Skip to main content

Advertisement

Log in

An application of Bayesian spatial statistical methods to the study of racial and poverty segregation and infant mortality rates in the US

  • Published:
GeoJournal Aims and scope Submit manuscript

Abstract

The infant mortality rate is a fundamental measure of population health used internationally. In the United States, the infant mortality rate is higher than what would be expected for a country of its affluence. We present an analysis of US county infant mortality rates using modern Bayesian spatial statistical methodologies. Our key predictors in our statistical analysis are residential racial and poverty segregation, measured by the dissimilarity, interaction and spatial proximity indexes. We use both Exploratory Spatial Data Analysis methods and Hierarchical Bayesian spatial regression models to examine the influences of these segregation measures on the infant mortality rate for each county, net of income inequality, degree of rurality and relative socioeconomic deprivation. The spatial measures of racial segregation suggest that when blacks live in close proximity to each other, this tends to increase the infant mortality rate. The results for poverty segregation suggest the same pattern, when poor populations live in close proximity to one another this is generally detrimental to the county infant mortality rate. However, interaction between blacks and whites and poor and non-poor residents of an area is protective for infant mortality.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  • Acevedo-Garcia, D. (2000). Residential segregation and the epidemiology of infectious diseases. Social Science and Medicine, 51(8), 1143–1161.

    Article  Google Scholar 

  • Acevedo-Garcia, D., & Lochner, K. A. (2003). Residential segregation and health. In I. Kawachi & L. F. Berkman (Eds.), Neighborhoods and health (pp. 265–287). Oxford: Oxford University Press.

    Chapter  Google Scholar 

  • Acevedo-Garcia, D., & Osypuk, T. L. (2008). Invited commentary: Residential segregation and health-the complexity of modeling separate social contexts. American Journal of Epidemiology, 168(11), 1255–1258. doi:10.1093/aje/kwn290.

    Article  Google Scholar 

  • Arato, N. M., Dryden, I. L., & Taylor, C. C. (2006). Hierarchical Bayesian modelling of spatial age-dependent mortality. Computational Statistics & Data Analysis, 51(2), 1347–1363. doi:10.1016/j.csda.2006.02.007.

    Article  Google Scholar 

  • Assuncao, R. M., Schmertmann, C. P., Potter, J. E., & Cavenaghi, S. M. (2005). Empirical Bayes estimation of demographic schedules for small areas. Demography, 42(3), 537–558.

    Article  Google Scholar 

  • Banerjee, S., Carlin, B. P., & Gelfand, A. E. (2004). Hierarchical modeling and analysis of spatial data. Boca Raton, FL: Chapman & Hall/CRC.

    Google Scholar 

  • Basso, O., & Wilcox, A. J. (2009). Intersecting birth weight-specific mortality curves: Solving the riddle. American Journal of Epidemiology, 169(7), 787–797. doi:10.1093/aje/kwp024.

    Article  Google Scholar 

  • Bell, J. F., Zimmerman, F. J., Almgren, G. R., Mayer, J. D., & Huebner, C. E. (2006). Birth outcomes among urban African-American women: A multilevel analysis of the role of racial residential segregation. Social Science and Medicine, 63(12), 3030–3045. doi:10.1016/j.socscimed.2006.08.011.

    Article  Google Scholar 

  • Besag, J. (1974). Spatial interaction and the statistical analysis of lattice systems. Journal of the Royal Statistical Society Series B-Methodological, 36(2), 192–236.

    Google Scholar 

  • Besag, J., York, J. C., & Mollie, A. (1991). Bayesian image restoration with two applications in spatial statistics. Annals of the Institute of Statistical Mathematics, 43(1), 1–59.

    Article  Google Scholar 

  • Buka, S. L., Brennan, R. T., Rich-Edwards, J. W., Raudenbush, S. W., & Earls, F. (2003). Neighborhood support and the birth weight of urban infants. American Journal of Epidemiology, 157(1), 1–8.

    Article  Google Scholar 

  • Cerda, M., Buka, S. L., & Rich-Edwards, J. W. (2008). Neighborhood influences on the association between maternal age and birthweight: A multilevel investigation of age-related disparities in health. Social Science and Medicine, 66(9), 2048–2060. doi:10.1016/j.socscimed.2008.01.027.

