The Role of Racial Residential Segregation in Black-White Disparities in Firearm Homicide at the State Level in the United States, 1991-2015

J Natl Med Assoc. 2019 Feb;111(1):62-75. doi: 10.1016/j.jnma.2018.06.002. Epub 2018 Jul 11.


Objective: To investigate the relationship between racial residential segregation and differences in Black-White disparities in overall firearm homicides across U.S states.

Methods: Using a linear regression, we evaluated the relationship between racial residential segregation, as measured by the index of dissimilarity, and the Black-White firearm homicide disparity ratio in 32 states over the period 1991-2015. To account for clustering of observations within states, we used a generalized estimating equations approach.

Results: After controlling for measures of White and Black deprivation, multivariate analysis showed that racial segregation was positively associated with the Black-White firearm homicide disparity. For each 10-point increase in the index of dissimilarity, the ratio of Black to White firearm homicide rates in a state increased by 39%. After controlling for levels of White and Black deprivation, racial segregation remained negatively associated with White firearm homicide rates and positively associated with Black firearm homicide rates.

Conclusions: These findings suggest that racial segregation may increase the disparity in firearm homicide between the Black and White population.

Keywords: Dissimilarity index; Firearm; Homicide; Racial inequality; Residential segregation; Structural racism.

MeSH terms

  • African Americans / statistics & numerical data*
  • European Continental Ancestry Group / statistics & numerical data*
  • Health Status Disparities*
  • Homicide / ethnology
  • Homicide / statistics & numerical data*
  • Humans
  • Multivariate Analysis
  • Social Segregation*
  • United States / epidemiology
  • Wounds, Gunshot / ethnology
  • Wounds, Gunshot / mortality*