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Purpose – This chapter discusses health disparities among African Americans living in urban spaces within the United States.

Approach – This chapter provides an overview of health disparities in morbidity and mortality related to maternal and child health (maternal mortality rate, infant mortality, and low birth weight).

Practical implications – This chapter describes research and interventions that strive to increase our ability to understand and reduce health disparities. Eliminating health disparities not only is beneficial to these affected groups but also offers the opportunity to improve the health of the entire U.S. population.

Originality/value – This chapter adds to our understanding of the correlates of health disparities for African American women and children as well as successful interventions that have proven effective in ameliorating these disparities.

W.E.B. DuBois, in his 1903 collection of writings entitled The Souls of Black Folk, describes what he calls “The Veil,” which succinctly sums up the deadly and adverse experiences of African Americans in the US. With DuBois contemplations of a Veil under which US Blacks alone live and die as context, this paper takes a look at the modern condition of African Americans in the US, whether they continue to exist within DuBois Veil in modern times (twentieth and twenty-first centuries), and if so, to what extent. As a routine examination and inspection of the condition of Blacks in the US, focus is placed on black lives lost, beginning with an appraisal of their size in the US population overtime, and in comparison with other racial and ethnic groups in the US. US census data, health data collected from the Centers for Disease Control and Prevention, and crime data collected from the Federal Bureau of Investigation are examined to construct a composite of the condition of contemporary Blacks in the US as compared to other groups in the US, focusing attention specifically on the rates at which their lives are lost compared to others through infant mortality, low fertility rates, abortion, and high rates of homicide. This analysis concludes with a look at death from homicide before, during, and after the post-1990s drop in the crime rate.

African American men and women suffer from health problems such as hypertension, cardiovascular disease, diabetes, AIDS, sickle cell anemia, and various forms of cancer, often at a higher rate than the rest of the population. There is a need for information about these and other health problems affecting this particular community. This annotated bibliography includes recent articles, books, Internet resources, and Web sites. The audience for this essay includes the layperson, health‐care professionals, and information specialists who wish to provide information to patrons on these important health issues.

Children experience toxic stress if there is pronounced activation of their stress-response systems, in situations in which they do not have stable caregiving. Due to their exposure to multiple poverty-related risks, African American children may be more susceptible to exposure to toxic stress. Toxic stress affects young children’s brain and neurophysiologic functioning, which leads to a wide range of deleterious health, developmental, and mental health outcomes. Given the benefits of early care and education (ECE) for African American young children, ECE may represent a compensating experience for this group of children, and promote their positive development.

Studies repeatedly have found social disparities of health at many levels of spatial aggregation. A second body of empirical research, demonstrating relationships between an area's racial and class composition and its environmental conditions, has led to the rise of an environmental justice movement. However, few studies have connected these two sets of findings to ask whether social disparities in health outcomes are due to local environmental disparities. This chapter investigates whether the association between racial and socioeconomic composition and multiple health conditions across New York City zip codes is partly mediated by neighborhood physical, built, and social environments.

Postneonatal mortality (PNM), which differs from infant and perinatal mortality, has been observed in the past 25 years with respect to the health outcomes of children. While infant and perinatal mortality have been well-evaluated regarding racial differentials, there are no substantial data on PNM in this perspective. The purpose of this study was to assess whether or not social determinants of health adversely affect racial/ethnic PNM differentials in the USA.

A cross-sectional, nonexperimental epidemiologic study design was used to assess race as an exposure function of PNM using Cohort Linked Birth/Infant Death Data (2013). The outcome variable assessed PNM, while the main independent variables were race, social demographic variables (i.e. sex and age) and social determinants of health (i.e. marital status and maternal education). The chi-square statistic was used to assess the independence of variables by race, while the logistic regression model was used to assess the odds of PNM by race and other confounding variables.

During 2013, there were 4,451 children with PNM experience. The cumulative incidence of PNM was 23.6% (n = 2,795) among white infants, 24.3% (n = 1,298) among Black/African-Americans (AA) and 39.5% (n = 88) were American-Indian infants (AI), while 21.3% (n = 270) were multiracial, χ² (3) = 35.7, p < 0.001. Racial differentials in PNM were observed. Relative to White infants, PNM was two times as likely among AI, odds ratio (OR) 2.11 (95% confidence interval [CI] 1.61, 2.78). After controlling for the confounding variables, the burden of PNM persisted among AI, although slightly marginalized, adjusted odds ratio (aOR) 1.70, (99% CI 1.10, 2.65).

In a representative sample of US children, there were racial disparities in PNM infants who are AI compared to their white counterparts, illustrating excess mortality. These findings suggest the need to allocate social and health resources in transforming health equity in this direction.

An important hypothesis put forth by Amartya Sen is that a given level of per capita real income in a population can generate quite different levels of socio‐economic well‐being depending on the economic infrastructure of that population and the distribution of income. Sen's hypothesis is refined in this paper to reflect the manner in which income is spent and labor is allocated and utilized within a household specific to particular groups within society and how this impacts upon both the level of well‐being and economic efficiency. The evidence on living conditions and mortality presented here from early twentieth century New York City, underlies the potential significance of the household economy as a key determinant of economic well‐being. Focusing simply on per capita income estimates, even corrected for the distribution of income, misses fundamentally important determinants of human capabilities and economic well‐being with potentially important implications for public policy.

Infant mortality has fallen rapidly in underdeveloped countries in the period since World War II. There is accumulating evidence, however, that this unprecedented decline was arrested in the late 1960s and early 1970s. Hence it is of critical importance to enquire into the determinants of infant mortality in these countries, in order to discover ways of reducing the enormous human suffering caused by the high rates of mortality which continue to prevail. Furthermore, such an understanding might facilitate a reduction in fertility, since it is widely accepted that a fall in infant mortality will lead ultimately to lower fertility .

This article examines whether increasing the income of the poor – measured as the income of the lowest quintile – is more beneficial in reducing infant and child mortality rates compared with increases in average income. Given the global importance in reducing infant mortality, the value of this research is important to academics, policymakers and practitioners alike.

Using a sample of 86 countries from 1995–2014 inclusive, our preferred estimation strategy uses an instrumental variable fixed-effects estimator.

Our results propose that the elasticity of the income of the lowest quintile never exceeds that of average income. Therefore, if reducing infant and child mortality is a key policy goal, then boosting average income may be preferable to raising incomes at the lower end of the distribution.

Given these findings, we open a gateway for new literature to add to this unexplored area of research in the income and health relationship.