    Article  Google Scholar 

  • Chen, J., Roth, R. E., Naito, A. T., Lengerich, E. J., & MacEachren, A. M. (2008). Geovisual analytics to enhance spatial scan statistic interpretation: an analysis of U.S. cervical cancer mortality. International Journal of Health Geographics, 7, 57.

    Article  Google Scholar 

  • Collins, J. W., & David, R. J. (2009). Racial disparity in low birth weight and infant mortality. Clinics in Perinatology, 36(1), 63–73. doi:10.1016/j.clp.2008.09.004.

  • Collins, J. W., & Schulte, N. F. (2003). Infant health: Race, risk, and residence. In I. Kawachi & L. F. Berkman (Eds.), Neighborhoods and health (pp. 223–232). New York: Oxford University Press.

    Chapter  Google Scholar 

  • Collins, C. A., & Williams, D. R. (1999). Segregation and mortality: The deadly effects of racism? Sociological Forum, 14(3), 495–523.

    Article  Google Scholar 

  • Ellen, I. G. (2000). Is segregation bad for your health? The case of low birth weight. In W. G. Gale & J. R. Pack (Eds.), Brookings-Wharton papers on Urban Affairs 2000 (pp. 203–229). Washington, DC: Brookings Institution Press.

    Article  Google Scholar 

  • Ellen, I. G., Mijanovich, T., & Dillman, K. (2001). Neighborhood effects on health: Exploring the links and assessing the evidence. Journal of Urban Affairs, 23(3–4), 391–408.

    Article  Google Scholar 

  • Elliott, P., & Wartenberg, D. (2004). Spatial epidemiology: Current approaches and future challenges. Environmental Health Perspectives, 112(9), 998–1006.

    Article  Google Scholar 

  • Finch, B. K., Lim, N., Perez, W., & Do, D. P. (2007). Toward a population health model of segmented assimilation: The case of low birth weight in Los Angeles. Sociological Perspectives, 50(3), 445–468. doi:10.1525/sop.2007.50.3.445.

    Article  Google Scholar 

  • Fu, L. Y., Colson, E. R., Corwin, M. J., & Moon, R. Y. (2008). Infant sleep location: Associated maternal and infant characteristics with sudden infant death syndrome prevention recommendations. Journal of Pediatrics, 153(4), 503–508. doi:10.1016/j.jpeds.2008.05.004.

    Article  Google Scholar 

  • Gelman, A. E. (2006). Prior distributions for variance parameters in hierarchical models. Bayesian Analysis, 1(3), 515–534.

    Google Scholar 

  • Gelman, A. E., & Rubin, D. (1992). Inference from interative simulatoin using multiple sequences (with discussion). Statistical Science, 7(4), 457–511.

    Article  Google Scholar 

  • Goza, F. W., Stockwell, E. G., & Balistreri, K. S. (2007). Racial differences in the relationship between infant mortality and socioeconomic status. Journal of Biosocial Science, 39(4), 517–529. doi:10.1017/s0021932006001581.

    Article  Google Scholar 

  • Grady, S. C. (2006). Racial disparities in low birthweight and the contribution of residential segregation: A multilevel analysis. Social Science and Medicine, 63(12), 3013–3029. doi:10.1016/j.socscimed.2006.08.017.

    Article  Google Scholar 

  • Grady, S. C., & Ramirez, I. J. (2008). Mediating medical risk factors in the residential segregation and low birthweight relationship by race in New York City. Health & Place, 14(4), 661–677. doi:10.1016/j.healthplace.2007.10.011.

    Article  Google Scholar 

  • Guest, A. M., Almgren, G., & Hussey, J. M. (1998). The ecology of race and socioeconomic distress: Infant and working age mortality in Chicago. Demography, 35(1), 23–34.

    Article  Google Scholar 

  • Hearst, M. O., Oakes, J. M., & Johnson, P. J. (2008). The effect of racial residential segregation on black infant mortality. American Journal of Epidemiology, 168(11), 1247–1254. doi:10.1093/aje/kwn291.

