Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, WI, USA.
Soc Psychiatry Psychiatr Epidemiol. 2019 May;54(5):533-541. doi: 10.1007/s00127-019-01654-5. Epub 2019 Jan 22.
Because segregation may shield blacks from discrimination as well as increase their exposure to concentrated poverty, its net impact on the mental well-being of black Americans is unclear. We investigated the intersection between segregation, neighborhood poverty, race, and psychological well-being.
Using data from the nationally representative 2008-2013 National Health Interview Survey merged with U.S. Census data, we examined the association between black-white metropolitan segregation (D-index and P-index) and psychological distress (a binary indicator based on the Kessler 6 score ≥ 13) for blacks and whites. Furthermore, we assessed whether neighborhood poverty explains and/or modifies the association. Logistic regression models were estimated separately for blacks and whites as well as for each segregation index.
Higher D- and P-indices were associated with higher odds of psychological distress for blacks. Neighborhood poverty explained some, but not all, of the association. In models that allowed for the impact of metropolitan segregation to vary by neighborhood poverty, higher segregation was found to be detrimental for blacks who resided in high poverty neighborhoods but not for those living in low poverty neighborhoods. We found no evidence that segregation impacts the mental health of whites-either detrimentally or beneficially-regardless of neighborhood poverty level.
The impact of segregation differs by neighborhood poverty and race. The psychological harm of structural racism, resulting in segregation and concentrated poverty, is not additive but multiplicative, reflecting a "triple jeopardy" for blacks, whereby their mental health is detrimentally impacted by the compounded effects of both neighborhood distress and racial segregation.
由于隔离可能会保护黑人免受歧视，同时也会使他们更容易受到贫困的集中影响，因此其对美国黑人心理健康的净影响尚不清楚。我们调查了隔离、社区贫困、种族和心理健康之间的交集。
利用来自具有全国代表性的 2008-2013 年全国健康访谈调查的数据，并与美国人口普查数据合并，我们考察了黑人和白人之间的大都市隔离（D 指数和 P 指数）与心理困扰（基于 Kessler 6 得分≥13 的二分指标）之间的关联。此外，我们评估了社区贫困是否解释和/或改变了这种关联。分别为黑人和白人以及每个隔离指数估计了逻辑回归模型。
较高的 D 指数和 P 指数与黑人心理困扰的几率增加有关。社区贫困解释了部分关联，但不是全部关联。在允许大都市隔离对社区贫困的影响有所不同的模型中，发现隔离对居住在高贫困社区的黑人不利，但对居住在低贫困社区的黑人没有不利影响。我们没有发现证据表明隔离会对白人的心理健康产生不利或有利影响-无论社区贫困水平如何。
隔离的影响因社区贫困和种族而异。结构性种族主义导致的隔离和贫困集中所造成的心理伤害不是累加的，而是相乘的，这反映了黑人的“三重困境”，即他们的心理健康受到社区困境和种族隔离的双重影响。
