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Beyond Black and White: Relationships between Segregation, Environmental Burden, and Birth Outcomes among Black and Latino populations.

Publication ,  Journal Article
Fiffer, MR; Lilienfeld, A; Zephyr, D; Tootoo, JL; Soale, A-N; Bravo, MA; Miranda, ML
Published in: American journal of epidemiology
March 2026

Segregation measures over time likely mask the movement of Latinos into predominantly non-Hispanic Black (NHB) areas. Due to systematic disinvestment, the co-location of NHB and Latinos may correlate with environmental and social stressors. We construct a combined racial isolation (RI) measure for Blacks and Latinos for the 72 246 contiguous U.S. census tracts. We compare trends (1990-2015) in RI of NHB individuals and RI of NHB and Hispanic individuals (RI-NHB + H). We estimate correlations between RI-NHB + H and CDC Environmental Justice Index (EJI) components. We assess associations between EJI, RI-NHB + H, and birthweight percentiles using North Carolina detailed birth records (n = 504 363; 2015-2019). Between 1990-2015, RI-NHB + H and RI-NHB increased in most (88.7%) and the majority (69.1%) of U.S. census tracts, respectively. The largest local, spatial correlations between RI-NHB + H and EJI occurred in the southeast, southwest, and parts of the west coast, where both are high. For NHB and NHW mothers, the association between EJI and birthweight percentiles was increasingly negative at higher levels of RI-NHB + H. Among Hispanic mothers, the association was negative at mid RI levels, but not at high RI levels. Our results underscore the changing nature of segregation in the U.S. and illuminate cumulative impacts experienced by NHB and Latino populations on reproductive health.

Duke Scholars

Published In

American journal of epidemiology

DOI

EISSN

1476-6256

ISSN

0002-9262

Publication Date

March 2026

Start / End Page

kwag051

Related Subject Headings

  • Epidemiology
  • 4202 Epidemiology
 

Citation

APA
Chicago
ICMJE
MLA
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Fiffer, M. R., Lilienfeld, A., Zephyr, D., Tootoo, J. L., Soale, A.-N., Bravo, M. A., & Miranda, M. L. (2026). Beyond Black and White: Relationships between Segregation, Environmental Burden, and Birth Outcomes among Black and Latino populations. American Journal of Epidemiology, kwag051. https://doi.org/10.1093/aje/kwag051
Fiffer, Melissa R., Aaron Lilienfeld, Dominique Zephyr, Joshua L. Tootoo, Abdul-Nasah Soale, Mercedes A. Bravo, and Marie Lynn Miranda. “Beyond Black and White: Relationships between Segregation, Environmental Burden, and Birth Outcomes among Black and Latino populations.American Journal of Epidemiology, March 2026, kwag051. https://doi.org/10.1093/aje/kwag051.
Fiffer MR, Lilienfeld A, Zephyr D, Tootoo JL, Soale A-N, Bravo MA, et al. Beyond Black and White: Relationships between Segregation, Environmental Burden, and Birth Outcomes among Black and Latino populations. American journal of epidemiology. 2026 Mar;kwag051.
Fiffer, Melissa R., et al. “Beyond Black and White: Relationships between Segregation, Environmental Burden, and Birth Outcomes among Black and Latino populations.American Journal of Epidemiology, Mar. 2026, p. kwag051. Epmc, doi:10.1093/aje/kwag051.
Fiffer MR, Lilienfeld A, Zephyr D, Tootoo JL, Soale A-N, Bravo MA, Miranda ML. Beyond Black and White: Relationships between Segregation, Environmental Burden, and Birth Outcomes among Black and Latino populations. American journal of epidemiology. 2026 Mar;kwag051.
Journal cover image

Published In

American journal of epidemiology

DOI

EISSN

1476-6256

ISSN

0002-9262

Publication Date

March 2026

Start / End Page

kwag051

Related Subject Headings

  • Epidemiology
  • 4202 Epidemiology