Racism, Place, and Health of Urban Black Elders: Relationship of Neighborhood Effects and Reaction to Discrimination on Self-rated Health

As a population, older African Americans in the United States have more compromised health in terms of numbers and severity of conditions, ages at onset, and levels of physical function than European Americans of similar ages. Some of the inequality may be due to life-long exposure to institutional, interpersonal, and internalized racism. This monograph describes the results of a survey of African Americans ages 60 years and older living in Baltimore, Maryland. The study sets out to explain differences in self-rated health using report of racism, reaction to unfair treatment, and physical and psychosocial characteristics of participants? neighborhoods. Mental health, measured by a modified CES-D depression score, is most closely associated with health status. No effect of reported interpersonal or internalized racism is demonstrated in this work. Neighborhood deprivation is associated with health, but effects are mostly explained by individual-level factors. Taking lifecourse and biopsychosocial approaches, this monograph synthesizes epidemiologic and historic approaches to understanding the health status of older African Americans living in 26 western Baltimore neighborhoods.