My interest in the potential impact of segregation on the health of blacks (African Americans) was stimulated by the chance reading of an article in a sociological journal ( Massey and Denton, 1987) dealing with time trends in black-white residential segregation. The higher degree of segregation of U.S. whites from blacks than from other racial and ethnic groups, and the obvious association between segregation and overall quality of life, suggested that segregation might be related in complex ways to the health of blacks. My first work in this area, dealing with infant mortality ( Polednak, 1991), was done without awareness of previous efforts to examine the association between segregation and black infant mortality rates ( Yankauer, 1950; LaVeist, 1989).
This book brings together data from several studies that have examined the association between degree of black-white residential segregation and mortality rates for blacks in selected U.S. urban areas, with some control (statistically) for variation in black-white disparities in social class. It also presents previously unpublished analyses that include additional calendar years of mortality data, along with data from the 1990 U.S. census. These analyses are useful mainly in generating hypotheses to be explored by analytic studies that include information on individuals. The goal of these analyses is to increase interest, on the part of sociologists and epidemiologists, in what might be called the "epidemiology of American apartheid." This extends the work of sociologists Massey and Denton on American Apartheid ( 1993) into the area of public health. Mortality rates are used not only because of the availability of data but also because they demonstrate the underprivileged status of blacks. By tradition in public health, infant mortality rates have been used as an index of social progress.
The goal is to call greater attention to the high mortality rates for blacks in many urban areas, as a reflection of their unique experience with discrimination. Such attempts recognize bell hooks's perceptive comments ( 1995) about the hopelessness (for blacks) of adopting the role of victim, despite obvious victimization, and understandable black ambivalence with regard to integration and "assimilation." Despite these dilemmas, the epidemiology of American apartheid should prove not only challenging but rewarding, in terms of its implications for social and health policy.
The intended audience includes sociologists, especially medical sociologists, who are likely to be familiar with the issue of segregation but not with its