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      Association between Self-Rated Health and the Ethnic Composition of the Residential Environment of Six Ethnic Groups in Amsterdam

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          Abstract

          Background: Studies on the association between health and neighborhood ethnic composition yielded inconsistent results, possibly due to methodological limitations. We assessed these associations at different spatial scales and for different measures of ethnic composition. Methods: We obtained health survey data of 4673 respondents of Dutch, Surinamese, Moroccan, Turkish other non-Western and other Western origin. Neighborhood ethnic composition was measured for buffers varying from 50–1000 m. Associations with self-rated health were measured using logistic multilevel regression analysis, with control for socioeconomic position at the individual and area level. Results: Overall ethnic heterogeneity was not related to health for any ethnic group. The presence of other Surinamese was associated with poor self-rated health among Surinamese respondents. The presence of Moroccans or Turks was associated with poor health among some groups. The presence of Dutch was associated with better self-rated health among Surinamese and Turks. In most cases, these associations were stronger at lower spatial scales. We found no other associations. Conclusions: In Amsterdam, self-rated health was not associated with ethnic heterogeneity in general, but may be related to the presence of specific ethnic groups. Policies regarding social and ethnic mixing should pay special attention to the co-residence of groups with problematic interrelations.

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          Most cited references49

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          Ecological Fallacies and the Analysis of Areal Census Data

          S Openshaw (1984)
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            The buffering effects of ethnic density on experienced racism and health.

            Studies in the United Kingdom (UK) show a consistent inequality between the health of ethnic minorities and that of white people. This is exacerbated by the over-representation of ethnic minorities in deprived areas, which have been associated with poorer infant and child health, chronic disease, and high mortality rates. Ethnic density, defined as the proportion of ethnic minority residents in an area, is generally thought of in relation to the negative impacts of area effects on health. However, it can be considered in terms of social networks and supportive communities, possibly mitigating the detrimental impact of racism on the health of ethnic minority people. This study investigated the ethnic density effect and hypothesised that ethnic minority people who live in areas of high ethnic density would report decreased experienced racism and better health outcomes compared to their counterparts living in areas of low ethnic density. Multiple logistic regressions were conducted using data from the Fourth National Survey of Ethnic Minorities and the 1991 UK Census. Results showed a negative association between ethnic density and psychotic symptomatology, but no evidence of an association between ethnic density and general self-rated health. Findings confirm that the experience of racism is lower in places of higher ethnic density and indicate a tendency for a weaker association between racism and health as ethnic density increases.
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              Racial disparities in low birthweight and the contribution of residential segregation: a multilevel analysis.

              S Grady (2006)
              This study investigates the geography of racial disparities in low birthweight in New York City by focusing on racial residential segregation and its effect on the risk of low birthweight among African-American infants and mothers. This cross-sectional multilevel analysis uses birth records at the individual level (n=96,882) and racial isolation indices at the census tract or neighborhood level (n=2095) to measure their independent and cross-level effects on low birthweight. This study found that residential segregation and neighborhood poverty operate at different scales to increase the risk of low birthweight. At the neighborhood scale residential segregation is positively and significantly associated with low birthweight, after controlling for individual-level risk factors and neighborhood poverty. Residential segregation explains neighborhood variation in low birthweight means and race effects across census tracts, which cannot be accounted for by neighborhood poverty alone. At the individual scale-increasing levels of residential segregation does not significantly reduce or exacerbate individual-level risk factors for low birthweight; whereas increasing levels of neighborhood poverty significantly eliminates the race effect and reduces the protective effect of being foreign-born on low birthweight, after controlling for other individual-level risk factors and residential segregation. These findings are contradictory to previous health research that shows protective mechanisms associated with ethnic density in local areas. It is likely that structural factors underlying residential segregation, i.e., racial isolation, impose additional stressors on African-American women that may offset or disguise positive attributes associated with ethnic density. However, as poverty is concentrated within these neighborhoods, differences between races in low birthweight cease to exist. This study demonstrates that residential segregation and neighborhood poverty are important determinants of racial disparity in low birthweight in New York City.
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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                12 November 2015
                November 2015
                : 12
                : 11
                : 14382-14399
                Affiliations
                [1 ]Department of Human Geography, Planning & International Development Studies, Faculty of Social and Behavioural Sciences, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands; E-Mail: s.musterd@ 123456uva.nl
                [2 ]Department of Epidemiology and Health Promotion, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT Amsterdam, The Netherlands; E-Mail: hdijkshoorn@ 123456ggd.amsterdam.nl
                [3 ]Department of Public Health, Academic Medical Centre, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands; E-Mail: a.kunst@ 123456amc.uva.nl
                Author notes
                [* ]Author to whom correspondence should be addressed; E-Mail: e.m.veldhuizen@ 123456uva.nl ; Tel.: +31-20-525-7398; Fax: +31-20-525-4051.
                Article
                ijerph-12-14382
                10.3390/ijerph121114382
                4661654
                26569282
                d48bb67e-2121-4b8a-9077-52ebd035f273
                © 2015 by the authors; licensee MDPI, Basel, Switzerland.

                This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 12 September 2015
                : 06 November 2015
                Categories
                Article

                Public health
                neighborhood ethnic composition,own ethnic density,ethnic heterogeneity,self-rated health,spatial scale

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