Segregation’s Unexpected Link with Black Health in History


Medicine, Health Care Segregation’s Unexpected Link with Black…

Published: September 12, 2017.
Released by Ohio State University  

COLUMBUS, Ohio – Racial housing segregation had some unexpected relationships with how long both blacks and whites lived historically in the United States, a new study suggests.

Using data from North Carolina from 1909 to 1975, researchers found that racially segregated areas generally had higher mortality rates, in both urban and rural areas. But, surprisingly, blacks sometimes lived longer in segregated areas than they did in more integrated environments, while whites had shorter lifespans in segregated rural areas.

The study is the first to be able to measure the effect of segregation on health in rural areas and one of few to look at the historical effects of segregation, said Trevon Logan, co-author of the study and professor of economics at The Ohio State University.

“The study shows that the effects of segregation apply not only to the present, but also to the past,” Logan said. “More importantly, we found that segregation was related to health outcomes in rural as well as urban areas.”

Logan conducted the study with John Parman, associate professor of economics at the College of William and Mary. Their results appear online in the journal Social Science Medicine and will be published in a future print edition.

The researchers used a measure of historical segregation they developed that allows them, for the first time, to analyze segregation in rural communities.

Their measure used complete census manuscript files to identify the races of next-door neighbors. In rural areas, where there may not be traditional neighborhoods, this allowed the researchers to be the first to measure racial segregation.

The researchers used this segregation data along with death certificates from North Carolina to see how segregation was related to mortality in both urban and rural areas for blacks and whites.

Results showed that whites lived roughly 10 years longer than blacks during the time studied. But findings differed by levels of segregation and whether people lived in urban or rural areas.

For black adults, living in segregated urban and rural areas was associated with a longer lifespan. For example, urban black females living in highly segregated areas lived about five years longer than those who lived in neighborhoods with average levels of segregation. For black men, the result was even more pronounced – nearly 10 years.

In rural areas, blacks also lived longer in more highly segregated areas.

Logan said he suspects that segregation may have been protective of health for blacks historically because, in an era before antibiotics, they would have less exposure to deadly infectious diseases.

“In a period with a lack of access to quality health care, especially for black people, less exposure between races could have had large, positive effects on black health,” he said.

“Segregation would not have the same protective effects today that it did before antibiotics.”

For whites, the results were different. The data suggest that whites in segregated urban areas may have lived longer than those in more integrated areas, but the results were not entirely consistent.

However, white men and women in segregated rural areas did tend to die at slightly younger ages than those in more integrated areas.

Why was that?

While the data can’t say for sure, Logan said racism may have played a role. Whites in segregated rural areas may have been less likely to support public health projects – such as cleaner water – if they would have had to share them with nearby black areas. They may have been more likely to want public health improvements if blacks lived nearby in the belief that it would protect their own health.

The study also looked at infant mortality data in the South for the 1900 and 1910 federal censuses. Results suggested that segregation was not consistently related to differences in infant mortality between blacks and whites in both urban and rural areas. However, blacks did suffer higher levels of infant mortality than did whites.

Overall, the results shed new light on segregation in America, Logan said.

“Our results suggest that segregation mattered in rural areas, as well as urban areas,” Logan said. “And the effects of segregation were evident long before the Great Migration of African Americans to urban centers.”


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