ArticleJournal of racial and ethnic health disparities2026
Race and Risk: Disentangling the Racialized Distribution of Neighborhood Resources and Differential Health Risks in Southern U.S. Cities.
Article in Journal of racial and ethnic health disparities, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Neighborhood-level resource availability is a key determinant of population health. Racial capitalism and disinvestment shape the spatial distribution of essential health-promoting neighborhood resources, yet few studies consider the conjuncture of resource scarcity type and race and class composition in shaping chronic disease outcomes. This study addresses this gap by analyzing 3,011 urban neighborhoods in the southern United States to examine: (1) the sociodemographic correlates of distinct types of resource scarcity, and (2) the associations between those scarcity types and five chronic health outcomes: hypertension, obesity, diabetes, asthma, and physical inactivity. Findings reveal that predominantly Black neighborhoods face the highest risk of experiencing multiple forms of resource scarcity via food-pharmacy deserts (RRR=5.165, p<.001) relative to neighborhoods with smaller proportions of Black residents. Moreover, higher income neighborhoods are more likely to lack greenspace (RRR=1.064, p<.05) relative to low-income neighborhoods. While neighborhood-level resource scarcity is associated with greater health risk, across resource scarcity type, asthma (β=.043, p<.001) and diabetes (β=.05, p<.001) prevalence have the strongest association with food-pharmacy scarcity while obesity prevalence is most strongly associated with pharmacy-green scarcity (β=.074, p<.001) relative to other resource scarcity types. Paradoxically, greenspace-only scarcity is associated with lower hypertension, inactivity, and obesity prevalence, highlighting the complex social contexts shaping environmental health benefits. The disproportionate burden of cooccurring resource scarcity in predominantly Black neighborhoods and the inconsistent protective effect of income suggests that addressing health disparities requires more targeted, place-based interventions that account for both the type and combination of missing resources in marginalized communities.
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