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Objectives. To quantify the relationship between the segregation of Black, Indigenous, and Latinx communities and COVID-19 testing sites in populous US cities. Methods. We mapped testing sites as of June 2020 in New York City; Chicago, Illinois; Los Angeles, California; and Houston, Texas; we applied Bayesian methods to estimate the association between testing site location and the proportion of the population that is Black, Latinx, or Indigenous per block group, the smallest unit for which the US Census collects sociodemographic data. Results. In New York City, Chicago, and Houston, the expected number of testing sites decreased by 1.29%, 3.05%, and 1.06%, respectively, for each percentage point increase in the Black population. In Chicago, Houston, and Los Angeles, testing sites decreased by 5.64%, 1.95%, and 1.69%, respectively, for each percentage point increase in the Latinx population. Conclusions. In the largest highly segregated US cities, neighborhoods with more Black and Latinx residents had fewer COVID-19 testing sites, likely limiting these communities’ participation in the early response to COVID-19. Public Health Implications. In light of conversations on the ethics of racial vaccine prioritization, authorities should consider structural barriers to COVID-19 control efforts. (Am J Public Health. 2022;112(3):518–526. https://doi.org/10.2105/AJPH.2021.306558 )

In the United States, Black youth tend to grow up in remarkably less resourced neighborhoods than White youth. This study investigates whether and to what extent Black youth are moreover exposed to less resourced activity spaces beyond the home. We draw on GPS data from a large sample of urban youth in the Columbus, Ohio–based Adolescent Health and Development in Context study (2014–2016) to examine to what extent Black youth experience nontrivial, disproportionate levels of exposure to more disadvantaged and segregated contexts in their daily routines compared with similarly residentially situated White youth. Specifically, we estimate Black–White differences in nonhome exposure to concentrated disadvantage, racial segregation, collective efficacy, and violent crime. We find that Black youths' activity spaces have substantially higher rates of racial segregation and violent crime than those of White youth, and substantially lower levels of collective efficacy—even after accounting for a host of individual- and home neighborhood–level characteristics. We find more modest evidence of differences in exposure to socioeconomic disadvantage. These findings have important implications for neighborhood-centered interventions focused on youth well-being and the contextual effects and segregation literatures more generally.

Background: Black adults experience a disproportionately higher burden of cardiovascular risk factors and disease in comparison with White adults in the United States. Less is known about how sex-based disparities in cardiovascular mortality between these groups have changed on a national scale over the past 20 years, particularly across geographic determinants of health and residential racial segregation. Methods: We used CDC WONDER (Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research) to identify Black and White adults age ≥25 years in the United States from 1999 to 2019. We calculated annual age-adjusted cardiovascular mortality rates (per 100 000) for Black and White women and men, as well as absolute rate differences and rate ratios to compare the mortality gap between these groups. We also examined patterns by US census region, rural versus urban residence, and degree of neighborhood segregation. Results: From 1999 to 2019, age-adjusted mortality rates declined overall for both Black and White adults. There was a decline in age-adjusted cardiovascular mortality among Black (602.1 to 351.8 per 100 000 population) and White women (447.0 to 267.5), and the absolute rate difference (ARD) between these groups decreased over time (1999: ARD, 155.1 [95% CI, 149.9–160.3]; 2019: ARD, 84.3 [95% CI, 81.2–87.4]). These patterns were similar for Black (824.1 to 526.3 per 100 000) and White men (637.5 to 396.0; 1999: ARD, 186.6 [95% CI, 178.6–194.6]; 2019: ARD, 130.3 [95% CI, 125.6–135.0]). Despite this progress, cardiovascular mortality in 2019 was higher for Black women (rate ratio, 1.32 [95% CI, 1.30–1.33])— especially in the younger (age Conclusions: During the past 2 decades, age-adjusted cardiovascular mortality declined significantly for Black and White adults in the United States, as did the absolute difference in death rates between these groups. Despite this progress, Black women and men continue to experience higher cardiovascular mortality rates than their White counterparts.

Despite continued interest in gender (in)equality at work, Canadian research on gender occupational segregation stopped in the early 2000s. We revisit gender occupational segregation trends using newly developed harmonized occupational categories which resolve temporal changes in occupational classifications. Our analysis of the 1991-2016 Canadian Census Masterfiles finds gender occupational segregation, whether measured by the index of dissimilarity or Gini index, has steadily decreased since the 1990s. Yet the pace of its decline has slowed since 2000. This can be explained by the diminishing changes in vertical segregation, measured by inequality in earnings across occupations. Our results contribute to an ongoing debate about a stalled gender revolution. We also suggest new topics for future study.Malgré l'intérêt soutenu pour l'inégalité entre les sexes au travail, les recherches canadiennes sur la ségrégation professionnelle entre les sexes ont cessé au début des années 2000. Nous réexaminons les tendances en matière de ségrégation professionnelle entre les sexes à l'aide de catégories professionnelles harmonisées nouvellement développées qui résolvent les changements temporels dans les classifications professionnelles. Notre analyse des fichiers principaux du recensement canadien de 1991 à 2016 révèle que la ségrégation professionnelle entre les sexes, qu'elle soit mesurée par l'indice de dissimilarité ou l'indice de Gini, a diminué de façon constante depuis les années 1990. Pourtant, le rythme de son déclin a ralenti depuis 2000. Cela peut s'expliquer par la diminution des changements dans la ségrégation verticale, mesurée par l'inégalité des revenus entre les professions. Nos résultats contribuent au débat en cours sur l'enlisement de la révolution du genre. Nous suggérons également de nouveaux sujets d'étude pour l'avenir.

Following the Great Depression and related home foreclosures, the federal government established new agencies to facilitate access to affordable home mortgages, including the Home Owners' Loan Corporation (HOLC) and Federal Housing Administration (FHA). HOLC and FHA directed widespread neighborhood appraisals to determine investment risk, referred to as "redlining," which took into account residents' race. Redlining thereby contributed to segregation, disinvestment, and racial inequities in opportunities for homeownership and wealth accumulation. Recent research examines associations between historical redlining and subsequent environmental determinants of health and health-related outcomes. In this scoping review, we assess the extent of the current body of evidence, the range of outcomes studied, and key study characteristics, examining the direction and strength of the relationship between redlining, neighborhood environments, and health as well as different methodological approaches. Overall, studies nearly universally report evidence of an association between redlining and health-relevant outcomes, although heterogeneity in study design precludes direct comparison of results. We critically consider evidence regarding HOLC's causality and offer a conceptual framework for the relationship between redlining and present-day health. Finally, we point to key directions for future research to improve and broaden understanding of redlining's enduring impact and translate findings into public health and planning practice.

This study compares and contrasts residents' perceptions of segregation measures using qualitative and quantitative data. Most studies exploring racial residential segregation and health outcomes use large-scale, metropolitan-wide measures. As a result, we have limited understanding of racial residential segregation outside of Census data, particularly about the firsthand experiences of those living in segregated areas. The purpose of this study was to compare data from Census-based measures of racial residential segregation with qualitative descriptions of these same constructs by pregnant, Black women in two US cities. Using novel qualitative interview questions, we explored the dimensions of segregation and neighborhood racial distribution among a sample of 27 pregnant, Black women between April and November 2019. The participants included in this sample had perceptions about their neighborhood segregation and demographic composition that were often different from the data derived from existing residential US Census data. The differences between qualitative and quantitative measures and the possible reasons for the discordance suggest new approaches to measurement and new directions for the study of segregation and health.

