The study tested whether childhood residential racial segregation causes later cardiovascular disease (CVD) or hypertension. Railroad layouts in Northern US cities, set before the Great Migration, served as an instrument for segregation. Ananat's railroad data were linked to the birthplaces of 829 Black and 1,262 White Panel Study of Income Dynamics participants. Race-stratified accelerated failure time models followed them to 2023, adjusting for other railroad features, socioeconomic status and birth year. Segregation was estimated to delay onset of CVD or hypertension in White people and to hasten it in Black people. Instrument strength and confidence intervals varied by model, and standard confounder-adjusted models showed much weaker effects in the same direction.
Why it is interesting: Most evidence linking segregation to heart disease is associational. This study uses a natural experiment to test whether childhood segregation causes Black–White differences in cardiovascular disease onset.
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