Segregation, Poverty, and Mortality in Urban African Americans

By Anthony P. Polednak | Go to book overview

4
From Socioeconomic Epidemiology toward the Epidemiology of American Apartheid

The conceptual framework in Chapter 1 involves consideration of the effects of social class on the health of blacks and the possibility of a combined effect of black poverty and the segregation of blacks in urban areas ("concentration" or "neighborhood" effects). In this chapter, the results of a few studies of the relationship between poverty (or, more broadly, social class) and mortality are outlined, including the pioneering work of Kitagawa and Hauser ( 1973) on "socioeconomic epidemiology." The extension of this field to encompass segregation as a variable in predicting variation in mortality rates for blacks, and black/white ratios of mortality rates, is introduced, to be followed by detailed analyses in Chapter 5.


Socioeconomic Epidemiology

General Studies

The relationship between social class and risk of illness and death has a long history, including the observations of R. Virchow ( 1821-1902) on epidemics in Upper Silesia, with his belief in the relevance of "liberty, education and prosperity" to health ( Silver, 1987; Susser, 1983, 1985). This topic is receiving increasing attention in epidemiology, sociology, and psychology (e.g., Adler et al., 1994; Liberatos et al., 1988; Marmot et al., 1987; Susser, 1985). Statistical studies started in Europe, due to the availability of data on occupational or other social-class indicators as well as better systems of registration of the population, and this tradition has continued ( Susser, 1983, 1985; Marmot et al., 1991; Vagero, 1991).

In Britain evidence indicates a widening gap in health and mortality between

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