Context: Segregation has been linked to unequal life chances. Individuals from marginalized communities experience more crime, higher levels of poverty, poorer health, and less civic engagement. In addition, segregated metropolitan regions have been found to display inequality in access to basic services. This article builds on these findings by linking segregation to infection and deaths from COVID-19. Methods: Using census data matched to COVID infection and death statistics at the county level, this article offers a theoretical basis for the researchers' choice of segregation measures and predictions for different racial groups. It analyzes the relationship between two dimensions of segregation—racial isolation and racial unevenness—and COVID outcomes for different racial and ethnic groups. Findings: In counties where Black and Latino residents lived in more racially isolated neighborhoods, they were much more likely to contract COVID-19. This pattern was exacerbated in counties with a high proportion of frontline workers. In addition, racial segregation increased COVID-19 death rates for Black, Latino, and white residents. Conclusions: These findings suggest that devastating outcomes of the coronavirus pandemic were linked to a long history of racial marginalization and entrenched discrimination produced by structural inequalities embedded in our geographies. This knowledge should be used to inform public health planning.

El proceso de acreditación internacional de docentes de la asignatura inglés para continuar funciones en el magisterio ecuatoriano ha causado ansiedad y sensación de exclusión laboral. Este trabajo tiene como objetivo activar la capacidad resiliente como ruta que aporta al desarrollo profesional y bienestar de los docentes de inglés como lengua extranjera de Ecuador. Este trabajo se afilia al paradigma post naturalista en el que se utilizó una fusión de los enfoques cualitativo y cuantitativo de la investigación socioeducativa durante el periodo 2019-2021. Los participantes son doscientos sesenta docentes de en servicio (45%) y en etapa formativa (55%) domiciliados en la provincia de Manabí. Se administra el cuestionario de Ansiedad de Valero y las estrategias de resiliencia de la Asociación Americana de Psicología (2017). Los instrumentos utilizados son grupo focal, observación participante y cuestionario tipo Likert. Entre los resultados se presenta las percepciones de los participantes respecto al acceso, complejidad y relevancia del proceso de certificación internacional, una categorización de las manifestaciones de ansiedad presentadas durante el proceso de acreditación y los cambios en los niveles de resiliencia en pretest y postest. Se concluye que los niveles de ansiedad pueden ser reducidos al trabajar la resiliencia mediante intervenciones educativas durante el proceso preparatorio, The requirement demanded of teachers of the English as a foreign language subject to continue functions in the teaching profession in Ecuador is one of the main causes of anxiety. This work aims to activate resilient capacity as a route that contributes to teachers' professional development and well-being as a foreign language in Ecuador. This work subscribed to the post-naturalistic paradigm. It used a fusion of the qualitative and quantitative approaches of socio-educational research during 2019-2021. The participants are two hundred and sixty teachers in service (45%) and in training stage (55%) domiciled in the province of Manabí. It used the Valero Anxiety questionnaire and the resilience strategies of the American Psychological Association. The instruments used are focus groups, participant observation, and a Likert-type questionnaire. The results show participants' perceptions regarding the access, complexity, and relevance of the international certification process are presented, a categorization of the manifestations of anxiety presented during the accreditation process, and the changes in the levels of resilience in pre-test and post-test. It concluded that anxiety levels could be reduced by working on resilience through educational interventions during the preparatory process for the international accreditation.

To compare and contrast pregnant, Black women's voices with quantitative measures of racial residential segregation, neighborhood disorder, and racial discrimination.Using a convergent design for the parent study, surveys and qualitative interviews were completed by Black pregnant women (n = 27).Content analysis was conducted and data were analyzed to assess for congruency or divergence for each concept related to structural racism (racial residential segregation, neighborhood disorder, and discrimination).No single concept had 100% agreement across qualitative and quantitative approaches. Participants disclosed experiences during some interviews that were not captured by the surveys. The qualitative interviews offered a more detailed description of the concepts which along with the quantitative measures, provided insights about how participants perceived these mechanisms.While important relationships about the mechanisms of structural racism and preterm birth can be examined using a single approach, using mixed methods can offer more insights about how those most impacted by preterm birth relate to these mechanisms. Future work will best add to the understanding of structural racism and preterm birth when study measures accurately reflect the experiences of the people who experience racism.

Historical, institutional racism within the housing market may have impacted present-day disparities in heat vulnerability. We quantified associations between historically redlined areas with present-day property and housing characteristics that may enhance heat vulnerability in Philadelphia, PA. We used color-coded Home Owners Loan Corporation (HOLC) maps and tax assessment data to randomly select 100 present-day (2018–2019) residential properties in each HOLC grade area (A = Best; B, C, and D = Most hazardous; N = 400 total). We conducted virtual inventories of the properties using aerial and streetview imagery for land cover and housing characteristics (dark roof color, flat roof shape, low or no mature tree canopy, no recently planted street trees) that may enhance heat vulnerability. We used modified Poisson regression models to estimate associations of HOLC grades with the property characteristics, unadjusted and adjusted for historical and contemporary measures of the neighborhood sociodemographic environment. Compared to grade A areas, higher proportions of properties in grade B, C, and D areas had dark roofs, low/no mature tree canopy, and no street trees. Adjusting for historical sociodemographics attenuated associations, with only associations with low or no tree canopy remaining elevated. Adjusting for present-day concentrated racial and socioeconomic deprivation did not substantially impact overall findings. In Philadelphia, PA, HOLC maps serve as spatial representations of present-day housing and land cover heat vulnerability characteristics. Further analyses incorporating longitudinal data on urban redevelopment, reinvestment, and neighborhood change are needed to more fully represent complex relationships among historical racism, residential segregation, and heat vulnerability. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11524-021-00602-6.

OBJECTIVE: To analyze the effect of economic and racial/ethnic residential segregation on breast cancer-specific survival (BCSS) in South Florida, a diverse metropolitan area that mirrors the projected demographics of many United States (US) regions. SUMMARY BACKGROUND DATA: Despite advances in diagnosis and treatment, racial and economic disparities in BCSS. This study evaluates these disparities through the lens of racial and economic residential segregation, which approximate the impact of structural racism. METHODS: Retrospective cohort study of stage I-IV BC patients treated at our institution from 2005–2017. Our exposures include index of concentration at the extremes (ICE), a measurement of economic and racial neighborhood segregation, which was computed at the census-tract level using American Community Survey data. The primary outcome was BCSS. RESULTS: Random effects frailty models predicted that patients living in low-income neighborhoods had higher mortality compared to those living in high-income neighborhoods (HR:1.56, 95%CI:1.23–2.00). Patients living in low-income non-Hispanic Black (NHB) and Hispanic neighborhoods had higher mortality compared to those living in high-income non-Hispanic White (NHW) neighborhoods (HR: 2.43, 95%CI:1.72, 3.43) and (HR: 1.99, 95%CI: 1.39, 2.84), after controlling for patient characteristics, respectively. In adjusted race-stratified analysis, NHWs living in low-income NHB neighborhoods had higher mortality compared to NHWs living in high-income NHW neighborhoods (HR:4.09, 95%CI:2.34–7.06). CONCLUSIONS: Extreme racial/ethnic and economic segregation were associated with lower BCSS. We add novel insight regarding NHW and Hispanics to a growing body of literature that demonstrate how the ecological effects of structural racism—expressed through poverty and residential segregation—shape cancer survival.

