A recent cross-sectional study of 150 neighborhoods in Durham County, North Carolina, has revealed a strong association between indicators of structural racism and the prevalence of chronic diseases such as chronic kidney disease, diabetes, and hypertension. The research, led by Dinushika Mohottige, MD, MPH, from the Icahn School of Medicine at Mount Sinai, was published in JAMA Network Open.
The study found that neighborhoods with higher burdens of structural racism, characterized by lower economic and racial spatial advantage, higher area deprivation, and higher rates of reported violent crimes, evictions, poverty, unemployment, and uninsurance, had greater prevalence of the aforementioned chronic conditions. Conversely, neighborhoods with lower prevalence of these diseases had higher median proportions of White residents, higher incomes, and lower area deprivation.
Mohottige and colleagues analyzed a range of global and discrete indicators of structural racism, including the density of child care centers, bus stops, tree cover, and police shootings. The prevalence of chronic conditions varied significantly across neighborhoods, with chronic kidney disease ranging from 0.6% to 8.2%, diabetes from 3.3% to 24.4%, and hypertension from 3.6% to 48.9%.
The findings suggest that structural racism may play a significant role in health disparities at the neighborhood level. While caution is advised in interpreting the results due to the cross-sectional and ecological nature of the study, the research underscores the potential for these indicators to inform future community health interventions aimed at mitigating neighborhood health inequities.
See “Structural Racism and Chronic Disease at the Neighborhood Level” by Malini Ghoshal on the MedCentral website (January 9, 2024)
