Multiple Meanings of Minority Concentration: Incorporating Contextual Explanations into the Analysis of Individual-Level U.S. Black Mortality Outcomes

Prior research on mortality for U.S. blacks focuses on the detrimental effects of minority concentration and residential segregation in metropolitan areas on health outcomes. To date, few studies have examined this relationship outside of large U.S. central cities. In this paper, we extend current research on the minority concentration and mortality relationship to explain the rural advantage in mortality for nonmetropolitan blacks. Using data from the 1986–1994 linked National Health Interview Survey/National Death Index, we examine the rural-urban gap in mortality for U.S. blacks. Our findings indicate that blacks in nonmetropolitan areas experience a lower risk of mortality than metropolitan central city blacks after indicators of socio-economic and health status are controlled. Our findings also point to the importance of accounting for contextual factors. Net of individual level controls, minority concentration exerts differential effects across metropolitan and nonmetropolitan areas, such that nonmetropolitan black residents experience a lower risk of mortality in high minority concentration areas than blacks in metropolitan central city areas. This finding suggests a reconceptualization of the meaning for minority concentration with respect to studies of health outcomes in nonmetropolitan communities.