Systemic racism: individuals and interactions, institutions and society

Systemic racism is a scientifically tractable phenomenon, urgent for cognitive scientists to address. This tutorial reviews the built-in systems that undermine life opportunities and outcomes by racial category, with a focus on challenges to Black Americans. From American colonial history, explicit practices and policies reinforced disadvantage across all domains of life, beginning with slavery, and continuing with vastly subordinated status. Racially segregated housing creates racial isolation, with disproportionate costs to Black Americans’ opportunities, networks, education, wealth, health, and legal treatment. These institutional and societal systems build-in individual bias and racialized interactions, resulting in systemic racism. Unconscious inferences, empirically established from perceptions onward, demonstrate non-Black Americans’ inbuilt associations: pairing Black Americans with negative valences, criminal stereotypes, and low status, including animal rather than human. Implicit racial biases (improving only slightly over time) imbed within non-Black individuals’ systems of racialized beliefs, judgments, and affect that predict racialized behavior. Interracial interactions likewise convey disrespect and distrust. These systematic individual and interpersonal patterns continue partly due to non-Black people’s inexperience with Black Americans and reliance on societal caricatures. Despite systemic challenges, Black Americans are more diverse now than ever, due to resilience (many succeeding against the odds), immigration (producing varied backgrounds), and intermarriage (increasing the multiracial proportion of the population). Intergroup contact can foreground Black diversity, resisting systemic racism, but White advantages persist in all economic, political, and social domains. Cognitive science has an opportunity: to include in its study of the mind the distortions of reality about individual humans and their social groups.

Assessing Disparity Using Measures of Racial and Educational Isolation

We develop a local, spatial measure of educational isolation (EI) and characterize the relationship between EI and our previously developed measure of racial isolation (RI). EI measures the extent to which non-college educated individuals are exposed primarily to other non-college educated individuals. To characterize how the RI-EI relationship varies across space, we propose a novel measure of local correlation. Using birth records from the State of Michigan (2005–2012), we estimate associations between RI, EI, and birth outcomes. EI was lower in urban communities and higher in rural communities, while RI was highest in urban areas and parts of the southeastern United States (US). We observed greater heterogeneity in EI in low RI tracts, especially in non-urban tracts; residents of high RI tracts are likely to be both educationally and racially isolated. Associations were also observed between RI, EI, and gestational length (weeks) and preterm birth (PTB). For example, moving from the lowest to the highest quintile of RI was associated with a 1.11 (1.07, 1.15) and 1.16 (1.10, 1.22) increase in odds of PTB among NHB and NHW women, respectively. Moving from the lowest to the highest quintile of EI was associated with a 1.07 (1.02, 1.12) and 1.03 (1.00, 1.05) increase in odds of PTB among NHB and NHW women, respectively. This work provides three tools (RI, EI, and the local correlation measure) to researchers and policymakers interested in how residential isolation shapes disparate outcomes.

Lead Emissions and Population Vulnerability in the Detroit Metropolitan Area, 2006–2013: Impact of Pollution, Housing Age and Neighborhood Racial Isolation and Poverty on Blood Lead in Children

This research investigates the relationships between airborne and depositional industrial lead emission concentrations modeled using Environmental Protection Agency’s (EPA’s) American Meteorological Society/Environmental Protection Agency Regulatory Model (AERMOD) and childhood blood lead levels (BLL) in the Detroit Metropolitan Area (DMA) 2006–2013. Linear and mediation interaction regression models estimated the effects of older housing and airborne and depositional lead emission concentrations on black and white childhood BLLs, controlling for neighborhood levels of racial isolation and poverty—important social structures in the DMA. The results showed a direct relationship between airborne and depositional lead emissions and higher childhood BLL, after controlling for median housing age. Lead emissions also exacerbated the effect of older housing on black and white children’s BLLs (indirect relationship), after controlling for social structures. Findings from this research indicate that black and white children exposed to lead-based paint/pipes in older housing are further impacted by industrial lead pollution that may lead to permanent neurological damage.

Abstract P881: Geospatial Analysis of Community and Patient Risk Factors for Poor Functional Outcome in Stroke

Introduction: Low neighborhood socioeconomic status has been associated with increased stroke risk, but it is not clear if this association is independent of individual socioeconomic status and clinical risk. Neighborhood racial segregation as defined by a racial isolation index (RI) has been shown to be associated with increased risk of stroke mortality. Using geospatial mapping techniques, we sought to determine the impact of neighborhood socioeconomic status and racial isolation on post-stroke functional outcome. Methods: Using our center’s prospective stroke registry, we matched charts for ischemic stroke patients seen between 1/1/2008 and 12/31/2018 with address data obtained from our hospital EMR for geospatial mapping. Racial Isolation (RI) and Neighborhood Deprivation Index (NDI) were calculated using census data. To assess the relationship between neighborhood factors and functional outcome, we used geographically weighted regression models. We fitted univariate and multivariate multinomial logistic regression models for functional outcome, and linear regression models for the percentage of poor functional outcome (defined as mRS 4-6). Significance was determined to be p < 0.05. Results: We included 5204 patients across 786 county census tracts. NDI (range -1.75 to 3.79) and RI (range 0 to 1) both appear to correlate visually with stroke rates of our patients across individual census tracts (Figure 1). Hypertension, diabetes, and dyslipidemia rates at individual and census tract level were significantly associated with poor functional outcome. NDI was not (OR 1.00 95% CI 0.99 - 1.00), but RI trended significant (OR 1.04 95% CI (0.99 - 1.09). Overall explanatory power was limited, warranting further investigation. Conclusions: Patient’s individual risk factors increased likelihood of poor functional outcome, but community segregation and socioeconomic deprivation indices are not predictors of poor functional outcome.

