{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T04:04:33Z","timestamp":1789099473396,"version":"build-2803163510"},"reference-count":90,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Studies elucidating determinants of residential neighborhood\u2013level health inequities are needed.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To quantify associations of structural racism indicators with neighborhood prevalence of chronic kidney disease (CKD), diabetes, and hypertension.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cross-sectional study used public data (2012-2018) and deidentified electronic health records (2017-2018) to describe the burden of structural racism and the prevalence of CKD, diabetes, and hypertension in 150 residential neighborhoods in Durham County, North Carolina, from US census block groups and quantified their associations using bayesian models accounting for spatial correlations and residents\u2019 age. Data were analyzed from January 2021 to May 2023.<\/jats:p>\n <\/jats:sec>\n \n Exposures<\/jats:title>\n Global (neighborhood percentage of White residents, economic-racial segregation, and area deprivation) and discrete (neighborhood child care centers, bus stops, tree cover, reported violent crime, impervious areas, evictions, election participation, income, poverty, education, unemployment, health insurance coverage, and police shootings) indicators of structural racism.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Outcomes of interest were neighborhood prevalence of CKD, diabetes, and hypertension.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n A total of 150 neighborhoods with a median (IQR) of 1708 (1109-2489) residents; median (IQR) of 2% (0%-6%) Asian residents, 30% (16%-56%) Black residents, 10% (4%-20%) Hispanic or Latino residents, 0% (0%-1%) Indigenous residents, and 44% (18%-70%) White residents; and median (IQR) residential income of $54\u202f531 ($37\u202f729.25-$78\u202f895.25) were included in analyses. In models evaluating global indicators, greater burden of structural racism was associated with greater prevalence of CKD, diabetes, and hypertension (eg, per 1-SD decrease in neighborhood White population percentage: CKD prevalence ratio [PR], 1.27; 95% highest density interval [HDI], 1.18-1.35; diabetes PR, 1.43; 95% HDI, 1.37-1.52; hypertension PR, 1.19; 95% HDI, 1.14-1.25). Similarly in models evaluating discrete indicators, greater burden of structural racism was associated with greater neighborhood prevalence of CKD, diabetes, and hypertension (eg, per 1-SD increase in reported violent crime: CKD PR, 1.15; 95% HDI, 1.07-1.23; diabetes PR, 1.20; 95% HDI, 1.13-1.28; hypertension PR, 1.08; 95% HDI, 1.02-1.14).<\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n This cross-sectional study found several global and discrete structural racism indicators associated with increased prevalence of health conditions in residential neighborhoods. Although inferences from this cross-sectional and ecological study warrant caution, they may help guide the development of future community health interventions.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.48914","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T11:01:13Z","timestamp":1703156473000},"page":"e2348914","source":"Crossref","is-referenced-by-count":59,"title":["Residential Structural Racism and Prevalence of Chronic Health Conditions"],"prefix":"10.1001","volume":"6","author":[{"given":"Dinushika","family":"Mohottige","sequence":"first","affiliation":[{"name":"Institute for Health Equity Research, Department of Population Health, Icahn School of Medicine at Mount Sinai, New York, New York"},{"name":"Barbara T. 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Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa M.","family":"McElroy","sequence":"additional","affiliation":[{"name":"Division of Abdominal Transplant Surgery, Department of Surgery, Duke University, Durham, North Carolina"},{"name":"Department of Population Health, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Wang","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina"},{"name":"Department of Population Health, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley N.","family":"Cabacungan","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patti","family":"Ephraim","sequence":"additional","affiliation":[{"name":"Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Lantos","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina"},{"name":"Department of Pediatrics, Duke University, Durham, North Carolina"},{"name":"Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Peskoe","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Lunyera","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keisha","family":"Bentley-Edwards","sequence":"additional","affiliation":[{"name":"Duke Global Health Institute, Duke University, Durham, North Carolina"},{"name":"Duke Cancer Institute, Duke University, Durham, North Carolina"},{"name":"Samuel DuBois Cook Center on Social Equity, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa J.","family":"Diamantidis","sequence":"additional","affiliation":[{"name":"Division of General Internal Medicine, Department of Medicine, Duke University, Durham, North Carolina"},{"name":"Division of Nephrology, Department of Medicine, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian","family":"Reich","sequence":"additional","affiliation":[{"name":"Department of Statistics, North Carolina State University, Raleigh"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. 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