Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr 24;10(4):e0122963.
doi: 10.1371/journal.pone.0122963. eCollection 2015.

Association between an Internet-Based Measure of Area Racism and Black Mortality

David H Chae  1 , Sean Clouston  2 , Mark L Hatzenbuehler  3 , Michael R Kramer  4 , Hannah L F Cooper  5 , Sacoby M Wilson  6 , Seth I Stephens-Davidowitz  7 , Robert S Gold  1 , Bruce G Link  3
Affiliations

Association between an Internet-Based Measure of Area Racism and Black Mortality

David H Chae et al. PLoS One. .

Abstract

Racial disparities in health are well-documented and represent a significant public health concern in the US. Racism-related factors contribute to poorer health and higher mortality rates among Blacks compared to other racial groups. However, methods to measure racism and monitor its associations with health at the population-level have remained elusive. In this study, we investigated the utility of a previously developed Internet search-based proxy of area racism as a predictor of Black mortality rates. Area racism was the proportion of Google searches containing the "N-word" in 196 designated market areas (DMAs). Negative binomial regression models were specified taking into account individual age, sex, year of death, and Census region and adjusted to the 2000 US standard population to examine the association between area racism and Black mortality rates, which were derived from death certificates and mid-year population counts collated by the National Center for Health Statistics (2004-2009). DMAs characterized by a one standard deviation greater level of area racism were associated with an 8.2% increase in the all-cause Black mortality rate, equivalent to over 30,000 deaths annually. The magnitude of this effect was attenuated to 5.7% after adjustment for DMA-level demographic and Black socioeconomic covariates. A model controlling for the White mortality rate was used to further adjust for unmeasured confounders that influence mortality overall in a geographic area, and to examine Black-White disparities in the mortality rate. Area racism remained significantly associated with the all-cause Black mortality rate (mortality rate ratio = 1.036; 95% confidence interval = 1.015, 1.057; p = 0.001). Models further examining cause-specific Black mortality rates revealed significant associations with heart disease, cancer, and stroke. These findings are congruent with studies documenting the deleterious impact of racism on health among Blacks. Our study contributes to evidence that racism shapes patterns in mortality and generates racial disparities in health.

PubMed Disclaimer

Conflict of interest statement

Competing Interests: During the time of this research, SIS-D was at Harvard University. He was also a quantitative analyst at Google, Inc. SIS-D constructed the area racism measure prior to his affiliation with Google, Inc., and was not with Google, Inc. when the initial version of this manuscript was completed. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials. No other potential competing interests or financial disclosures were reported by the authors of this paper.

Figures

Fig 1
Fig 1. Proportion of Google queries containing the “N-word” by designated market area, 2004–2007.
See this image and copyright information in PMC

References

    1. Chae DH, Nuru-Jeter AM, Francis D, Lincoln KD. Conceptualizing racial disparities in health: advancement of a socio-psychobiological approach. Du Bois Rev. 2011;8: 63–77.
    1. Williams DR, Neighbors HW, Jackson JS. Racial/ethnic discrimination and health: findings from community studies. Am J Public Health. 2008;98: S29–37. - PMC - PubMed
    1. Williams DR, Collins C. Racial residential segregation: a fundamental cause of racial disparities in health. Public Health Rep. 2001;116: 404–416. - PMC - PubMed
    1. Dinwiddie GY, Gaskin DJ, Chan KS, Norrington J, McCleary R. Residential segregation, geographic proximity and type of services used: evidence for racial/ethnic disparities in mental health. Soc Sci Med. 2013;80: 67–75. 10.1016/j.socscimed.2012.11.024 - DOI - PMC - PubMed
    1. Duncan DT, Kawachi I, White K, Williams DR. The geography of recreational open space: influence of neighborhood racial composition and neighborhood poverty. J Urban Health. 2013;90: 618–631. 10.1007/s11524-012-9770-y - DOI - PMC - PubMed

Publication types

LinkOut - more resources