Racial Disparities Among US Neighborhoods May Have Implications for Health Outcomes


Large geographical data may offer insight on race and ethnic health inequities across the United States.

A new study has found that predominantly White neighborhoods had more green spaces, fewer dilapidated buildings, and more single-family homes compared with neighborhoods with mostly Black residents or other minoritized racial or ethnic groups.

This observational study was published in Jama Network Open.

“Large datasets on determinants of health can help us better understand the associations between past and present policies—including racist and antiracist policies—and neighborhood health outcomes,” said corresponding author, Elaine O. Nsoesie, PhD, MS, associate professor of global health at Boston University School of Public Health, in a statement.

Using satellite images and neighborhood demographics, the researchers of this study aimed to identify an association between built environment and neighborhood racial composition and health.

The data for this study included 164 million Google Street View images from November 1-30, 2019. Race, ethnicity, and socioeconomic information came from the 2019 American Community Service 5-year estimates, and information on health outcomes came from the CDC’s 2020 Population Level Analysis and Community Estimates data set, which surveyed residents 18 years and older from May 23 to November 16, 2022.

The study included 59,231 urban census tracts and observed 5 neighborhood characteristics: dilapidated buildings, green spaces, crosswalks, multifamily homes, and single-lane roads. The census tract was 1160,595 (0.4%) American Indian and Alaska Native; 53,321,345 (19.5%) Hispanic; 462,259 (0.2%) Native Hawaiian and other Pacific Islander; 17,166,370 (6.3%) non-Hispanic Asian; 35,958,480 (13.2%) non-Hispanic Black; and 158,043,260 (57.7%) non-Hispanic White residents.

The largest inequities were associated with green spaces and multifamily homes. Predominantly Black neighborhoods had 2% (P < .001) less green space than White neighborhoods, and other racial minority neighborhoods had 11% (P < .001)less green space. Additionally, compared with White neighborhoods, neighborhoods with racial minorities other than Black had 17% (P < .001) more multifamily houses.

Compared with White neighborhoods, all other neighborhoods had more dilapidated buildings. Minoritized racial and ethnic groups other than Black had an average 6% (P < .001) more dilapidated buildings, and predominantly Black neighborhoods had less than 1% (P = .03) more dilapidated buildings compared with predominantly White neighborhoods.

Neighborhoods with predominantly Black residents had the highest rates of sleeping problems (total effect size, 7.66%; 95% CI, 7.57%-7.75%; P < .001) and diabetes (total effect size, 4.95%; 95% CI, 4.88%-5.03%; P < .001), followed by neighborhoods with predominantly minoritized groups other than Black residents. Predominantly Black neighborhoods also had a higher prevalence of asthma (total effect size, 1.40%; 95% CI, 1.37%-1.43%; P < .001) compared with predominantly White neighborhoods. 

Compared with other neighborhoods, predominantly White neighborhoods had fewer dilapidated buildings, more green space, and fewer crosswalks. Neighborhoods with predominantly minoritized racial or ethnic groups other than Black residents had more dilapidated buildings than predominantly White neighborhoods. Furthermore, a built environment was associated with structural racism and redlining of neighborhoods, resulting in segregated communities, poor housing conditions, unwalkable neighborhoods, and other disadvantages for people of color that determine social detriments of health.

"Our findings really demonstrate the path-dependent nature of inequality and racial disparities,” said study co-lead author Ahyoung Cho, a racial data/policy tracker at CAR and a political science PhD student at Boston University, in a statement. “It is critical to develop appropriate policies to address structural racism.”


Yang Y, Cho A, Nguyen Q, Nsoesie EO. Association of neighborhood racial and ethnic composition and historical redlining with built environment indicators derived from street view images in the US. JAMA Network Open. 2023;6(1). doi:10.1001/jamanetworkopen.2022.51201

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