    Article  Google Scholar 

  • Hummer, R. A. (1993). Racial differentials in infant mortality in the U.S.: An examination of social and health determinants. Social Forces, 72(2), 529–554.

    Google Scholar 

  • Huynh, M., Parker, J. D., Harper, S., Pamuk, E., & Schoendorf, K. C. (2005). Contextual effect of income inequality on birth outcomes. International Journal of Epidemiology, 34(4), 888–895.

    Article  Google Scholar 

  • Iceland, J., Sharpe, C., & Steinmetz, E. (2005). Class differences in African American residential patterns in US metropolitan areas: 1990–2000. Social Science Research, 34(1), 252–266. doi:10.1016/j.ssresearch.2004.02.001.

    Article  Google Scholar 

  • Kain, J. F. (1968). Housing segregation, Negro employment, and metropolitan decentralization. Quarterly Journal of Economics, 82(2), 175–197.

    Article  Google Scholar 

  • Kato, S. K., Vieira, D. D., & Fachel, J. M. G. (2009). Utilization of fully Bayesian modeling to detect patterns in relative risk variation for infant mortality in Rio Grande do Sul State, Brazil. Cadernos De Saude Publica, 25(7), 1501–1510.

    Article  Google Scholar 

  • Kawachi, I., Kennedy, B. P., & Wilkinson, R. G. (1999). Crime: Social disorganization and relative deprivation. Social Science and Medicine, 48(6), 719–731.

    Article  Google Scholar 

  • Kramer, M. S., Demissie, K., Yang, H., Platt, R. W., Sauve, R., Liston, R., et al. (2000). The contribution of mild and moderate preterm birth to infant mortality. Journal of the American Medical Association, 284(7), 843–849.

    Article  Google Scholar 

  • Kramer, M. R., & Hogue, C. R. (2008). Place matters: Variation in the black/white very preterm birth rate across US metropolitan areas, 2002–2004. Public Health Reports, 123(5), 576–585.

    Google Scholar 

  • Lahr, M. B., Rosenberg, K. D., & Lapidus, J. A. (2007). Maternal-infant bedsharing: Risk factors for bedsharing in a population-based survey of new mothers and implications for SIDS risk reduction. Maternal and Child Health Journal, 11(3), 277–286. doi:10.1007/s10995-006-0166-z.

    Article  Google Scholar 

  • Laraia, B. A., Messer, L. C., Kaufman, J. S., Dole, N., Caughy, M., O’Campo, P., et al. (2006). Direct observation of neighborhood attributes in an urban area of the US south: characterizing the social context of pregnancy. International Journal of Health Geographics, 5, 1–11.

    Article  Google Scholar 

  • LaVeist, T. A. (1989). Linking residential segregation to the infant-mortality race disparities in U.S. cities. Sociology and Social Research, 73(2), 90–94.

    Google Scholar 

  • LaVeist, T. A. (1993). Segregation, poverty, and empowerment: Health consequences for African Americans. Milbank Quarterly, 71(1), 41–64.

    Article  Google Scholar 

  • Lawson, A. B. (2009). Bayesian disease mapping: Hierarchical modeling in spatial epidemiology. Boca Raton: CRC Press.

    Google Scholar 

  • Lawson, A. B., Biggeri, A. B., Boehning, D., Lesaffre, E., Viel, J. F., Clark, A., et al. (2000). Disease mapping models: An empirical evaluation. Statistics in Medicine, 19(17–18), 2217–2241.

    Google Scholar 

  • Lieberson, S., & Carter, D. K. (1982). A model for inferring the voluntary and involuntary causes of residential segregation. Demography, 19(4), 511–526.

    Google Scholar 

  • Lunn, D., Spiegelhalter, D., Thomas, A., & Best, N. (2009). The BUGS project: Evolution, critique and future directions (with discussion). Statistics in Medicine, 28(25), 3049–3082.

    Article  Google Scholar 

  • Lunn, D. J., Thomas, A., Best, N., & Spiegelhalter, D. (2000). WinBUGS—a Bayesian modelling framework: Concepts, structure, and extensibility. Statistics and Computing, 10(4), 325–337.

