In America, hypersegregation is more common among Blacks compared to other racial groups (Massey and Denton 1988; Wilkes and Iceland 2004). During the year 2000, Parillo (2008) found that 38.5% of the Black community (which equates to approximately 13.3 million) lived in hypersegregation. What is most alarming about this statistic is the way in which persistent racial segregation couples with durability of concentrated poverty. Massey (1990:5) found that “rising rates of black poverty interact with high levels of black segregation to concentrate poverty in black neighborhoods.” Subsequently, Charles (2003) implicates hypersegregation as a key factor in the concentration of poverty within Black communities. Not only does hypersegregation lead to poverty, it also creates an opportunity line clustering advantage in some neighborhoods and disadvantage in others (Sampson 2012). Sampson (2012:100) explains, “There is a deep and divided structure in the concentration of wellbeing across multiple dimensions” within segregated communities. The pockets of concentrated disadvantage are frequently Black or nonWhite spaces, making the opportunity line the durable manifestation of Du Bois’s color line. As a result, the stability of hypersegregation sustains generational poverty in the Black community (Sampson 2012).
The concentrated disadvantage stemming from hypersegregation emerges as an interdependent and interconnected web of concentrated poverty, crime, incarceration, unemployment, infant mortality, violence, hopelessness and declining financial investment in the neighborhoods, which can drastically limit the residents’ choices of escaping poverty (Massey and Denton 1993; Sampson 2012; Desmond 2016). Sampson (2012:46) explains,
Crime and health-related problems tend to come bundled together at the neighborhood level are predicted by neighborhood characteristics such as concentration of poverty, racial isolation, single parent families, and to a lesser extent rates of residential and housing instability.
Not only are these factors bundled together, but they are also interdependent. For example, Eitle (2009:35) found that “hypersegregation was a significant, independent predictor of Black homicide rates.” Black homicide rates, in turn, are also a predictor of infant mortality rates (Sampson 2012). To take it one step further, a strong positive correlation exists between infant mortality rates and the presence of food deserts (Broad 2016). All of these factors, or strings of the web, may appear independent on the surface but underneath are all a byproduct of the concentrated deprivation created by hypersegregation (Massey and Denton 1993; Sampson 2012).
The interdependent factors generated within areas of hypersegregation work together as an interlocking structure which facilitates resources and opportunity to some and acts as a barrier to others on the basis of race. This structure acts as a resistance to minority groups while simultaneously functioning as a catalyst for majority groups. “Neighborhoods that are both Black and poor, and that are characterized by high unemployment and female-headed families, are ecologically distinct, a characteristic that is not simply the same thing as low economic status” (Sampson 2012:101). Hypersegregation creates communities of not just disadvantage but of ecological distinctions, whose underpinnings are different. Massey (1990) elaborates on this when he references how segregation builds deprivation into the socioeconomic environment.
The interlocking structure of segregation impacts the design of the neighborhood and level of resources which are social determinants of health (NACCHO 2014). Segregation is a social determinant of health implicated as the root cause of racial health disparities (Osypuk 2008). Williams (2005:1) concludes
the residential concentration of African Americans is high and distinctive, and the related inequities in neighborhood environments, socioeconomic circumstances, and medical care are important factors in initiating and maintaining racial disparities in health. African Americans are more prone to cancer, diabetes, hypertension, preterm births and other chronic disease than any other population in the United States (Landrine and Corral 2009). These disparities, which hold true historically across socioeconomic lines, contribute to a higher death rate for Blacks (Sampson 2012)
Oftentimes, highly segregated communities are characterized by lack of supermarkets, a condition known as food deserts. The U.S. Department of Agriculture Economic Research Service defines a food desert as an area where more than 40% of the population has an income less than or equal to 200% of the Federal Poverty Threshold and lives more than a mile from a supermarket or large grocery store (USDA 2015). Within the Black community, there are two to three times fewer grocery stores than in White communities with similar SES (Landrine and Corral 2009). This is significant because Cheadle (1991:257) found “several statistically significant relationships between measures of the availability of healthful products in grocery stores and the reported consumption of healthful products by individuals living near those stores.” The correlation between access to healthy foods, fresh fruits and vegetables and their consumption demonstrates the impact the location of grocery stores has on the health of the local community (Cheadle 1991). With no alternative, the community is forced to eat more canned and/or processed foods and faces limited and lower quality of fresh produce. Interestingly, while supermarkets are scarce, fast food restaurants are prevalent. “Segregated black neighborhoods contain 2–3 times more fast food outlets than do white neighborhoods of comparable SES. This contributes to Blacks consuming more fast food than Whites, which in turn contributes to Black disparities in obesity and diabetes” (Landrine and Corral 2009:3). This high level of access to fast food combined with low level access to quality fresh food has a direct impact on obesity caused by increased consumption of less favorable food (Landrine and Corral 2009).
Another social determinant of health is the lack of recreational facilities which in turn leads to lack of physical activity for children, as well as adults. Black neighborhoods contain fewer parks and recreation facilities compared to White neighborhoods (Center of Disease Control and Prevention 1999). This lack of facilities provides less opportunity to exercise, which directly relates to quality of health. Landrine and Corral (2009:4) state
“Given the increased access to fast food and lower access to supermarkets and recreational facilities in segregated Black neighborhoods, it is not surprising that BMI increases with segregation; every 1 SD increase in Black segregation is associated with a 0.423 increase in Black body mass index and a 14% increase in Blacks’ odds of being overweight”
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