Born on the wrong side of the tracks: Exploring the causal effects of segregation on infant health
Journal of Health Economics · 2024 · Vu, Hoa、Green, Tiffany L.、Swan, Laura E.T.
中文摘要
既有研究发现,高水平的居住种族隔离,即各种族/族裔群体彼此隔绝的程度,与婴儿健康结局恶化相关,尤其是在非西班牙裔 (NH) 黑人婴儿群体中。然而,由于隔离暴露并非随机,隔离是否以及多大程度上与婴儿健康存在因果联系尚不清楚。为克服这一实证局限,我们利用 19 世纪铁路轨道布设的外生变异来预测当代隔离,该方法最早由 Ananat (2011) 提出。与既有文献一致,我们发现居住隔离与该地区黑人婴儿群体不良出生结局存在统计显著关联。使用 OLS 方法会低估隔离对婴儿健康的负面影响。我们未能检测到对 NH 白人婴儿群体健康结局的可比效应。此外,我们识别出居住隔离影响黑人婴儿群体健康结局的若干关键机制,包括孕早期产前保健可及性较低、反黑人偏见水平较高、交通障碍更大以及粮食不安全加剧。鉴于不良出生结局对成年人的健康与福祉具有不利影响,研究结果表明,宫内暴露于居住隔离可能对黑人—白人在整个生命历程中的不平等具有重要意涵。
Abstract
Prior research has found that a high level of residential racial segregation, or the degree to which racial/ethnic groups are isolated from one another, is associated with worsened infant health outcomes, particularly among non-Hispanic (NH) Black infant populations. However, because exposure to segregation is non-random, it is unclear whether and to what extent segregation is causally linked to infant health. To overcome this empirical limitation, we leverage exogenous variation in the placement of railroad tracks in the 19th century to predict contemporary segregation, an approach first introduced by Ananat (2011). In alignment with prior literature, we find that residential segregation has statistically significant associations with negative birth outcomes among Black infant populations in the area. Using OLS methods underestimates the negative impacts of segregation on infant health. We fail to detect comparable effects on health outcomes among NH White infant populations. Further, we identify several key mechanisms by which residential segregation could influence health outcomes among Black infant populations, including lower access to prenatal care during the first trimester, higher levels of anti-Black prejudice, greater transportation barriers, and increased food insecurity. Given that poor birth outcomes have adverse effects on adults’ health and well-being, the findings suggest that in-utero exposure to residential segregation could have important implications for Black–White inequality over the life course.