We reviewed research that examines racism as an independent variable and one or more health outcomes as dependent variables in Black American adults aged 50 years and older in the USA. Of the 43 studies we reviewed, most measured perceived interpersonal racism, perceived institutional racism, or residential segregation. The only two measures of structural racism were birth and residence in a “Jim Crow state.” Fourteen studies found associations between racism and mental health outcomes, five with cardiovascular outcomes, seven with cognition, two with physical function, two with telomere length, and five with general health/other health outcomes. Ten studies found no significant associations in older Black adults. All but six of the studies were cross-sectional. Research to understand the extent of structural and multilevel racism as a social determinant of health and the impact on older adults specifically is needed. Improved measurement tools could help address this gap in science.

Objectives. To describe associations between neighborhood racial and economic segregation and violence during the COVID-19 pandemic. Methods. For 13 US cities, we obtained zip code–level data on 5 violence outcomes from March through July 2018 through 2020. Using negative binomial regressions and marginal contrasts, we estimated differences between quintiles of racial, economic, and racialized economic segregation using the Index of Concentration at the Extremes as a measure of neighborhood privilege (1) in 2020 and (2) relative to 2018 through 2019 (difference-in-differences). Results. In 2020, violence was higher in less-privileged neighborhoods than in the most privileged. For example, if all zip codes were in the least privileged versus most privileged quintile of racialized economic segregation, we estimated 146.2 additional aggravated assaults (95% confidence interval = 112.4, 205.8) per zip code on average across cities. Differences over time in less-privileged zip codes were greater than differences over time in the most privileged for firearm violence, aggravated assault, and homicide. Conclusions. Marginalized communities endure endemically high levels of violence. The events of 2020 exacerbated disparities in several forms of violence. Public Health Implications. To reduce violence and related disparities, immediate and long-term investments in low-income neighborhoods of color are warranted. (Am J Public Health. 2022;112(1):144–153. https://doi.org/10.2105/AJPH.2021.306540 )

Purpose Use a large nationally representative population to evaluate whether differences in mortality in relation to residential racial and ethnic segregation and diversity varied by gender, and race or Hispanic ethnicity in the United States. Methods The Mortality Disparities in American Communities (MDAC) was used to evaluate mortality risk in relation to segregation. MDAC is a nationally representative record linkage of the 2008 American Community Survey data with mortality outcomes derived from the National Death Index through 2015. Gender-stratified mortality risk for White, Black, and Hispanic groups in relation to quartiles of residential segregation, composition, and diversity were modeled using parametric survival regression with an exponential distribution, adjusted for individual-level socioeconomic characteristics. Results The study population included >3,950,000 individuals and >273,000 all-cause mortality outcomes. Statistically significant differences in associations were observed with Black segregation vs. Hispanic segregation across Black or Hispanic groups; some differences in stratification by gender for Hispanic and Non-Hispanic Black groups, but gender-stratified associations were more similar in non-Hispanic Whites. Conclusion Future multidisciplinary and ethnographic research is needed to identify the specific structural mechanisms by which these associations differ to support means by which to more effectively target public health interventions.

Milliyetçiliği, modernist bir bakış açısıyla değerlendiren kuramcılar; milliyetçiliğin asimilasyonist süreçle etnik azınlıkları baskın gruplar içinde eritme veya “gelenek icat etme” gibi enstrümanlar kullanarak “sosyal bütünleşme” amacına hizmet ettiğini iddia etmişlerdir. Makalede milliyetçiliğin Türkiye’deki ana akım temsilcisi olan Milliyetçi Hareket Partisi’nin (MHP) sosyal bütünleşme işlevini yerine getirip getirmediğinin sorunsallaştırılması hedeflenmiştir. Makalenin amacı, MHP’nin Türkiye’deki sosyal bütünleşme ihtiyacına ne ölçüde cevap verebildiğini sorunsallaştırarak araştırmaktır. MHP’nin örnek olay analizi üzerinden milliyetçiliğin toplumsal bütünleşmeye mi yoksa toplumsal ayrışmaya mı hizmet ettiğini karşılaştırmalı bir perspektiften inceleyen çalışmada, ilkin toplumsal bütünleşme ve ayrışmaya yönelik yaklaşımlar incelenmiştir. Sonrasında MHP özelinde milliyetçiliğin toplumsal bütünleşme ve toplumsal ayrışma işlevi ile ilişkiselliği eleştirel bir biçimde analiz edilmiştir. Makale, nitel bir araştırmadır. Doküman analizi yoluyla toplanan veriler, yorumsamacı ve betimleyici bir yöntemle analiz edilmiştir. Bu bağlamda parti liderlerinin kongre konuşmaları, seçim beyannameleri, MHP ve milliyetçilik konularında yazılan kitaplar, tezler ve makaleler incelenmiştir. Makalede, ulus-devletin temel ideolojisi olan milliyetçiliğin bütünleştirici söylemlerinin aslında dışlayıcı bir nitelik taşıdığı MHP somut örneği üzerinden gösterilmeye çalışılmıştır., Theorists, who study nationalism from a modernist approach, claim that nationalism serves the needs of “social integration” by using techniques such as “inventing tradition” or by dissolving ethnic minorities into dominant groups through the assimilation process. The aim of this article is to investigate whether or not the Nationalist Movement Party (NMP), the mainstream political representative of nationalism in Turkey, fulfills its social integration function. The article aims at analyzing to what extend the NMP can respond to the social integration needs in Turkey. In the study, examining whether nationalism serves the needs of social integration or social segregation from a comparative perspective with a specific focus on the case of the NMP, approaches to the issue of social integration and segregation are, first, scrutinized. Then, the relationship of nationalism with social integration and social segregation functions is critically analyzed with reference to the NMP. The article uses a qualitative research perspective. The data collected through document analysis is elaborated by using a hermeneutic and descriptive method. In this context, the congress speeches of party leaders, election declarations, the books, articles, and theses written on the NMP and nationalism are examined. In the article, it is tried to show that the nationalist discourse of the NMP actually has an exclusionary character.

Social segregation, limited opportunities for interaction and increasing semi-private public spaces, largely contribute to underused public areas of the city. This paper argues that playful design ...

Actualmente las ciudades atraviesan intensos procesos de transformación asociados a la segregación social y la fragmentación espacial. El resultado es el poco contacto entre clases y la débil construcción colectiva de los espacios públicos, cada vez más frágiles. Este artículo indaga un proyecto de intervención en el espacio urbano en la Ciudad de Mendoza, Argentina. Se considera que el mismo constituye un espacio de frontera que tiende a integrar territorios en desuso y a sus agentes intervinientes más allá de los objetivos explícitos (relacionados con el diseño urbano e infraestructura) que presentaba el proyecto. El estudio se realizó a partir del análisis de documentos oficiales, observaciones y entrevistas.

Rationale: Racial residential segregation has been associated with worse health outcomes, but the link with chronic obstructive pulmonary disease (COPD) morbidity has not been established.Objective...

A política de isolamento compulsório da hanseníase praticada no Brasil entre as décadas de 1920 e 1980 segregou não apenas os acometidos pela doença, mas também seus filhos. Apesar da enfermidade não ser hereditária, os menores eram isolados em uma das 36 instituições preventoriais coordenadas, especialmente, por entidades filantrópicas. Nesses estabelecimentos, a trajetória dos internos foi marcada pela violência em suas diversas faces: física, institucional, social e psicológica. O desligamento da instituição era igualmente traumático, dado o despreparo para a vida extramuros. A política de segregação dos filhos das pessoas com hanseníase foi executada também em outros países, como Portugal. The policy of compulsory leprosy isolation practiced in Brazil from the 1920s to the 1980s segregated not only those affected by the disease but also their children. Although the disease is not hereditary, the minors were isolated in one of the 36 preventive institutions especially coordinated by philanthropic entities. In those establishments, the trajectory of the inmates was marked by violence in its various aspects: physical, institutional, social and psychological. Leaving the institution was equally traumatic, given the lack of preparation for life outside the walls. The policy of segregation of the children of people with leprosy was also implemented in other countries, such as Portugal.

