Objectives: To examine the relationship between racial/ethnic neighborhood concentration and self-reported health before and after adjustment of individual- and neighborhood-level characteristics and to determine whether this association varies by race/ethnicity and perception of neighborhood.
Design: The data are derived from the 1999 and 2002 New York City Social Indicator Survey, a cross-sectional survey. Logistic regression was used to assess the strength of the association between racial/ethnic neighborhood concentration and self-reported health before and after controlling for other covariates.
Setting: The survey was conducted in New York City in 1999 and 2002.
Participants: A final sample of 2,845 individuals who self-identified as White, Black, Hispanic, or Asian was linked by zip code to the 2000 US Census.
Main outcome measure: Self-reported health was used as a dichotomous variable, good health status (including responses of excellent, very good, pretty good, or good) and poor health status (including the responses fair or poor).
Results: Overall, 21.8% of respondents rated their health as poor, and those who live in neighborhoods with a high concentration of Blacks reported poorer health (27.2%) than those who live in neighborhoods with a low concentration of Blacks (17.3%, P<.001). Our findings suggest that individuals living in the most concentrated neighborhoods were almost two times more likely (odds ratio 1.77, 95% confidence interval 1.12-2.79) to perceive their health as poor compared to their counterparts living in less concentrated neighborhoods.
Conclusions: This study demonstrates that poor self-reported health varies with patterns of concentration of Blacks in a neighborhood, after adjusting for individual- and neighborhood-level characteristics and perception of neighborhood. The results underscore the need for elucidating the pathways by which racial/ethnic neighborhood concentration affects health.