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J Health Soc Behav. 2002 Sep;43(3):359-81.

Individual and contextual risks of death among race and ethnic groups in the United States.

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Agency for Healthcare Research and Quality, Center for Cost and Financing Studies, 2101 East Jefferson Street, Suite 500, Rockville, MD 20852, USA.


An emerging area of social science research focuses on individual-level and contextual-level determinants of black-white adult mortality differentials in the United States. However, no research on adult mortality differentials has distinguished multiple Hispanic subgroups and explored the role of nativity at both the individual and contextual levels for small geographic areas. Using the 1986-1997 National Health Interview Survey-National Death Index linked file, we examine the effects of individual and contextual factors on black-white and multiple Hispanic subgroups (Mexican Americans, Puerto Ricans, and "other" Hispanic) differentials in adult mortality. In addition, we use a new, innovative geographic area--the very small area--as our contextual unit of analysis. We find that excess mortality risks for all race-ethnic groups considered are associated with not only individual characteristics, but also neighborhood characteristics. In addition, percent foreign born in a neighborhood is protective of Hispanic subgroup mortality for Puerto Rican, Mexican American, and "other" Hispanic adults in the 45-64 age category. These findings indicate a need for future research to examine more throughly the pathways through which neighborhood factors affect multiple Hispanic subgroup mortality and the role of nativity as a protective factor for older adult Hispanic mortality.

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