Cardiovascular diseases (CVDs), as the leading cause of death in the U.S., pose a disproportionate burden to racial/ethnic minorities. Walkability, as a key concept of the built environment, reflecting walking and physical activity, is associated with health behaviors that help to reduce CVDs risk. While the unequal social variation and spatial distribution inequality of the CVDs and the role of walkability in preventing CVDs have been explored, the moderating factors through which walkability affects CVDs have not been quantitatively analyzed. In this paper, the spatial statistical techniques combined with the regression model are conducted to study the distribution of the CVDs’ health outcomes and factors influencing their variation in the Chicago metropolitan area. The spatial statistical results for the CVDs’ health outcomes reveal that clusters of low-value incidence are concentrated in the suburban rural areas and areas on the north side of the city, while the high-value clusters are concentrated in the west and south sides of the city and areas extending beyond the western and southern city boundaries. The regression results indicate that racial segregation reduced the positive association between health outcomes and walkability, although both racial segregation and walkability factors were positively associated with CVDs’ health outcomes.

Resumo O objetivo desse artigo é avaliar a associação entre segregação residencial racial e mortalidade por homicídios em Minas Gerais (MG). Trata-se de estudo ecológico, com os municípios de MG como unidades de análise. O desfecho foi óbitos por homicídio ocorridos de 2008 a 2012 e a exposição a medida de segregação residencial índice de interação racial, estimada para 2010 a partir dos dados do censo demográfico; outras covariáveis foram renda média per capita e índice de Gini. As variáveis foram apresentadas em mapas temáticos e a associação entre elas foi investigada por modelos hierárquicos bayesianos. Houve associação negativa entre o índice de interação racial e a mortalidade por homicídios (coeficiente=-1,787; IC95%=-2,459; -1,119), em modelo ajustado pela renda per capita. Os municípios de MG com maior interação racial tiveram em média uma menor mortalidade por homicídios. Abstract This article aims to evaluate the association between racial residential segregation and homicide mortality in the state of Minas Gerais (MG), Brazil. We conducted an ecological study in which the units of analysis were municipalities in MG. The outcome was homicide deaths between 2008 and 2012 and the exposure variable was residential segregation measured using the racial interaction index, calculated using data from the 2010 Demographic Census. The covariables were per capita family income and the Gini index. The variables were presented in tables and thematic maps and associations were measured using Bayesian hierarchical models. The results of the model adjusted for per capita family income showed a negative association between the racial interaction index and homicide mortality (coefficient=-1.787; 95%CI=-2.459; -1.119). Homicide mortality was lower in municipalities with higher levels of racial interaction.

Prior studies of neighborhood racial segregation and intrauterine growth have not accounted for confounding factors in early life. We used the Life-Course Influences on Fetal Environment Study of births to Black women in metropolitan Detroit, 2009–2011, ( N = 1,408) to examine whether health and social conditions in childhood and adulthood confound or modify the association of neighborhood segregation (addresses during pregnancy geocoded to census tract racial composition) and gestational age-adjusted birthweight. Before adjusting for covariates, women living in a predominantly (≥75%) Black neighborhood gave birth to 47.3 grams (95% CI: –99.0, 4.4) lighter infants, on average, compared with women living in

The obesity rate in Chicago has increased up to more than 30% in the last two decades. Obesity is a major problem in Chicago, where 36% of the city's high school students and 61% of adults in the metropolitan area are overweight or obese. Simultaneously, Chicago remains highly segregated by race-a phenomenon that begs for spatial analysis of health. Extant work exploring associations between the food retail environment and obesity has provided mixed findings, and virtually, none of this work has been done with the effects of the interaction between racial segregation and the food retail environment on obesity, where obesity rates are among the highest in the segregation area for the city defined by racial segregation. This study explores whether being overweight or obese is associated with urban food environments, such as access to different types of food retail outlets, and how its associations interact with racial factors, at the community level. This study uses the 2016-2018 data from the Healthy Chicago Survey to investigate the spatial variations in obesity and their association with food environments in Chicago. Also, this study examines the moderating effects of racial segregation on associations between obesity and access to food retail outlets. Using spatial statistics and regression models with interaction terms, this study assesses how the urban food environment can interact with racial segregation to explain the spatial distribution of obesity. The results indicate that the obesity population is highly concentrated in the African American community. In Chicago, each additional convenience store in a community is associated with a 0.42% increase in the obesity rate. Fast food restaurant access is predictive of a greater obesity rate, and grocery store access is predictive of less obesity rate in a community with a higher percentage of African American population. Findings can be used to promote equitable access to food retail outlets, which may help reduce broader health inequities in Chicago.

Purpose The COVID-19 pandemic has had a profound impact on American life. However, the burden of the pandemic has not been distributed equally. The purpose of this study was to investigate whether racial and economic residential segregation were associated with COVID-19 related factors in the nation's capital, Washington D.C., during the first year of the pandemic. Methods Racial, economic, and racialized economic segregation were assessed using the Index of Concentration at the Extremes measure and data from the 2014–2018 American Community Survey. COVID-19 related factors (i.e., incidence, testing rate, and percent positivity) were assessed using data from the Washington D.C. government. Spearman rank correlation was used to assess the relationship between each segregation measure and each COVID-19 related factor. Results Washington D.C. neighborhoods with a higher concentration of African Americans, lower income residents, and African Americans with low income had a higher incidence of COVID-19 and greater percent positivity, but lower testing rates compared to their counterparts. Conclusions There is a geographic mismatch between neighborhoods most vulnerable to COVID-19 and the neighborhoods where the testing resources are being used. More resources should be allocated to the most vulnerable neighborhoods to address the COVID-19 pandemic in an equitable manner.

Se presentan en este artículo los resultados de una investigación realizada entre los años 2015 y 2017 que abordó las relaciones interculturales entre migrantes regionales y argentinos que habitan la Ciudad Autónoma de Buenos Aires. La investigación indagó en los procesos de segregación socio-espacial y su vinculación con la diversidad migratoria en la escuela, analizando comparativamente las comunas de la ciudad con mayor y menor presencia migratoria latinoamericana. Las preguntas que guiaron la investigación fueron: ¿de qué manera la diversidad migratoria en la escuela supone relaciones de conflicto?, ¿qué diferencias y particularidades están presentes en la educación para nativos y migrantes? ¿y para habitantes de las distintas comunas en función de sus características socio-demográficas? ¿qué características asume el proceso de segregación social y cómo incide la institución escolar en el mismo? Desde una estrategia cualitativa se realizaron entrevistas a docentes directivos de escuelas públicas y se relevaron documentos ministeriales vinculados al tema. La perspectiva interpretativa orientó el análisis de contenido de los discursos presentes en ambas fuentes. De la reflexión exhaustiva de los datos analizados surge la evidente tensión entre la aspiración de integración de la diversidad migratoria en la escuela y los discursos y acciones que perpetúan su exclusión.

