Allgood Kristi L, Fleischer Nancy L, Assari Shervin, Morenoff Jeffrey, Needham Belinda L
Department of Epidemiology and Biostatistics, Texas A&M University, 212 Adriance Lab Road, Office 231, College Station, TX, 77843, USA.
School of Public Health, Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI, USA.
J Racial Ethn Health Disparities. 2024 Sep 16. doi: 10.1007/s40615-024-02135-5.
Although cardiovascular disease (CVD) mortality rates are declining for American adults, a disparity remains between non-Hispanic Black and non-Hispanic White adults. Previous research has shown that residential segregation, a form of structural racism, experienced in childhood is associated with later-life racial and ethnic health disparities, including disparities in CVD and its risk factors. However, little is known about the health consequences of exposure to segregated schools, especially among those living in neighborhoods with high concentrations of minoritized people. This study used data from the In-School, Wave I, and Wave IV surveys of the National Longitudinal Study of Adolescent to Adult Health to examine a novel school measure of school racial segregation (Index of the Concentration of Extremes, ICE) as a predictor of Framingham 30-year CVD risk scores. We used General Estimating Equation models to evaluate the association between ICE, measured at Wave I, and two different 30-year CVD risk scores, measured at Wave IV, and examined whether the relationship varied by race. We observed that higher levels of school segregation were associated with a higher 30-year CVD risk among non-Hispanic Black participants while higher segregation was associated with a lower 30-year CVD risk for non-Hispanic White participants. This research suggests that exposure to segregation in the school setting may contribute to observed disparities in CVD among US adults.
尽管美国成年人的心血管疾病（CVD）死亡率正在下降，但非西班牙裔黑人和非西班牙裔白人成年人之间的差距依然存在。先前的研究表明，童年经历的居住隔离作为一种结构性种族主义形式，与晚年的种族和族裔健康差距有关，包括心血管疾病及其风险因素方面的差距。然而，对于接触隔离学校的健康后果知之甚少，尤其是在那些少数族裔聚居社区的居民中。本研究使用了青少年到成人健康全国纵向研究的在校、第一波和第四波调查数据，以检验一种新的学校种族隔离衡量指标（极端集中度指数，ICE）作为弗雷明汉30年心血管疾病风险评分的预测指标。我们使用广义估计方程模型来评估第一波测量的ICE与第四波测量的两种不同的30年心血管疾病风险评分之间的关联，并检验这种关系是否因种族而异。我们观察到，学校隔离程度较高与非西班牙裔黑人参与者30年心血管疾病风险较高相关，而较高的隔离程度与非西班牙裔白人参与者30年心血管疾病风险较低相关。这项研究表明，在学校环境中接触隔离可能导致美国成年人中观察到的心血管疾病差异。
