Discussion: Residential Segregation
Human biology. All aspects of health, physical and mental, developed within the human body as a result of organic makeup.
3. Lifestyle. The aggregation of personal decisions over which the individual has control. Self- imposed risks created by unhealthy lifestyle choices can be said to contribute to, or cause, illness or death.
4. Health care organization. The quantity, quality, arrangement, nature, and relationships of people and resources in the provision of health care.
These four domains were later refined to include five intersecting domains:
1. environmental exposures,
3. behavior (lifestyle) choices,
4. social circumstances, and
5. medical care (Institute of Medicine [IOM], 2001).
All five domains are integrated and affected by one another. For example, people who have more education usually have higher incomes (social circumstances), are more likely to live in neighborhoods with fewer environmental health risks (environmental exposures), and have money to purchase healthier foods (lifestyle). Let’s look at each of these domains in more detail.
Environmental conditions are believed to play an important role in producing and maintaining health disparities. The environment influences our health in many ways, including through exposures to physical, chemical, and biological risk factors and through related changes in our behavior in response to those factors. In general, whites and minorities do not have the same exposure to environmental health threats because they live in different neighborhoods. Residential segregation still exists.
Residential segregation between white and black populations continues to be very high in U.S. metropolitan areas. Residential segregation of Hispanics/Latinos is not yet as high as that of African Americans, but it has been increasing over the past few decades; black segregation has modestly decreased (Iceland, Weinberg, & Steinmetz, 2002).
Growing evidence suggests that segregation is a key determinant of racial inequalities for a broad range of societal outcomes, including health disparities (Acevedo-Garcia, Osypuk, McArdle, & Williams, 2008). Segregation affects health outcomes in a multitude of ways. It limits the socioeconomic advancement of minorities through educational quality and employment, and lowers the returns of home ownership due to lower school quality, fewer job opportunities, and lower property values in disadvantaged neighborhoods. Segregation also leads to segregation in health care settings, which in turn is associated with disparities in the quality of treatment (Acevedo-Garcia et al., 2008).
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