ArticleHealth services research2009
Racial segregation and disparities in health care delivery: conceptual model and empirical assessment.
Article in Health services research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
48 citing papers in PubMed, 74 citations in OpenAlex.
- Trial
- Upstream Factors Associated With Hospitalization in Black- and Minority-Serving Hospitals.JAMA network open · 2026Observational
- Relationship Between Residential Racial and Economic Segregation and Main Causes of Death in US Counties.Journal of racial and ethnic health disparities · 2026Article
- Referrals and Black-White Coronary Heart Disease Treatment Disparities: A Qualitative Study of Primary Care Physician Perspectives.Journal of general internal medicine · 2025Article
- Alternative Approaches to Characterizing Disparate Care by Race, Ethnicity, and Insurance Between Hospitals.International journal of environmental research and public health · 2025Article
- Segregation in hospital care for Medicare beneficiaries by race and ethnicity and dual-eligible status from 2013 to 2021.Health services research · 2025Article
- Transporting difference-in-differences estimates to assess health equity impacts of payment and delivery models.Health services research · 2025Article
- Measuring Spatial Social Polarization in Public Health Research: A Scoping Review of Methods and Applications.Journal of urban health : bulletin of the New York Academy of Medicine · 2025Article
- Association between clinician team segregation, receipt of cardiovascular care and outcomes in valvular heart diseases.ESC heart failure · 2025Article
- A State-Level Examination into Structural Racism and Racialized Disparities in Sexually Transmitted Infections.Spatial demography · 2025Article
- COVID-19's effect on healthcare disparities: delivery, reimbursement, and premature mortality in residentially segregated populations.Frontiers in public health · 2025Article
- Racial and Ethnic Composition of Populations Served by Freestanding Children's Hospitals and Disparities in Outcomes of Pediatric Lupus.Arthritis care & research · 2024Article
- Achieving Equity in Child and Adolescent Mental Health by Addressing Racism Through Prevention Science.Adversity and resilience science · 2024Article
- The segregation of physician networks providing care to black and white patients with heart disease: Concepts, measures, and empirical evaluation.Social science & medicine (1982) · 2024Article
- Provider Care Segregation and Hospital-Region Racial Disparities in the United States for Acute Ischemic Stroke and Endovascular Therapy Outcomes.Journal of the American Heart Association · 2024Article
- Association of geographical disparities and segregation in regional treatment facilities for Black patients with aneurysmal subarachnoid hemorrhage in the United States.Frontiers in public health · 2024Article
- Cross-sectional comparison of health care delivery and reimbursement between segregated and nonsegregated communities in Hungary.Frontiers in public health · 2024Article
- Article
- Segregated Patterns of Hospital Care Delivery and Health Outcomes.JAMA health forum · 2023Article
- Race and Ethnicity and Emergency Department Discharge Against Medical Advice.JAMA network open · 2023Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThis study examines two dimensions of racial segregation across hospitals, using a disease for which substantial disparities have been documented. DATA SOURCES: Black (n=32,289) and white (n=244,042) patients 67 years and older admitted for acute myocardial infarction during 2004-2005 in 105 hospital markets were identified from Medicare data. Two measures of segregation were calculated: Dissimilarity (i.e., dissimilar distribution by race across hospitals), and Isolation (i.e., racial isolation within hospitals). For each measure, markets were categorized as having low, medium, or high segregation. STUDY
designThe relationship of hospital segregation to residential segregation and other market characteristics was evaluated. Cox proportional hazards regression was used to evaluate disparities in the use of revascularization within 90 days by segregation level.
resultsAgreement of segregation category based on Dissimilarity and Isolation was poor (kappa=0.12), and the relationship of disparities in revascularization to segregation differed by measure. The hazard of revascularization for black relative to white patients was lowest (i.e., greatest disparity) in markets with low Dissimilarity, but it was unrelated to Isolation.
conclusionsSignificant racial segregation across hospitals exists in many U.S. markets, although the magnitude and relationship to disparities depends on definition. Dissimilar distribution of race across hospitals may reflect divergent cultural preferences, social norms, and patient assessments of provider cultural competence, which ultimately impact utilization.
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Registered trials
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