The association between ethnic density and poor self-rated health among US Black and Hispanic people.

OBJECTIVE: US studies have found that members of ethnic minority groups may have better mental health when they live in areas with a higher concentration of people of the same ethnicity. We investigate if the same effect is found for self-rated health in a population based sample of US Black and Hispanic people.

DESIGN: We used multilevel logistic regression to test whether or not same-ethnic density, measured at the level of the Metropolitan Statistical Area (MSA), using the US census 2000, was associated with self-rated health amongst 3117 Black men, 4288 Black women, 6253 Hispanic men and 6534 Hispanic women from the US Current Population Survey, Annual Demographic File, 2000, after adjustment.

RESULTS: When ethnic density was modelled as a categorical variable, but not as a linear variable, there was a significant association between ethnic density and poor self-rated health for Black men and women. Relative to those living at same-ethnic densities of 0-4.9%, living at densities of greater than 5% was associated with increased risk of poor self-rated health, with the greatest incremental difference being for relatively small increases in ethnic density from 0-4.9% to 5-9.9% (odds ratio [OR] 1.85, 95% confidence interval [CI] 1.16-2.94), with subsequent increases in ethnic density having limited impact. The OR for densities of 10-14.9% was 2.03, 95% CI 1.23-3.34; for densities of 15-24.9% the OR was 2.19, 95% CI 1.33-3.62 and for densities of 25-50% the OR was 2.21, 95% CI 1.28-3.81. For Hispanics there was a significant interaction between gender and same-ethnic density. For women, higher levels of same-ethnic density were associated with a reduced risk of poor self-rated health. Conversely, for men greater ethnic density was linked to an increased risk.

CONCLUSIONS: Associations between ethnic density and self-rated health are inconsistent and differ by ethnicity and gender.