Individual and Contextual Risks of Death among Race and Ethnic Groups in the United States

Stephanie A. Bond Huie, U.S. Department of Health and Human Services (DHHS)

This paper examines the effects of both individual- and contextual-level factors on black/white and multiple Hispanic subgroup (Mexican-Americans, Puerto Ricans, and other Hispanic) differentials in adult (ages 18-64) mortality. In addition, we use a new, innovative, and more appropriate geographic area - the very small area (VSA) - as our unit of analysis at the contextual level. We employ the 1986-1997 National Health Interview Survey-National Death Index (NHIS-NDI) linked file and Cox proportional hazards models to reveal that higher mortality risks are associated with not only individual characteristics, but also neighborhood characteristics. Findings also indicate that 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. In addition, Hispanics/Latinos ages 45-64 in neighborhoods with a high percent foreign born experience lower risks of mortality than other individuals even net of controls for individual-level nativity and socioeconomic status.