Segregation and mortality over time and space.

Few studies have been able to measure the evolution of segregation on health disparities or assess whether those disparities existed in rural communities prior to the Great Migration of African Americans to urban centers. We use a newly developed measure of historical racial residential segregation based on individual-level data. The measure exploits complete census manuscript files to identify the races of next-door neighbors. This measure is the first and only measure of historical segregation for rural communities, allowing us to greatly extend the empirical analysis of the effects of racial segregation on health over space and time. Using this comprehensive measure of racial residential segregation, we estimate the historical relationship between racial segregation and mortality. We find that conditional on racial composition, racially segregated environments had higher mortality rates and it was not always the case that the outcomes for blacks were worse than those of whites. These effects of segregation on health differed between urban and rural locations. We conclude by noting how comprehensive measures of segregation can extend the analysis of structural factors in racial health disparities to rural residents and to the historical evolution of health disparities.