The Diverging Impacts of Segregation on Obesity Risk by Nativity and Neighborhood Poverty Among Hispanic Americans

While racial residential segregation is frequently cited as a fundamental cause of racial health disparities, its health impacts for Hispanic Americans remain unclear. We argue that several shortcomings have limited our understanding of how segregation influences Hispanic health outcomes, most notably a failure to assess the possible diverging impacts of segregation by neighborhood poverty level and the conflation of segregation with ethnic enclaves. We use multiple years of restricted geocoded data from a nationally representative sample of the US population (2006-2013 National Health Interview Survey) to investigate the association between metropolitan-level Hispanic segregation and obesity by nativity and neighborhood poverty level. We find segregation to be protective against obesity for Hispanic immigrants who reside in low poverty neighborhoods. For Hispanic immigrants residing in higher neighborhood poverty, no association between segregation and obesity was found. Among US-born Hispanics, we observe an increased risk of obesity-but only for those in high poverty neighborhoods. No association was found for those in low and medium neighborhood poverty. Results provide evidence to indicate that the relationship between segregation and health for Hispanics is not uniform within a metropolitan area. In the case of obesity, the consequences of metropolitan Hispanic segregation can be either protective, null, or deleterious depending not only on local neighborhood context but also on nativity.