    Article  Google Scholar 

  • MacDorman, M. F., Callaghan, W. M., Mathews, T. J., Hoyert, D. L., & Kochanek, K. D. (2007). Trends in preterm-related infant mortality by race and ethnicity, United States, 1999–2004. International Journal of Health Services, 37(4), 635–641. doi:10.2190/HS.37.4.c.

    Article  Google Scholar 

  • Masi, C. M., Hawkley, L. C., Piotrowski, Z. H., & Pickett, K. E. (2007). Neighborhood economic disadvantage, violent crime, group density, and pregnancy outcomes in a diverse, urban population. Social Science and Medicine, 65(12), 2440–2457. doi:10.1016/j.socscimed.2007.07.014.

    Article  Google Scholar 

  • Mason, S. M., Messer, L. C., Laraia, B. A., & Mendola, P. (2009). Segregation and preterm birth: The effects of neighborhood racial composition in North Carolina. Health & Place, 15(1), 1–9. doi:10.1016/j.healthplace.2008.01.007.

    Article  Google Scholar 

  • Massey, D. S. (1996). The age of extremes: Concentrated affluence and poverty in the twenty-first century. Demography, 33(4), 395–412.

    Article  Google Scholar 

  • Massey, D. S., & Denton, N. A. (1988). The dimensions of residential segregation. Social Forces, 67(2), 281–315.

    Google Scholar 

  • Massey, D. S., & Denton, N. A. (1989). Hypersegregation in U.S. metropolitan areas: Black and Hispanic segregation along five dimensions. Demography, 26(3), 373–391.

    Article  Google Scholar 

  • Massey, D. S., & Eggers, M. L. (1990). The ecology of inequality: Minorities and the concentration of poverty, 1970–1980. The American Journal of Sociology, 95(5), 1153–1188.

    Article  Google Scholar 

  • Matthews, S. A., Yang, T. C., Hayslett, K. L., & Ruback, R. B. (2010). Built environment and property crime in Seattle, 1998–2000: A Bayesian analysis. Environment and Planning A, 42(6), 1403–1420. doi:10.1068/a42393.

    Article  Google Scholar 

  • McLaughlin, D. K., Stokes, C. S., Smith, P. J., & Nonoyama, A. (2007). Differential mortality across the United States: The influence of place-based inequality. In L. M. Lobao, G. Hooks, & A. R. Tickamyer (Eds.), The sociology of spatial inequality (pp. 141–162). Albany: State University of New York Press.

    Google Scholar 

  • Messer, L. C., Oakes, J. M., & Mason, S. (2010). Effects of socioeconomic and racial residential segregation on preterm birth: A cautionary tale of structural confounding. American Journal of Epidemiology, 171(6), 664–673. doi:10.1093/aje/kwp435.

    Article  Google Scholar 

  • Morales, L. S., Staiger, D., Horbar, J. D., Carpenter, J., Kenny, M., Geppert, J., et al. (2005). Mortality among very low-birthweight infants in hospitals serving minority populations. American Journal of Public Health, 95(12), 2206–2212. doi:10.2105/ajph.2004.046730.

    Article  Google Scholar 

  • Moran, P. A. P. (1950). Notes on continuous stochastic phenomena. Biometrika, 37(1/2), 17–23.

    Article  Google Scholar 

  • Ocana-Riola, R., & Mayoral-Cortes, J. M. (2010). Spatio-temporal trends of mortality in small areas of Southern Spain. BMC Public Health, 10. doi:10.1186/1471-2458-10-26.

  • Ostfeld, B. M., Perl, H., Esposito, L., Hempstead, K., Hinnen, R., Sandler, A., et al. (2006). Sleep environment, positional, lifestyle, and demographic characteristics associated with bed sharing in sudden infant death syndrome cases: A population-based study. Pediatrics, 118(5), 2051–2059. doi:10.1542/peds.2006-0176.

    Article  Google Scholar 

  • Pearl, M., Braveman, P., & Abrams, B. (2001). The relationship of neighborhood socioeconomic characteristics to birthweight among 5 ethnic groups in California. American Journal of Public Health, 91(11), 1808–1814.

    Article  Google Scholar 

  • Pickett, K. E., Collins, J. W., Masi, C. M., & Wilkinson, R. G. (2005). The effects of racial density and income incongruity on pregnancy outcomes. Social Science and Medicine, 60(10), 2229–2238. doi:10.1016/j.socscimed.2004.10.023.