Através da história, a religião tem sido uma força catalisadora para muitas das transformações mais marcantes em todas as sociedades. Como elemento de aculturação, a religião serviu como muleta psicológica e emocional para os espantos e medos que o homem experimentou pela sua incapacidade em entender as transformações do seu envolvimento. O divino emergiu com naturalidade na forma como o homem procurou entender o mundo. A mulher, raramente entrou no encontro do humano com a sua transcendência. Através dos tempos, o papel da mulher foi secundarizado, seja pelas suas particularidades biológicas, seja pelos papeis sociais que lhe estavam cometidos. Para essa segregação social da mulher a religião deu expressivo contributo. Hoje, a luta da mulher ainda passa, em algumas sociedades, pela assunção dos seus direitos fundamentais sonegados pelas regras morais intrínsecas a algumas religiões. Palavras-Chave: Religião. Mulher. História. Abstract Throughout history, religion has been a catalyst for many of the most striking transformations in all societies. As an element of acculturation, religion served as a psychological and emotional crutch for the astonishment and fears that human kind suffered due to his inability to understand the changes in his involvement. The divine emerged naturally in the way man understood the world. The woman rarely entered the human encounter with his transcendence. Throughout the ages, the role of women has become secondary, either because of their biological particularities or because of the social roles that were committed to them. Religion has made a significant contribution to this social segregation of women. Today, the struggle of women still involves, in some societies, the assumption of their fundamental rights withheld by the moral rules intrinsic to some religions. Keyword: Religion. Woman. History.

As an extension of public space, the public transport system in modern society is an arena for cross-group interactions. Uncovering social segregation in public transport space is an essential step in shaping a socially sustainable transport system. Based on 2011 origin–destination flow data for London, we simulate the working flows between each pair of connected tube stations for every occupation with minimised transfer times and travelling hours and calculate the multi-occupation segregation index for all tube stations and segments. This segregation index captures the density and diversity aspects of the working population. The results demonstrate that segregation levels vary significantly across stations, lines, and segments. Transfer stations and tube segments in the city centre do not necessarily have lower levels of segregation. Those stations or segments close to a terminus can also be socially inclusive, e.g., Heathrow. Victoria is the line with the lowest levels of segregation, and Green Park is the most socially inclusive station during commuting peaks. The proposed mapping approach demonstrates the spatial complexity in the social performance of the public transport system and provides a tool for implementing relevant policy with improved precision.

BACKGROUND: Black/African American women in the United States are more likely to live in neighborhoods with higher social vulnerability than other racial/ethnic groups, even when adjusting for personal income. Social vulnerability, defined as the degree to which the social conditions of a community affect its ability to prevent loss and suffering in the event of disaster, has been used in research as an objective measure of neighborhood social vulnerability. Black/African American women also have the highest rates of hypertension and obesity in the United States. OBJECTIVES: The purpose of this study was to examine the relationship between neighborhood social vulnerability and cardiovascular risk (hypertension and obesity) among Black/African American women. METHODS: We conducted a secondary analysis of data from the InterGEN Study that enrolled Black/African American women in the Northeast United States. Participants' addresses were geocoded to ascertain neighborhood vulnerability using the Centers for Disease Control and Prevention's Social Vulnerability Index at the census tract level. We used multivariable regression models to examine associations between objective measures of neighborhood quality and indicators of structural racism and systolic and diastolic blood pressure and obesity (body mass index > 24.9) and to test psychological stress, coping, and depression as potential moderators of these relationships. RESULTS: Seventy-four percent of participating Black/African American women lived in neighborhoods in the top quartile for social vulnerability nationally. Women living in the top 10% of most socially vulnerable neighborhoods in our sample had more than a threefold greater likelihood of hypertension when compared to those living in less vulnerable neighborhoods. Objective neighborhood measures of structural racism (percentage of poverty, percentage of unemployment, percentage of residents >25 years old without a high school diploma, and percentage of residents without access to a vehicle) were significantly associated with elevated diastolic blood pressure and obesity in adjusted models. Psychological stress had a significant moderating effect on the associations between neighborhood vulnerability and cardiovascular risk. DISCUSSION: We identified important associations between structural racism, the neighborhood environment, and cardiovascular health among Black/African American women. These findings add to a critical body of evidence documenting the role of structural racism in perpetuating health inequities and highlight the need for a multifaceted approach to policy, research, and interventions to address racial health inequities.

Resumo Tomando como referencia o campo dos estudos sobre deficiencia ( disability studies ) e a conceitualizacao de capacitismo – forma particular de marginalizacao das pessoas com deficiencia –, o artigo investiga a ligacao entre as ideias eugenistas e o surgimento de uma modalidade de educacao destinada a essas pessoas, a educacao especial. Nesse sentido, as ciencias biomedicas, ao operarem uma separacao entre normalidade e anormalidade ofereceram as bases necessarias para a distincao entre capazes e incapazes, tornando estes inferiores aqueles. Por sua vez, isso leva a por em questao as matrizes epistemologicas que subjazem tais distincoes, considerando-as como participantes nos fundamentos do pensamento ocidental e, portanto, implicadas nos projetos politicos que desembocaram em segregacao racial, social e desumanizacao de diferentes grupos. Palavras-chave: Estudos sobre Deficiencia. Capacitismo. Educacao. Educacao Especial. Abstract Taking as reference the field of disability studies and the conceptualization of ableism - a particular form of marginalization of people with disabilities - this article investigates the connection between eugenic ideas and the emergence of a modality of education aimed at these people: special education. In this sense, the biomedical sciences offered, by operating a separation between normality and abnormality, the necessary basis for the distinction between capable and incapable, making these inferior to those. In turn, this leads us to question the epistemological matrices that underlie such distinctions, considering them as participants in the foundations of Western thought and, therefore, implicated in the political projects that led to racial, social segregation and dehumanization of different groups. Keywords: Disability Studies. Ableism. Education. Special Education.

Resumo Este estudo avalia o impacto de políticas de ampliação do acesso ao ensino superior na redução de iniquidades no perfil dos egressos de cursos médicos no Brasil. Estudo transversal que utiliza dados do Censo da Educação Superior de 2018. Foram realizadas análises para identificar associação entre ser beneficiário da Lei de Cotas, do Programa Universidade para Todos ou do Fundo de Financiamento Estudantil e três marcadores: nascimento em município de pequeno porte, ser não-branco ou ter cursado ensino médio em escola pública. Realizamos análises utilizando teste de qui-quadrado de Pearson e análise multivariada através de regressão de Poisson. Houve associação significativa entre ser beneficiário destas políticas e ser egresso não branco, ter nascido em município de pequeno porte e ser egresso de escola pública no ensino médio. Todas as políticas apresentaram resultados de Razões de Prevalências (RP) ajustadas superiores a um e com significância estatística. A Lei de Cotas foi a política mais efetiva com RP=1,92 para ser egresso não-branco, RP=6,66 para ter estudado ensino médio em escola pública e RP=1,08 para ter nascido em município de pequeno porte. Apesar destes resultados, estes grupos continuam sub-representados nos cursos médicos e na composição da força de trabalho. Abstract This study assesses the effectiveness of policies to expand access to higher education in reducing inequities in the profile of graduates from medical courses in Brazil. This work consists of a cross-sectional study using data from the 2018 Higher Education Census. Analyses were carried out to identify the association between being a beneficiary of the Quota Law, the University for All Program, or the Student Financing Fund and three markers: born in a small-sized municipality, being non-white, or having attended high school in a public school. Analyses were performed using Pearson’s chi-square test, and multivariate analysis was conducted using Poisson regression. A significant association was found between being a beneficiary of these policies and being a non-white graduate, who was born in a small town and who had studied in a public high school. All policies presented adjusted Prevalence Ratio (PR), which demonstrated an association with statistical significance. The Quota Law was the most effective policy, with RP=1.92 for non-white graduates, RP=6.66 for having studied in a public high school, and RP=1.08 for being born in a small town. Despite these results, these groups remain underrepresented in medical courses and in the workforce.

