Does social selection explain the association between state-level racial animus and racial disparities in self-rated health in the United States?

Abstract

PurposeRacism, whether defined at individual, interpersonal, or structural levels, is associated with poor health among Blacks. This association may arise because exposure to racism causes poor health, but geographic mobility patterns pose an alternative explanation—namely, Black individuals with better health and resources can move away from racist environments. MethodsWe examine the evidence for selection effects using nationally representative, longitudinal data (1990–2009) from the Panel Study on Income Dynamics (n = 33,852). We conceptualized state-level racial animus as an ecologic measure of racism and operationalized it as the percent of racially-charged Google search terms in each state. ResultsAmong those who move out of state, Blacks reporting good self-rated health (SRH) are more likely to move to a state with less racial animus than Blacks reporting poor SRH (P = .01), providing evidence for at least some selection into environments with less racial animus. However, among Blacks who moved states, over 80% moved to a state within the same quartile of racial animus, and fewer than 5% resided in states with the lowest level of racial animus. ConclusionsGeographic mobility patterns are therefore likely to explain only a small part of the relationship between racial animus and SRH. These results require replication with alternative measures of racist attitudes and health outcomes.