Political Economies of Acute Childhood Illnesses: Measuring Structural Racism as Mesolevel Mortgage Market Risks

Objectives: Health studies of structural racism/discrimination have been animated through the deployment of neighborhood effects frameworks that engage institutional­ist concerns about sociopolitical resources and mobility structures. This study high­lights the acute illness risks of place-based inequalities and neighborhood-varying race-based inequalities by focusing on access to and the regulation of mortgage markets.Design: By merging neighborhood data on lending processes from the Home Mortgage Disclosure Act with individual health from the Project on Human Development in Chicago Neighborhoods, this article evalu­ates the acute childhood illness risks of four mutually inclusive, political economies using multilevel generalized linear models.Setting: Chicago, IL, USAParticipants: Youth aged 0 to 17 yearsMethods: Multilevel logistic regressionMain Outcome Measures: The prevalence of 11 acute illnesses (cold/flu, sinus trouble, sore throat/tonsils, headache, upset stom­ach, bronchitis, skin infection, pneumonia, UTI, fungal disease, mononucleosis) and the past-year frequencies of 6 acute illnesses (cold/flu, sinus trouble, sore throat/tonsils, headache, upset stomach, bronchitis) are evaluated.Results: The most theoretically consistent predictor of illness is a measure identifying neighborhoods with above-city-median levels of racial disparities in the regulation of loans – a mesolevel measure of structural racism. In areas with high levels of Minority- White differences in less regulated credit, youth are more likely to have a range of acute illnesses and experience them at more frequent intervals in the past year.Conclusions: This article highlights the substantive and methodological importance of focusing on multidimensional representa­tions of institutionalized political economic inequalities circumscribed and traversed by the power relations established by institu­tions and the state.Ethn Dis.2021;31(Suppl1):319-332; doi:10.18865/ed.31.S1.319