Subsidized housing and school segregation: Examining the relationship between federally subsidized affordable housing and racial and economic isolation in schools

Each year, the federal government provides billions of dollars in support for low-income families in their acquisition of housing. In this analysis, we examine how several of these subsidized housing programs, public housing and Low Income Housing Tax Credit (LIHTC) financed housing, relate to patterns of school segregation for children. We use GIS to examine the location of subsidized housing vis-à-vis district boundaries and school attendance boundaries in four Texas counties. We then examine patterns of segregation between schools with and without subsidized housing in their attendance zones, as well as the extent of economic and racial isolation experienced by students in those schools. Our results illustrate that public housing and LIHTC housing developments are zoned to racially and economically isolated schools, and that developments are associated with especially high levels of economic and racial isolation for Black and Latinx students. We conclude by discussing implications for housing and education policy to ameliorate these patterns.

Geosocial Factors Associated With Adherence to Statin Medications

Background: Individual patient characteristics, social determinants, and geographic access may be associated with patients engaging in appropriate health behaviors. Objective: To assess the relationship between statin adherence, geographic accessibility to pharmacies, and neighborhood sociodemographic characteristics in Michigan. Methods: The proportion of days covered (PDC) was calculated from pharmacy claims of a large insurer of adults who had prescriptions for statins between July 2009 and June 2010. A PDC ≥0.80 was defined as adherent. The predictor of interest was a ZIP code tabulation area (ZCTA)-level measure of geographic accessibility to pharmacies, measured using a method that integrates availability and access into a single index. We fit unadjusted models as well as adjusted models controlling for age, sex, and ZCTA-level measures of socioeconomic status (SES), racial isolation (RI) of non-Hispanic blacks, and urbanicity. Results: More than 174 000 patients’ claims data were analyzed. In adjusted models, pharmacy access was not associated with adherence (0.99; 95% CI: 0.96, 1.03). Greater RI (0.87; 95% CI: 0.85, 0.88) and urban status (0.93; 95% CI: 0.89, 0.96) were associated with lower odds of adherence. Individuals in ZCTAs with higher SES had higher odds of adherence, as were men and older age groups. Conclusion and Relevance: Adherence to statin prescriptions was lower for patients living in areas characterized as being racially segregated or lower income. Initiating interventions to enhance adherence, informed by understanding the social and systematic barriers patients face when refilling medication, is an important public health initiative that pharmacists practicing in these areas may undertake.

Choice without Inclusion?: Comparing the Intensity of Racial Segregation in Charters and Public Schools at the Local, State and National Levels

We conduct descriptive and inferential analyses of publicly available Common Core of Data (CCD) to examine segregation at the local, state, and national levels. Nationally, we find that higher percentages of charter students of every race attend intensely segregated schools. The highest levels of racial isolation are at the primary level for public and middle level for charters. We find that double segregation by race and class is higher in charter schools. Charters are more likely to be segregated, even when controlling for local ethnoracial demographics. A majority of states have at least half of Blacks and a third of Latinx in intensely segregated charters. At the city level, we find that higher percentages of urban charter students were attending intensely segregated schools.

Segregation and the Cost of Money: Race, Poverty, and the Prevalence of Alternative Financial Institutions

Payday lenders, check cashers, and other “alternative” financial services (AFS) have garnered attention from policymakers and advocates for the poor because they are more expensive than traditional banking—constituting what some call a “Ghetto Tax.” This is the first study to explore neighborhood-level AFS geography on the national scale. Leveraging a dataset comprising the universe of AFS in 2015, I show that not only are there substantial differences in AFS presence between white and non-white neighborhoods, but that these disparities are largest in the most segregated metropolitan areas. This finding supports theories that racial segregation creates easily identifiable markets for institutions to avoid, target, and exploit. I further show that while AFS presence declines with neighborhood income, the gap between black and white neighborhoods is widest among high-income neighborhoods, reflecting the unique vulnerability of even affluent blacks to institutional marginalization. This work documents how the overlapping geographies of racial isolation and AFS prevalence shape the very cost of money for different racial groups, illustrating the importance of institutions transmitting the effects of racial isolation.