Racial and Environmental Inequalities in Spatial Patterns in Asthma Prevalence in the US South

Research on asthma prevalence and neighborhood effects shows how health disparities may be linked to neighborhood racial composition and local exposure to toxic air, but it often leaves aside how neighborhoods are spatially interconnected. Informed by urban studies and environmental justice research, this study suggests that analyses of asthma disparities can adopt a complementary spatial framework that highlights how social outcomes are patterned across geographic space. Using data from more than 4,000 census tracts in the US South, spatial models examine the direct and indirect effects of racial composition and air pollution on asthma prevalence within neighborhoods. Findings show that presence in neighborhoods with more Black residents and with greater air pollution are associated with higher asthma prevalence, and that contiguous areas sharing these characteristics also were positively associated with higher asthma rates. The effect for proportion of Black residents is much greater than air pollution. Implications center on how spatial modeling, environmental justice, and urban social science can contribute to our understanding of how urban asthma disparities come to be.