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September 1998 (Volume 76)
Norman J. Waitzman
Ken R. Smith
Milbank Memorial Fund
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The increase in income inequality in the United States over the past 20 years has been accompanied by a pronounced increase in economic segregation in urban areas. No research to date has analyzed the potential effects of such spatial segregation on mortality. To investigate these effects, the mortality experience of respondents aged 30 years and older on the 1986-94 National Health Interview Surveys residing in any one of 30 large metropolitan areas in the United States was analyzed. Concentrated poverty was associated with significantly elevated risk of mortality, even after controlling for individual household income. Concentrated affluence showed a consistent, protective effect only among the elderly. The effects were most pronounced among the poor, but were not confined to them. Urban planning should take into account the effects associated with economic residential segregation.
Author(s): Norman J. Waitzman; Ken R. Smith
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Volume 76, Issue 3 (pages 341–373) DOI: 10.1111/1468-0009.00095 Published in 1998
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The Milbank Quarterly’s multidisciplinary approach and commitment to applying the best empirical research to practical policymaking offers in-depth assessments of the social, economic, historical, legal, and ethical dimensions of health and health care policy.