Racial/ethnic disparities in academic performance may result from a confluence of adverse exposures that arise from structural racism and accrue to specific subpopulations. This study investigates childhood lead exposure, racial residential segregation, and early educational outcomes. Geocoded North Carolina birth data is linked to blood lead surveillance data and fourth-grade standardized test scores (n = 25,699). We constructed a census tract-level measure of racial isolation (RI) of the non-Hispanic Black (NHB) population. We fit generalized additive models of reading and mathematics test scores regressed on individual-level blood lead level (BLL) and neighborhood RI of NHB (RINHB). Models included an interaction term between BLL and RINHB. BLL and RINHB were associated with lower reading scores; among NHB children, an interaction was observed between BLL and RINHB. Reading scores for NHB children with BLLs of 1 to 3 µg/dL were similar across the range of RINHB values. For NHB children with BLLs of 4 µg/dL, reading scores were similar to those of NHB children with BLLs of 1 to 3 µg/dL at lower RINHB values (less racial isolation/segregation). At higher RINHB levels (greater racial isolation/segregation), children with BLLs of 4 µg/dL had lower reading scores than children with BLLs of 1 to 3 µg/dL. This pattern becomes more marked at higher BLLs. Higher BLL was associated with lower mathematics test scores among NHB and non-Hispanic White (NHW) children, but there was no evidence of an interaction. In conclusion, NHB children with high BLLs residing in high RINHB neighborhoods had worse reading scores.

Previous studies have shown, in the United States (U.S.), that communities of color are exposed to significantly higher temperatures in urban environments than complementary White populations. Studies highlighting this disparity have generally been cross-sectional and are therefore “snapshots” in time. Using surface urban heat island (SUHI) intensity data, U.S. Census 2020 population counts, and a measure of residential segregation, this study performs a comparative analysis between census tracts identified as prevalent for White, Black, Hispanic and Asian populations and their thermal exposure from 2003 to 2018. The analysis concentrates on the top 200 most populous U.S. cities. SUHI intensity is shown to be increasing on average through time for the examined tracts. However, based on raw observations the increase is only statistically significant for White and Black prevalent census tracts. There is a 1.25 K to ~2.00 K higher degree of thermal exposure on average for communities of color relative to White prevalent areas. When examined on an inter-city basis, White and Black prevalent tracts had the largest disparity, as measured by SUHI intensity, in New Orleans, LA, by 7.00 K) and Asian (

In the early 1970s, the balkanization of the US labor market into “men’s occupations” and “women’s occupations” began to unravel, as women entered the professions and other male-typed sectors in record numbers. This decline in gender segregation continued on for several decades but then suddenly stalled at the turn of the century and shows no signs of resuming. Although the stall is itself undisputed, its sources remain unclear. Using nearly a half-century of data from the General Social Survey, we show that a resurgence in segregation-inducing forms of intergenerational transmission stands behind the recent stall. Far from serving as impartial conduits, fathers are now disproportionately conveying male-typed occupations to their sons, whereas mothers are effectively gender-neutral in their transmission outcomes. This segregative turn among fathers accounts for 47% of the stall in the gender segregation trend (between 2000 and 2018), while the earlier integrative turn among fathers accounts for 34% of the initial downturn in segregation (between 1972 and 1999). It follows that a U-turn in intergenerational processes lies behind the U-turn in gender segregation.

This research examines how school choice impacts school segregation. Specifically, this work demonstrates that even if parents do not take the racial demographics of schools into account, preference differences between Black and White parents for other school attributes can still result in segregation. These preference differences stem from motivational differences in pursuit of social status. Given that the de facto US racial hierarchy assigns Black people to a lower social status, Black parents are more motivated to seek schools that signal that they can improve their children’s status. Simulations of parental school decisions at scale show that preference differences under an unmitigated school-choice policy lead to more segregated schools, impacting more than half a million US children for every 3-percentage-point increase in school-choice availability. In contrast, if Black and White parents have similar preferences, unmitigated school choice would reduce racial segregation. This research may inform public policy concerning school choice and school segregation. University of Southern California University of Wisconsin–Madison Virginia Tech Published version

The continued harm of Black individuals in the US by law enforcement officers calls for reform of both law enforcement officers and structural racism embedded in communities.To examine the association between county characteristics and racial and ethnic disparities in legal intervention injuries.This retrospective, cross-sectional study was conducted among 27 671 patients presenting to California hospitals from January 1, 2016, to December 31, 2019, with legal intervention injuries (defined as any injury sustained as a result of an encounter with any law enforcement officer) as identified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes.Legal intervention injuries were classified by International Statistical Classification of Diseases and Related Health Problems, Tenth Revision external cause of injury code Y35. Expected injury counts were calculated for each county by multiplying statewide median rates of injury per capita for each age-racial and ethnic group, and then observed to expected injury ratios were measured. The association between county injury ratio, percentage of Black individuals, and residential segregation (measured using an index of dissimilarity) was modeled, stratifying by race and ethnicity.A total of 27 671 patients (24 159 male patients [87.3%]; 1734 Asian and Pacific Islander [6.3%], 5049 Black [18.2%], 11 250 Hispanic [40.7%], and 9638 White [34.8%]; mean [SD] age, 34.2 [12.5] years) presented with legal intervention injuries in California from 2016 to 2019. Observed to expected injury ratios ranged from 0 to 7 for Black residents and from 0 to 5 for White residents. High observed to expected injury ratios for Black residents (408 observed vs 60 expected; ratio = 7) were clustered around San Francisco Bay Area counties and corresponded with a higher proportion of Black residents. High observed to expected injury ratios for White residents (57 observed vs 11 expected; ratio = 5) clustered around rural northern California counties and corresponded with higher mean percentage of residents with income below the federal poverty level and fewer urban areas.This study suggests that residential segregation may be associated with increased legal intervention injury rates for Black residents of California counties with a large percentage of Black residents. Reform efforts to address racial and ethnic disparities in these injuries should carefully consider and address the legacy of discriminatory policies that has led to segregated communities in California and the United States.

The relationship between the social structure of urban spaces and the evolution of the COVID-19 pandemic is becoming increasingly evident. Analyzing the socio-spatial structure in relation to cases may be one of the keys to explaining the ways in which this contagious disease and its variants spread. The aim of this study is to propose a set of variables selected from the social context and the spatial structure and to evaluate the temporal spread of infections and their different degrees of intensity according to social areas. We define a model to represent the relationship between the socio-spatial structure of the urban space and the spatial distribution of pandemic cases. We draw on the theory of social area analysis and apply multivariate analysis techniques to check the results in the urban space of the city of Malaga (Spain). The proposed model should be considered capable of explaining the functioning of the relationships between societal structure, socio-spatial segregation, and the spread of the pandemic. In this paper, the study of the origins and consequences of COVID-19 from different scientific perspectives is considered a necessary approach to understanding this phenomenon. The personal and social consequences of the pandemic have been exceptional and have changed many aspects of social life in urban spaces, where it has also had a greater impact. We propose a geostatistical analysis model that can explain the functioning of the relationships between societal structure, socio-spatial segregation, and the temporal evolution of the pandemic. Rather than an aprioristic theory, this paper is a study by the authors to interpret the disparity in the spread of the pandemic as shown by the infection data.

