Assessing the effects of racial residential segregation on the distribution of individual risk factors has the potential to further demonstrate how RRS contributes to the disparity in preterm birth. To date, no study has examined the distribution of risk factors by RRS. This study contributes empirical results of the differential distribution of risk factors associated with PTB by RRS, and subsequently, race/ethnicity. This research highlights a potential mechanism of disparities in PTB.
Link and Phelan (1995) discuss the importance of understanding the influence of context on health outcomes. This method provides a framework for understanding how segregation can impact proximal factors to preterm birth and the black-white disparity that persists. But the main goal of this research method is to demonstrate that there is an empirical effect of RRS, the contextual factor, on proximal risks for preterm, and not to
highlight proximal factors that should instead be intervened on. As Link and Phelan (1995) point out with the example of SES, even if proximal factors are intervened upon, other proximal factors will emerge as contributors to an outcome “because a deeper sociological process is at work” (p. 87). Moreover, they write, “the essential feature of fundamental social causes, is that they involve access to resources (money, knowledge, power, prestige, interpersonal resources, e.g., social support) that can be used to avoid risks” (p. 87).
Segregation creates systems that limit access to a plethora of resources, and is shown here to have a fundamental association with racial/ethnic disparities in preterm birth.
Categories of segregation will be used to present the prevalence of each individual- level risk factor; therefore, the greatest amount of change will be achieved by addressing this contextual factor. This is not to say that black and white residents should be forced to move to make residential areas more heterogeneous, but rather to focus attention on the economic, health, educational, and social resources available in an area, with interventions that
normalize these differences. Therefore, the greatest significance of this line of research is empirically delineating how residential segregation affects the health of individuals. These results will help researchers better understand where to intervene to address a health issue affected by social context. The results should also have policy implications for funding research and interventions that will take the U.S. closer to eliminating racial and ethnic disparities in health.
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