“Racial mortality inversion”: Black-white disparities in mortality among people experiencing homelessness in the United States

IF 3.6 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Matthew Fowle , Jamie Chang , Katherine Saxton
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引用次数: 0

Abstract

Disparities in mortality between Black and White people have long been observed. These disparities persist at all income levels. However, similar patterns in racial mortality disparities are not observed among people experiencing homelessness. Instead, studies in a handful of cities show a reversal in the Black-White mortality disparity in the United States: Black people experiencing homelessness are less likely to die compared to White people experiencing homelessness. We propose a theory of “racial mortality inversion” and test whether inverted Black-White mortality patterns are observable in homeless populations throughout the United States. Using a novel dataset of 18,618 homeless decedents in 20 localities across 10 states and the District of Columbia, we find consistent evidence for “racial mortality inversion” across time and place. Between 2015 and 2020, the aggregate White homeless mortality rate was 67.8%–138.4% higher than the rate for the Black homeless population. Inverted racial mortality rates were observed in all 20 localities and in nearly every year. Across the entire sample, higher average ages of death were also observed for Black people compared to White people experiencing homelessness in 5 of 6 years, though racial inversion in age was not consistent across localities. These findings offer novel insight into racial health disparities among people experiencing homelessness and may inform policies and programs that seek to prevent homelessness and homeless mortality across racial groups.

"种族死亡率倒置":美国无家可归者死亡率的黑白差异
黑人和白人之间的死亡率差异早已存在。这些差距在所有收入水平上都持续存在。然而,在无家可归者中却没有观察到类似的种族死亡率差异模式。相反,对少数几个城市的研究表明,美国黑人和白人的死亡率差距出现了逆转:与无家可归的白人相比,无家可归的黑人死亡的可能性更小。我们提出了 "种族死亡率倒置 "理论,并检验了在美国各地的无家可归者中是否可以观察到黑白死亡率倒置的模式。我们使用一个包含 10 个州和哥伦比亚特区 20 个地方的 18618 名无家可归者死者的新数据集,发现了跨时间和地点的 "种族死亡率倒置 "的一致证据。2015 年至 2020 年间,白人无家可归者的总死亡率比黑人无家可归者的死亡率高出 67.8%-138.4%。在所有 20 个地方,几乎每年都能观察到种族死亡率倒挂现象。在整个样本中,还观察到黑人的平均死亡年龄在 6 年中的 5 年高于无家可归的白人,尽管种族年龄倒置在各地并不一致。这些发现为我们深入了解无家可归者的种族健康差异提供了新的视角,并可为旨在防止无家可归和无家可归者跨种族群体死亡的政策和计划提供参考。
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来源期刊
Ssm-Population Health
Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
6.50
自引率
2.10%
发文量
298
审稿时长
101 days
期刊介绍: SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.
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