    Article  Google Scholar 

  • Pickett, K. E., Shaw, R. J., Atkin, K., Kiernan, K. E., & Wilkinson, R. G. (2009). Ethnic density effects on maternal and infant health in the Millennium Cohort Study. Social Science and Medicine, 69(10), 1476–1483. doi:10.1016/j.socscimed.2009.08.031.

    Article  Google Scholar 

  • Polednak, A. P. (1991). Black-white differences in infant-mortality in 38 standard metropolitan statistical areas. American Journal of Public Health, 81(11), 1480–1482.

    Article  Google Scholar 

  • Polednak, A. P. (1996). Trends in US urban black infant mortality, by degree of residential segregation. American Journal of Public Health, 86(5), 723–726.

    Article  Google Scholar 

  • R Development Core Team. (2010). R: A language and environment for statistical computing. (2.11.0 ed.). Vienna, Austria: R Foundation for Statistical Computing.

  • Reardon, S. F. (2006). A conceptual framework for measuring segregation and its association with population outcomes. In J. M. Oakes & J. S. Kaufman (Eds.), Methods in social epidemiology (pp. 169–192). San Francisco: Jossey-Bass.

    Google Scholar 

  • Reardon, S. F., & O’Sullivan, D. (2004). Measures of spatial segregation. Sociological Methodology, 34(1), 121–162.

    Article  Google Scholar 

  • Roberts, E. M. (1997). Neighborhood social environments and the distribution of low birthweight in Chicago. American Journal of Public Health, 87(4), 597–603.

    Article  Google Scholar 

  • Sartorius, B. K. D., Kahn, K., Vounatsou, P., Collinson, M. A., & Tollman, S. M. (2010). Young and vulnerable: Spatial-temporal trends and risk factors for infant mortality in rural South Africa (Agincourt), 1992–2007—art. no. 645. BMC Public Health, 10, 645.

    Article  Google Scholar 

  • Schabenberger, O., & Gotway, C. A. (2005). Statistical methods for spatial data analysis. Boca Raton, FL: Chapman and Hall/CRC.

    Google Scholar 

  • Schempf, A., Strobino, D., & O’Campo, P. (2009). Neighborhood effects on birthweight: An exploration of psychosocial and behavioral pathways in Baltimore, 1995–1996. Social Science and Medicine, 68(1), 100–110. doi:10.1016/j.socscimed.2008.10.006.

    Article  Google Scholar 

  • Schmertmann, C. P., Potter, J. E., & Cavenaghi, S. M. (2008). Exploratory analysis of spatial patterns in Brazil’s fertility transition. Population Research and Policy Review, 27(1), 1–15. doi:10.1007/S11113-007-9052-7.

  • Schulz, A., Williams, D. R., Isreal, B. A., & Lempert, L. B. (2002). Racial and spatial relations as fundamental determinants of health in Detroit. Milbank Quarterly, 80(4), 677–707.

    Article  Google Scholar 

  • Shapiro-Mendoza, C. K., Tomashek, K. M., Kotelchuck, M., Barfield, W., Nannini, A., Weiss, J., et al. (2008). Effect of late-preterm birth and maternal medical conditions on newborn morbidity risk. Pediatrics, 121(2), E223–E232. doi:10.1542/peds.2006-3629.

    Article  Google Scholar 

  • Shapiro-Mendoza, C. K., Tomashek, K. M., Kotelchuck, M., Barfield, W., Weiss, J., & Evans, S. (2006). Risk factors for neonatal morbidity and mortality among “Healthy,” late preterm newborns. Seminars in Perinatology, 30(2), 54–60. doi:10.1053/j.semperi.2006.02.002.

    Article  Google Scholar 

  • Shoultz, G., Givens, J., & Drane, J. W. (2007a). Urban form, heart disease, and geography: A case study in composite index formation and bayesian spatial modeling. Population Research and Policy Review, 26(5/6), 661–685. doi:10.1007/s11113-007-9049-2.

