Ethnicity and mortality in the United States: Individual and community correlates

Ethnic gaps in mortality persist in the United States but the specific causes remain elusive. We propose a broader mortality framework that includes neighborhood characteristics that We test using data from a file that links the National Health Interview Survey (NHIS) from 1986 through 1990 with information from death certificates from the National Death Index (NDI), and additional census tract-level data from the 1990 Census STF-3A files. Cox proportional hazards models, which include measures of minority concentration and median income at the neighborhood level, for all-cause mortality during the follow-up, are estimated for men and women separately The concentration of African Americans in the neighborhood of residence, in addition to individual socioeconomic status, fully account for differential mortality between African American and non-Hispanic white men and women. For Mexican Americans, the concentration of Hispanics in the neighborhood slightly enhances their significant mortality advantage. From additional analyses, it appears that the pathway between residential segregation and mortality is routed through poorer neighborhood economic conditions for men and high levels of female headship in segregated neighborhoods for women. The final analysis conducted for men by age at death shows that both young and middle-aged African American men are affected by the concentration of African Americans in the community.