University of Minnesota School of Public Health, Division of Epidemiology and Community Health, West Bank Office Building, 1300 S. Second Street, Suite 300, Minneapolis, MN 55454, USA.
Am J Epidemiol. 2013 Feb 15;177(4):310-5. doi: 10.1093/aje/kws371. Epub 2013 Jan 20.
Research on racial residential segregation and health typically uses multilevel, population-based, slice-in-time data. Although research using this approach, including that by Kershaw et al. (Am J Epidemiol. 2013;177(4):299-309), has been valuable, I argue that to advance our understanding of how residential segregation influences health and health disparities, it is critical to incorporate a life-course perspective and integrate social theory. Applying a life-course perspective would entail modeling transitions, cumulative risk, and developmental and dynamic processes and mechanisms, as well as recognizing the contingency of contextual effects on different social groups. I discuss the need for analytic methods appropriate for modeling health effects of distal causes experienced across the life course, such as segregation, that operate through multiple levels and sequences of mediators, potentially across decades. Sociological theories of neighborhood attainment (e.g., segmented assimilation, ethnic resurgence, and place stratification theories) can guide effect-modification tests to help illuminate health effects resulting from intersections of residential processes, race/ethnicity, immigration, and other social determinants of health. For example, nativity and immigration history may crucially shape residential processes and exposures, but these have received limited attention in prior segregation-health literature.
关于居住隔离与健康的研究通常采用多层次、基于人群、时间切片的数据。虽然使用这种方法的研究，包括 Kershaw 等人的研究（Am J Epidemiol. 2013;177(4):299-309），具有重要价值，但我认为，为了增进我们对居住隔离如何影响健康和健康差异的理解，至关重要的是要纳入生命历程的视角并整合社会理论。应用生命历程视角需要对过渡、累积风险以及发展和动态过程和机制进行建模，同时要认识到不同社会群体对背景效应的偶然性。我讨论了需要分析方法来适当地模拟整个生命历程中经历的远程原因（例如隔离）对健康的影响，这些原因通过多个层次和中介的序列运作，可能跨越几十年。邻里获得的社会学理论（例如，分割同化、族裔复兴和地方分层理论）可以指导效应修正测试，以帮助阐明由于居住过程、种族/族裔、移民和其他健康决定因素的交叉而产生的健康影响。例如，原籍国和移民史可能对居住过程和暴露产生至关重要的影响，但这些在之前的隔离-健康文献中受到的关注有限。
