摘要：The authors examine the research evidence on the effect of residential segregation on health, identify research gaps, and propose new research directions. Four recommendations are made on the basis of a review of the sociological and social epidemiology literature on residential segregation: (1) develop multilevel research designs to examine the effects of individual, neighborhood, and metropolitan-area factors on health outcomes; (2) continue examining the health effects of residential segregation among African Americans but also initiate studies examining segregation among Hispanics and Asians; (3) consider racial/ethnic segregation along with income segregation and other metropolitan area factors such as poverty concentration and metropolitan governance fragmentation; and (4) develop better conceptual frameworks of the pathways that may link various segregation dimensions to specific health outcomes. PUBLIC HEALTH RESEARCH HAS uncovered significant racial/ethnic disparities in mortality and health outcomes. 1– 7 Spatial separation of population groups along racial/ethnic lines—and, to a lesser extent, along economic lines 8– 11 —is a key feature of the social organization of US urban areas. To date, several ecological studies conducted at the metropolitan area and city levels have shown positive associations between racial residential segregation and infant mortality rates, 12 adult mortality rates, 13 and crime rates 14 among African Americans. Here we first review the sociological literature on residential segregation, focusing on the concepts and empirical evidence that can be applied to research on racial/ethnic health disparities. We then review the literature on the relationship between residential segregation and health outcomes, noting existing conceptual and research design gaps in relation to the sociological literature. We conclude by suggesting that, to assess the role of residential segregation in racial/ethnic health disparities, there is a need for a multilevel approach grounded in both the sociological and social epidemiology literatures on neighborhood effects 15 and residential segregation. 8, 9, 16