Socioeconomic factors have exacerbated the impact of COVID–19 worldwide. Brazil, already marked by significant economic inequalities, is one of the most affected countries, with one of the highest mortality rates. Understanding how inequality and income segregation contribute to excess mortality by COVID–19 in Brazilian cities is essential for designing public health policies to mitigate the impact of the disease. This paper aims to fill in this gap by analyzing the effect of income inequality and income segregation on COVID–19 mortality in large urban centers in Brazil. We compiled weekly COVID–19 mortality rates from March 2020 to February 2021 in a longitudinal ecological design, aggregating data at the city level for 152 Brazilian cities. Mortality rates from COVID-19 were compared across weeks, cities and states using mixed linear models. We estimated the associations between COVID-19 mortality rates with income inequality and income segregation using mixed negative binomial models including city and week-level random intercepts. We measured income inequality using the Gini index and income segregation using the dissimilarity index using data from the 2010 Brazilian demographic census. We found that 88.2% of COVID–19 mortality rates variability was between weeks, 8.5% between cities, and 3.3% between states. Higher-income inequality and higher-income segregation values were associated with higher COVID–19 mortality rates before and after accounting for all adjustment factors. In our main adjusted model, rate ratios (RR) per 1 SD increases in income inequality and income segregation were associated with 17% (95% CI 9% to 26%) and 11% (95% CI 4% to 19%) higher mortality. Income inequality and income segregation are long-standing hallmarks of large Brazilian cities. Risk factors related to the socioeconomic context affected the course of the pandemic in the country and contributed to high mortality rates. Pre-existing social vulnerabilities were critical factors in the aggravation of COVID–19, as supported by the observed associations in this study.

Background Cardiovascular disease (CVD) disproportionately affects Black adults in the United States. This is increasingly acknowledged to be due to inequitable distribution of health-promoting resources. One potential contributor is inequities in educational opportunities, although it is unclear what aspects of education are most salient. School racial segregation may affect cardiovascular health by increasing stress, constraining socioeconomic opportunities, and altering health behaviors. We investigated the association between school segregation and Black adults’ CVD risk. Methods and findings We leveraged a natural experiment created by quasi-random (i.e., arbitrary) timing of local court decisions since 1991 that released school districts from court-ordered desegregation. We used the Panel Study of Income Dynamics (PSID) (1991 to 2017), linked with district-level school segregation measures and desegregation court order status. The sample included 1,053 Black participants who ever resided in school districts that were under a court desegregation order in 1991. The exposure was mean school segregation during observed schooling years. Outcomes included several adult CVD risk factors and outcomes. We fitted standard ordinary least squares (OLS) multivariable linear regression models, then conducted instrumental variables (IV) analysis, using the proportion of schooling years spent in districts that had been released from court-ordered desegregation as an instrument. We adjusted for individual- and district-level preexposure confounders, birth year, and state fixed effects. In standard linear models, school segregation was associated with a lower probability of good self-rated health (−0.05 percentage points per SD of the segregation index; 95% CI: −0.08, −0.03; p < 0.001) and a higher probability of binge drinking (0.04 percentage points; 95% CI: 0.002, 0.07; p = 0.04) and heart disease (0.01 percentage points; 95% CI: 0.002, 0.15; p = 0.007). IV analyses also found that school segregation was associated with a lower probability of good self-rated health (−0.09 percentage points; 95% CI: −0.17, −0.02, p = 0.02) and a higher probability of binge drinking (0.17 percentage points; 95% CI: 0.04, 0.30, p = 0.008). For IV estimates, only binge drinking was robust to adjustments for multiple hypothesis testing. Limitations included self-reported outcomes and potential residual confounding and exposure misclassification. Conclusions School segregation exposure in childhood may have longstanding impacts on Black adults’ cardiovascular health. Future research should replicate these analyses in larger samples and explore potential mechanisms. Given the recent rise in school segregation, this study has implications for policies and programs to address racial inequities in CVD.

Background Identifying county-level characteristics associated with high coronavirus 2019 (COVID-19) burden can help allow for data-driven, equitable allocation of public health intervention resources and reduce burdens on health care systems. Methods Synthesizing data from various government and nonprofit institutions for all 3142 United States (US) counties, we studied county-level characteristics that were associated with cumulative and weekly case and death rates through 12/21/2020. We used generalized linear mixed models to model cumulative and weekly (40 repeated measures per county) cases and deaths. Cumulative and weekly models included state fixed effects and county-specific random effects. Weekly models additionally allowed covariate effects to vary by season and included US Census region-specific B-splines to adjust for temporal trends. Results Rural counties, counties with more minorities and white/non-white segregation, and counties with more people with no high school diploma and with medical comorbidities were associated with higher cumulative COVID-19 case and death rates. In the spring, urban counties and counties with more minorities and white/non-white segregation were associated with increased weekly case and death rates. In the fall, rural counties were associated with larger weekly case and death rates. In the spring, summer, and fall, counties with more residents with socioeconomic disadvantage and medical comorbidities were associated greater weekly case and death rates. Conclusions These county-level associations are based off complete data from the entire country, come from a single modeling framework that longitudinally analyzes the US COVID-19 pandemic at the county-level, and are applicable to guiding government resource allocation policies to different US counties.

B. R. Ambedkar, the scholar, activist, and chief architect of the Indian constitution, in his early twentieth century works, referred to the untouchable quarters in India as ghettos. He recognized that untouchability was manifested through combining social separation with spatial segregation. Ambedkar’s theorization of untouchability can be applied along with feminist and Dalit scholars’ theories of the relationship between dynamic spatial experiences and the reworking of caste hierarchies to understand how securing control over productive assets, such as land, has altered social and spatial segregation in rural Bihar. Combined with narratives of the past and present, maps drawn by Bhuiyan Dalit women depicting the physical spaces they occupy in their village (i.e. housing, community center), the locations of sources of water and electricity, and the quality of the resources to which they have access demonstrate that gaining control over land following the Bodhgaya Land Movement (BGLM) of the late 1970s helped end the most overt and readily discernible forms of caste-based discrimination. Nevertheless, resource discrimination and spatial and social segregation continue, albeit more covertly. The logic of untouchability still undergirds social interactions in rural Bihar, preventing Dalits from fully realizing their rights as guaranteed by law.

This paper investigates gender-based segregation across different fields of study at the senior secondary level of schooling in a large developing country. We use a nationally representative longitudinal data set from India to analyze the extent and determinants of gender gap in higher secondary stream choice. Using fixed-effects regressions that control for unobserved heterogeneity at the regional and household levels, we find that girls are about 20 percentage points less likely than boys to study in science (STEM) and commerce streams as compared with humanities. This gender disparity is unlikely to be driven by gender-specific differences in cognitive ability, given that the gap remains large and significant even after we control for individuals' past test scores. We establish the robustness of these estimates through various sensitivity analyses: including sibling fixed effects, considering intrahousehold relationships among individuals, and addressing sample selection issues. Disaggregating the effect on separate streams, we find that girls are most underrepresented in the study of science. Our findings indicate that gender inequality in economic outcomes, such as occupational segregation and gender pay gaps, is determined by gendered trajectories set much earlier in the life course, especially at the school level.