    Article  Google Scholar 

  • Shoultz, G., Givens, J., & Drane, J. W. (2007b). Urban form, heart disease, and geography: A case study in composite index formation and bayesian spatial modeling. Population Research and Policy Review, 26(5–6), 661–685. doi:10.1007/S11113-007-9049-2.

  • Sims, M., Sims, T. L., & Bruce, M. A. (2007). Urban poverty and infant mortality rate disparities. Journal of the National Medical Association, 99(4), 349–356.

    Google Scholar 

  • Singh, G. K., & Kogan, M. D. (2007a). Persistent socioeconomic disparities in infant, neonatal, and postneonatal mortality rates in the United States, 1969–2001. Pediatrics, 119(4), E928–E939. doi:10.1542/peds.2005-2181. ISSN0031-4005

    Google Scholar 

  • Singh, G. K., & Kogan, M. D. (2007b). Widening socioeconomic disparities in US childhood mortality, 1969–2000. American Journal of Public Health, 97(9), 1658–1665. doi:10.2105/ajph.2006.087320.

    Article  Google Scholar 

  • Slack, T., Singelmann, J., Fontenot, K., Poston, D. L., Saenz, R., & Siordia, C. (2009). Poverty in the Texas borderland and lower Mississippi delta: A comparative analysis of differences by family type. Demographic Research, 20(Jan–June), 353–376.

    Article  Google Scholar 

  • Sparks, P. J., McLaughlin, D. K., & Stokes, C. S. (2009). Differential neonatal and postneonatal infant mortality rates across US counties: The role of socioeconomic conditions and rurality. Journal of Rural Health, 25(4), 332–341.

    Article  Google Scholar 

  • Sparks, P. J., & Sparks, C. S. (2010). An application of spatially autoregressive models to the study of US county mortality rates. Population, Space and Place, 16(6), 465–481.

    Google Scholar 

  • Spiegelhalter, D. J., Best, N., Carlin, B. P., & van der Linde, A. (2002). Bayesian measures of model complexity and fit (with discussion). Journal of the Royal Statistical Society Series B-Methodological, 64(4), 583–639.

    Article  Google Scholar 

  • VanderWeele, T. J., Lantos, J. D., Siddique, J., & Lauderdale, D. S. (2009). A comparison of four prenatal care indices in birth outcome models: Comparable results for predicting small-for-gestational-age outcome but different results for preterm birth or infant mortality. Journal of Clinical Epidemiology, 62(4), 438–445. doi:10.1016/j.jclinepi.2008.08.001.

    Article  Google Scholar 

  • Vinikoor, L. C., Kaufman, J. S., MacLehose, R. F., & Laraia, B. A. (2008). Effects of racial density and income incongruity on pregnancy outcomes in less segregated communities. Social Science and Medicine, 66(2), 255–259. doi:10.1016/j.socscimed.2007.08.016.

    Article  Google Scholar 

  • Voss, P. R., Long, D. D., Hammer, R. B., & Friedman, S. (2006). County child poverty rates in the US: A spatial regression approach. Population Research and Policy Review, 25(4), 369–391. doi:10.1007/S11113-006-9007-4.

    Article  Google Scholar 

  • Waller, L. A., & Gotway, C. A. (2004). Applied spatial statistics for public health data. New York: Wiley Interscience.

    Book  Google Scholar 

  • Wilkinson, R. G. (1996). Unhealthy societies: The afflictions of inequality. London: Routledge.

    Book  Google Scholar 

  • Yang, T. C., Jensen, L., & Haran, M. (2011). Social capital and human mortality: Explaining the rural paradox with county-level mortality data. Rural Sociology, 76(3), 347–374.

    Article  Google Scholar 

  • Yang, T. C., Teng, H. W., & Haran, M. (2009). The impacts of social capital on infant mortality in the U.S.: A spatial investigation. Applied Spatial Analysis and Policy, 2(3), 211–227.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Johnelle Sparks.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Johnelle Sparks, P., Sparks, C.S. & Campbell, J.J.A. An application of Bayesian spatial statistical methods to the study of racial and poverty segregation and infant mortality rates in the US. GeoJournal 78, 389–405 (2013). https://doi.org/10.1007/s10708-011-9445-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10708-011-9445-3

Keywords

Navigation