Population Research and Policy Review 23: 309–326, 2004.
© 2004 Kluwer Academic Publishers. Printed in the Netherlands.
Multiple meanings of minority concentration: Incorporating
contextual explanations into the analysis of individual-level U.S.
black mortality outcomes
TROY C. BLANCHARD, JERALYNN S. COSSMAN & MARTIN L.
Mississippi State University
Abstract. Prior research on mortality for U.S. blacks focuses on the detrimental effects of
minority concentration and residential segregation in metropolitan areas on health outcomes.
To date, few studies have examined this relationship outside of large U.S. central cities. In this
paper, we extend current research on the minority concentration and mortality relationship
to explain the rural advantage in mortality for nonmetropolitan blacks. Using data from the
1986-1994 linked National Health Interview Survey/National Death Index, we examine the
rural-urban gap in mortality for U.S. blacks. Our ﬁndings indicate that blacks in nonmetro-
politan areas experience a lower risk of mortality than metropolitan central city blacks after
indicators of socio-economic and health status are controlled. Our ﬁndings also point to the
importance of accounting for contextual factors. Net of individual level controls, minority
concentration exerts differential effects across metropolitan and nonmetropolitan areas, such
that nonmetropolitan black residents experience a lower risk of mortality in high minority
concentration areas than blacks in metropolitan central city areas. This ﬁnding suggests a
reconceptualization of the meaning for minority concentration with respect to studies of health
outcomes in nonmetropolitan communities.
Keywords: Minority concentration, mortality, rural-urban
Social scientists have long sought to explain rural-urban differences in
measures of health and socio-economic well-being. Compared to urban com-
munities, rural communities consistently exhibit lower rates of age-adjusted
mortality despite lower levels of health care access, higher rates of poverty,
and spatial isolation from the job opportunities available in large metro-
politan areas (McLaughlin et al. 2001; Clifford & Brannon 1985). Net of
economic barriers, such as poverty and inequality, population density, and
racial composition, rural residents experience a mortality advantage.
Although prior studies have acknowledged the rural-urban mortality gap
for the total population, few studies have examined whether the rural health
advantage extends to speciﬁc racial or ethnic segments of the population.