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Association between an Internet-Based Measure of Area Racism and Black Mortality

Racial disparities in health are well-documented and represent a significant public health concern in the US. Racism-related factors contribute to poorer health and higher mortality rates among Blacks compared to other racial groups. However, methods to measure racism and monitor its associations wi...

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Autores principales: Chae, David H., Clouston, Sean, Hatzenbuehler, Mark L., Kramer, Michael R., Cooper, Hannah L. F., Wilson, Sacoby M., Stephens-Davidowitz, Seth I., Gold, Robert S., Link, Bruce G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409363/
https://www.ncbi.nlm.nih.gov/pubmed/25909964
http://dx.doi.org/10.1371/journal.pone.0122963
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author Chae, David H.
Clouston, Sean
Hatzenbuehler, Mark L.
Kramer, Michael R.
Cooper, Hannah L. F.
Wilson, Sacoby M.
Stephens-Davidowitz, Seth I.
Gold, Robert S.
Link, Bruce G.
author_facet Chae, David H.
Clouston, Sean
Hatzenbuehler, Mark L.
Kramer, Michael R.
Cooper, Hannah L. F.
Wilson, Sacoby M.
Stephens-Davidowitz, Seth I.
Gold, Robert S.
Link, Bruce G.
author_sort Chae, David H.
collection PubMed
description Racial disparities in health are well-documented and represent a significant public health concern in the US. Racism-related factors contribute to poorer health and higher mortality rates among Blacks compared to other racial groups. However, methods to measure racism and monitor its associations with health at the population-level have remained elusive. In this study, we investigated the utility of a previously developed Internet search-based proxy of area racism as a predictor of Black mortality rates. Area racism was the proportion of Google searches containing the “N-word” in 196 designated market areas (DMAs). Negative binomial regression models were specified taking into account individual age, sex, year of death, and Census region and adjusted to the 2000 US standard population to examine the association between area racism and Black mortality rates, which were derived from death certificates and mid-year population counts collated by the National Center for Health Statistics (2004–2009). DMAs characterized by a one standard deviation greater level of area racism were associated with an 8.2% increase in the all-cause Black mortality rate, equivalent to over 30,000 deaths annually. The magnitude of this effect was attenuated to 5.7% after adjustment for DMA-level demographic and Black socioeconomic covariates. A model controlling for the White mortality rate was used to further adjust for unmeasured confounders that influence mortality overall in a geographic area, and to examine Black-White disparities in the mortality rate. Area racism remained significantly associated with the all-cause Black mortality rate (mortality rate ratio = 1.036; 95% confidence interval = 1.015, 1.057; p = 0.001). Models further examining cause-specific Black mortality rates revealed significant associations with heart disease, cancer, and stroke. These findings are congruent with studies documenting the deleterious impact of racism on health among Blacks. Our study contributes to evidence that racism shapes patterns in mortality and generates racial disparities in health.
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spelling pubmed-44093632015-05-12 Association between an Internet-Based Measure of Area Racism and Black Mortality Chae, David H. Clouston, Sean Hatzenbuehler, Mark L. Kramer, Michael R. Cooper, Hannah L. F. Wilson, Sacoby M. Stephens-Davidowitz, Seth I. Gold, Robert S. Link, Bruce G. PLoS One Research Article Racial disparities in health are well-documented and represent a significant public health concern in the US. Racism-related factors contribute to poorer health and higher mortality rates among Blacks compared to other racial groups. However, methods to measure racism and monitor its associations with health at the population-level have remained elusive. In this study, we investigated the utility of a previously developed Internet search-based proxy of area racism as a predictor of Black mortality rates. Area racism was the proportion of Google searches containing the “N-word” in 196 designated market areas (DMAs). Negative binomial regression models were specified taking into account individual age, sex, year of death, and Census region and adjusted to the 2000 US standard population to examine the association between area racism and Black mortality rates, which were derived from death certificates and mid-year population counts collated by the National Center for Health Statistics (2004–2009). DMAs characterized by a one standard deviation greater level of area racism were associated with an 8.2% increase in the all-cause Black mortality rate, equivalent to over 30,000 deaths annually. The magnitude of this effect was attenuated to 5.7% after adjustment for DMA-level demographic and Black socioeconomic covariates. A model controlling for the White mortality rate was used to further adjust for unmeasured confounders that influence mortality overall in a geographic area, and to examine Black-White disparities in the mortality rate. Area racism remained significantly associated with the all-cause Black mortality rate (mortality rate ratio = 1.036; 95% confidence interval = 1.015, 1.057; p = 0.001). Models further examining cause-specific Black mortality rates revealed significant associations with heart disease, cancer, and stroke. These findings are congruent with studies documenting the deleterious impact of racism on health among Blacks. Our study contributes to evidence that racism shapes patterns in mortality and generates racial disparities in health. Public Library of Science 2015-04-24 /pmc/articles/PMC4409363/ /pubmed/25909964 http://dx.doi.org/10.1371/journal.pone.0122963 Text en © 2015 Chae et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.
spellingShingle Research Article
Chae, David H.
Clouston, Sean
Hatzenbuehler, Mark L.
Kramer, Michael R.
Cooper, Hannah L. F.
Wilson, Sacoby M.
Stephens-Davidowitz, Seth I.
Gold, Robert S.
Link, Bruce G.
Association between an Internet-Based Measure of Area Racism and Black Mortality
title Association between an Internet-Based Measure of Area Racism and Black Mortality
title_full Association between an Internet-Based Measure of Area Racism and Black Mortality
title_fullStr Association between an Internet-Based Measure of Area Racism and Black Mortality
title_full_unstemmed Association between an Internet-Based Measure of Area Racism and Black Mortality
title_short Association between an Internet-Based Measure of Area Racism and Black Mortality
title_sort association between an internet-based measure of area racism and black mortality
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4409363/
https://www.ncbi.nlm.nih.gov/pubmed/25909964
http://dx.doi.org/10.1371/journal.pone.0122963
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