Racial segregation and health disparities between Black and White older adults

Objectives. In this study, we examined whether racial segregation is associated with poorer self-rated health among older adults, and whether racial segregation helps explain race disparities in self-rated health between Black and White older adults. Methods. We used multilevel data at the individual, neighborhood (tract), and county levels, from two national surveys-the Americans' Changing Lives (ACL) survey and the National Survey of Families and Households (NSFH). We used hierarchical linear models in order to regress self-rated health on county-, neighborhood-, and individual-level racial and socioeconomic variables. Results. In the NSFH, there was an association between county racial segregation and poorer self-rated health among White but not Black older adults (net of county percent Black and percent poverty). In the ACL, there was no statistically significant association between racial segregation and self-rated health. In the NSFH, there was some indication that Black older adults had better self-rated health when living in neighborhoods with a higher percentage of Black residents than the county percentage. Discussion. Although aggregate-level studies demonstrate associations between racial segregation and mortality rates, our multilevel analyses with two national data sets suggest only weak associations between racial segregation and self-rated health. However, socioeconomic status at multiple levels contributes to race disparities in health.