Racial Residential Segregation and Access to Health-Care Coverage: A Multilevel Analysis

Abstract

A developing body of research has demonstrated the impact of racial residential segregation on a variety of negative health outcomes. However, little is known about the effect of residential segregation on access to health care.

This study utilizes multilevel binary logit models based on individual-level health data from the 2008 Behavioral Risk Factor Surveillance System linked to metropolitan-area level data to examine the association between Black-White segregation in 136 metropolitan statistical areas in the United States and health-care coverage.

Overall, an increase in Black-White segregation is related to a decrease in the likelihood of having health insurance for Black residents and an increase in the Black-White gap in health-care coverage. These effects are substantial even when controlling for the effects of educational, social, and economic factors.

This study is the first to examine the impact of segregation on an individual's ability to access health-care coverage, which is an essential starting point for accessing health care in the United States.

Citation

Freeman Anderson, K. and Fullerton, A.S. (2012), "Racial Residential Segregation and Access to Health-Care Coverage: A Multilevel Analysis", Jacobs Kronenfeld, J. (Ed.) Issues in Health and Health Care Related to Race/Ethnicity, Immigration, SES and Gender (Research in the Sociology of Health Care, Vol. 30), Emerald Group Publishing Limited, Leeds, pp. 133-158. https://doi.org/10.1108/S0275-4959(2012)0000030009