All-cause mortality and residential racial and ethnic segregation and composition as experienced differently by individual-level race, ethnicity, and gender: Mortality disparities in american communities data

Purpose: Use a large nationally representative population to evaluate whether differences in mortality in relation to residential racial and ethnic segregation and diversity varied by gender, and race or Hispanic ethnicity in the United States. Methods: The Mortality Disparities in American Communities (MDAC) was used to evaluate mortality risk in relation to segregation. MDAC is a nationally representative record linkage of the 2008 American Community Survey data with mortality outcomes derived from the National Death Index through 2015. Gender-stratified mortality risk for White, Black, and Hispanic groups in relation to quartiles of residen -tial segregation, composition, and diversity were modeled using parametric survival regression with an exponential distribution, adjusted for individual-level socioeconomic characteristics. Results: The study population included > 3,950,0 0 0 individuals and > 273,0 0 0 all-cause mortality out-comes. Statistically significant differences in associations were observed with Black segregation vs. His-panic segregation across Black or Hispanic groups; some differences in stratification by gender for Hispanic and Non-Hispanic Black groups, but gender-stratified associations were more similar in non-Hispanic Whites. Conclusions: Future multidisciplinary and ethnographic research is needed to identify the specific struc-tural mechanisms by which these associations differ to support means by which to more effectively target public health interventions. (c) 2021 Elsevier Inc. All rights reserved.