“Our manuscript extends previous work in that it examines the specific question of racial inequalities and their contribution to racial health disparities.”

The efforts to understand and address persistent racial disparities in health and length of life are moving toward more comprehensive models that seek to understand the social contexts within which such disparities are produced. In this paper—using the Detroit metropolitan area as a case study—my colleagues and I propose, and provide evidence in support of, a conceptual framework for understanding the contribution of race-based residential segregation to persistent inequalities in the health of African American residents in aging urban areas in comparison to that of white Americans. Because the manuscript describes a conceptual framework, it also suggests a number of hypotheses that may be empirically tested, and scholars seeking to test those hypotheses may cite the underlying argument that is presented in the paper.

The conceptual model described in the paper draws upon and extends previous work that has proposed that social inequalities contribute to longstanding disparities in health. Our manuscript extends previous work in that it examines the specific question of racial inequalities and their contribution to racial health disparities. We draw upon empirical research to propose a series of pathways through which racial segregation may contribute to obdurate racial inequalities in health. The conceptual linkages made in the paper may be useful to others seeking to understand the social contexts within which such disparities are produced.

The conceptual model and empirical support that are presented in the manuscript offer a framework for examining a set of complex phenomenon and their potential interrelationships. We suggest specifically that racial disparities in health must be understood within the social and historical contexts within which they are produced, including underlying inequalities that influence access to the resources that are necessary to maintain health. These underlying inequalities influence multiple health outcomes, and continue to produce racial disparities in health even as the major causes of death change over time. This work builds on models that have been proposed by others who have examined these processes in relation to socioeconomic disparities in health: our application to racial disparities in health seeks to extend earlier models to encompass an understanding of relationships between racial and socioeconomic inequalities.

I became involved through efforts to understand and address the social conditions that influence health in urban communities.