Mapping Ethnic Enclaves for Health Disparities Research: A Hybrid Clustering Approach.

Ethnic enclaves, as an area-level social determinant of health, have significant implications for understanding ethnic health disparities. While a growing body of literature examines the impacts of residing in ethnic enclaves on the health of co-ethnics, studies often map enclaves solely from population concentrations within individual census tract. This approach overlooks the spatial clustering of populations in adjacent census tracts and the presence of cultural resources like ethnic-specific businesses and organizations. We develop and assess a hybrid clustering enclave model (HCEM) that maps spatial clustering patterns of both ethnic populations and cultural resources. We apply this approach to identify Chinese, Japanese, and Korean enclaves in Los Angeles County and compare the resulting ethnic enclaves to those mapped only from thresholds of ethnic population concentrations in individual census tracts. Depending on the types of health disparities assessed and the specific ethnicity of the enclave being mapped, different approaches to mapping Asian ethnic enclaves yield areas with larger or smaller health disparities than tracts mapped from population thresholds. Our results highlight the importance of aligning ethnic enclave measures with its conceptualization and potential health mechanisms when examining enclaves' health impacts. We offer an approach to make and assess maps which may help researchers to capture the multidimensional features of enclaves and to distinguish diverse types of enclaves for answering a range of specific questions about the role of place in ethnic health disparities.