Segregation, discrimination and mortality in U.S. blacks

Theoretically, segregation and discrimination could affect mortality among blacks (African Americans) not only through their impact on social class (including the concentration of blacks in high-poverty areas) but also by influencing health care and psychosocial factors. This paper reviews evidence that variation in mortality rates for black infants and young adults living in large metropolitan areas is associated with the level of black-white segregation. A few metropolitan areas in California with relatively low levels of segregation are shown to have low black death rates and small black-white differences in mortality rates for infants and young adult males (15-44 years old). In-depth studies are needed in these areas. Longitudinal studies of potential "risk factors" for disease and death among blacks should include: personal histories of experiences with discrimination, psychological reactions to discrimination, segregation indexes, quality of life in residential areas, and social class indicators.