific methods. In order to determine the inconsistency of findings, it is said that many research contributions are required, but this specific study is designed to help resolve some of the obscurity and confusion by focusing on the physical health consequences of segregation for two Hispanic groups: Puerto Rican Americans and Mexican Americans.
The two indicators of physical health used in this study are dependent variables separated into 2 categories: acute physical symptoms and disability. Acute physical symptoms are measured using six items, with respondents indicating the frequency of occurrence for each symptom in the past three months, while the disability category is evaluated comparative to instrumental activities of daily living— which include questions regarding limited health in everyday, normal activities such as carrying groceries and moderate activity.
The three research questions asked for the analysis are: 1. Does residential segregation affect the physical health of Puerto Rican and Mexican Americans? If yes, is the effect good, bad, or benign?; 2. Do the effects of residential segregation vary across generations; and 3. Do associations between residential segregation and health persist after controlling for neighborhood-level income in a multi-level model? The data for this study are drawn from two major sources: MIDUS: Survey of Minority Groups in Chicago and New York City, from the years 1995–1996, and the 1990 summary tape file 3 from the U.S. Bureau of the Census. The MIDUS minority survey used random sampling to assess the well-being of urban adults 25+ years of age and interviews were conducted in New York with Puerto Rican, Dominican, and African Americans compared to interviews in Chicago, which were conducted with Puerto Rican and Mexican Americans— the data analyzed for this study come only from the Chicago sample as they on the intended target of this study. The Census data contains information for measuring neighborhood-level variables. By connecting the survey data and the Census data, this study is able to analyze the influence of neighborhood-level segregation on health while controlling for both community features and individual-level characteristics.
It was found that segregation is associated with more health problems for Puerto Rican Americans but not for Mexican Americans. Residential isolation for Puerto Rican Americans is frequently linked with health problems— both acute physical symptoms and disability. They are disadvantaged in terms of health and there is no concrete evidence that neighborhood resources reduce health problems for this group, unlike Mexican Americans. Residential isolation does not have crucially beneficial effects for first generation Mexican Americans, but it is beneficial for second+ generation Mexican Americans. Second or later-generation Mexican Americans in segregated neighborhoods report fewer physical symptoms and less disability. In conclusion, segregation is unfavorable and detrimental for Puerto Rican Americans, but not for second+ generation Mexican Americans. The findings revealed that residential segregation has differential effects across Hispanic groups and suggest that a high degree of contact with Mexican Americans promotes health by facilitating flow of informal health resources and social support.