One in 10 people die awaiting transplantation from donor shortage. Only half of Americans register as organ donors. In this cross-sectional study, we evaluated population-level associations of neighborhood socioeconomic deprivation and racial segregation on organ donor registration rates. We analyzed state identification card demographic and organ donor registration data from 5 states to estimate the association between a neighborhood socioeconomic deprivation index (range [0, 1]; higher values indicate more deprivation) and a racial index of concentration at the extreme (ICE) (range [-1, 1]; lower values indicate predominantly black neighborhoods, higher values indicate predominantly white neighborhoods) on organ donor registration rates within a specified geography (census tract or ZIP code tabulation area [ZCTA]). Among 26 720 738 registrants, 32% of the sample were registered organ donors. At the census tract level, with each 0.1 decrease in the deprivation index, the organ donor registration rate increased by 6.8% (95% confidence interval [CI]: 6.6%, 7.0%). With each 0.1 increase in the racial ICE, the rate increased by 1.5% (95% CI: 1.5%, 1.6%). These associations held true at the ZCTA level. Areas with less socioeconomic deprivation and a higher concentration of white residents have higher organ donor registration rates. Public health initiatives should consider neighborhood context and novel data sources in designing optimal intervention strategies.

Residential and school segregation have historically mirrored each other, with school segregation seen as simply reflecting residential patterns given neighborhood-based school assignment policy. We argue that the relationship is circular, such that school options also influence residential outcomes. We hypothesize that the expansion of charter schools could simultaneously lead to an increase in school segregation and a decrease in residential segregation. We examine what happens when neighborhood and school options are decoupled via public school choice in the form of charter schools using data from the census and the Common Core of Data on a national sample of more than 1,500 metropolitan districts. We find that Black-White school segregation increased and residential segregation declined in response to increases in the charter enrollment share from 2000 to 2010. In districts with charter schools, the average increase in the charter enrollment share corresponded to a 12% increase in school segregation and 2% decline in residential segregation. We find no relationship between charter school expansion and school segregation between White and Hispanic students, perhaps because Hispanic students attend more racially diverse charters than White or Black students. White-Hispanic residential segregation declined as charter enrollment increased. Our results demonstrate that educational policy is consequential for both school and neighborhood population processes. When these two contexts are decoupled via public school choice, school and neighborhood segregation patterns move in opposite directions, rather than mirroring each other. Our findings also provide a cautionary lesson for unfettered expansion of choice without integration imperatives.

Rationale: Racial residential segregation has been associated with worse health outcomes, but the link with chronic obstructive pulmonary disease (COPD) morbidity has not been established. Objectives: To investigate whether racial residential segregation is associated with COPD morbidity among urban Black adults with or at risk of COPD. Methods: Racial residential segregation was assessed using isolation index, based on 2010 decennial census and baseline address, for Black former and current smokers in the multicenter SPIROMICS (Subpopulations and Intermediate Outcome Measures in COPD Study), a study of adults with or at risk for COPD. We tested the association between isolation index and respiratory symptoms, physiologic outcomes, imaging parameters, and exacerbation risk among urban Black residents, adjusting for established COPD risk factors, including smoking. Additional mediation analyses were conducted for factors that could lie on the pathway between segregation and COPD outcomes, including individual and neighborhood socioeconomic status, comorbidity burden, depression/anxiety, and ambient pollution. Measurements and Main Results: Among 515 Black participants, those residing in segregated neighborhoods (i.e., isolation index ⩾0.6) had worse COPD Assessment Test score (β = 2.4; 95% confidence interval [CI], 0.7 to 4.0), dyspnea (modified Medical Research Council scale; β = 0.29; 95% CI, 0.10 to 0.47), quality of life (St. George’s Respiratory Questionnaire; β = 6.1; 95% CI, 2.3 to 9.9), and cough and sputum (β = 0.8; 95% CI, 0.1 to 1.5); lower FEV(1)% predicted (β = −7.3; 95% CI, −10.9 to −3.6); higher rate of any and severe exacerbations; and higher percentage emphysema (β = 2.3; 95% CI, 0.7 to 3.9) and air trapping (β = 3.8; 95% CI, 0.6 to 7.1). Adverse associations attenuated with adjustment for potential mediators but remained robust for several outcomes, including dyspnea, FEV(1)% predicted, percentage emphysema, and air trapping. Conclusions: Racial residential segregation was adversely associated with COPD morbidity among urban Black participants and supports the hypothesis that racial segregation plays a role in explaining health inequities affecting Black communities.

Purpose To identify the county‐level effects of social determinants of health (SDoH) on COVID‐19 (corona virus disease 2019) mortality rates by rural–urban residence and estimate county‐level exceedance probabilities for detecting clusters. Methods The county‐level data on COVID‐19 death counts as of October 23, 2020, were obtained from the Johns Hopkins University. SDoH data were collected from the County Health Ranking and Roadmaps, the US Department of Agriculture, and the Bureau of Labor Statistics. Semiparametric negative binomial regressions with expected counts based on standardized mortality rates as offset variables were fitted using integrated Laplace approximation. Bayesian significance was assessed by 95% credible intervals (CrI) of risk ratios (RR). County‐level mortality hotspots were identified by exceedance probabilities. Findings The COVID‐19 mortality rates per 100,000 were 65.43 for the urban and 50.78 for the rural counties. Percent of Blacks, HIV, and diabetes rates were significantly associated with higher mortality in rural and urban counties, whereas the unemployment rate (adjusted RR = 1.479, CrI = 1.171, 1.867) and residential segregation (adjusted RR = 1.034, CrI = 1.019, 1.050) were associated with increased mortality in urban counties. Counties with a higher percentage of college or associate degrees had lower COVID‐19 mortality rates. Conclusions SDoH plays an important role in explaining differential COVID‐19 mortality rates and should be considered for resource allocations and policy decisions on operational needs for businesses and schools at county levels.

The paper seeks to identify and assess the polarising, indirect and direct favourable influence of Belgrade, as the capital and the largest city in Serbia, in the development of settlements and centres within its administrative area, i.e. the territory administratively named the City of Belgrade. The paper includes an analysis of demographic trends, including commuting trends, and the functional and morphological changes in the settlements of the Belgrade region between 1971 and 2011. Various analytical and synthetic methods have been used to assess the investigated territory's degree of transformation, including both positive effects and the negative consequences of the impact of various factors. Suburban areas are not clearly delimited. Belgrade's urban area is not marked by social segregation. The initial hypothesis that the Belgrade region underwent a complex and multifaceted transformation has been confirmed, which will significantly determine future planning solutions, especially as regards the identified causes of the transformation, the factors of which have not been significantly changed in the transition, post-socialist period. The appropriateness of development planning measures and governing policies in this area is of crucial importance for the country as a whole.

OBJECTIVES To examine the effects of racial residential segregation and structural racism on the diagnosis, treatment, and outcomes of patients with prostate cancer. PATIENTS AND METHODS This retrospective cohort study examined men diagnosed with prostate cancer between 2005 and 2015. We collected data from Black and White men, aged ≥30 years, living within the 100 most populous counties participating in the Surveillance, Epidemiology, and End Results programme, a nationally representative dataset. The racial Index of Dissimilarity, a validated measure of segregation, was the primary exposure of interest. Outcomes of interest included advanced stage at diagnosis (Stage IV), surgery for localised disease (Stage I-II), and 10-year overall and cancer-specific survival. Multivariable Poisson regression analyses with robust error variance estimated the relative risk (RR) of advanced stage at diagnosis and surgery for localised disease at differing levels of segregation. Survival analysis was performed using competing hazards analysis. RESULTS Multivariable models estimating stage at diagnosis showed that the disparities between Black and White men disappeared at low levels of segregation. Disparities in receiving surgery for localised disease persisted across all levels of segregation. In racially stratified analyses, segregation had no effect on stage at diagnosis or surgical resection for Black patients. White patients saw a 56% (RR 0.42, P