Invisible and unequal

Unincorporated community status as a structural determinant of health

Bibliographic Data

ID4599898
AuthorsCristina Gomez-Vidal (University of California, Berkeley, corresponding author), Anne M Gomez (0000-0002-9461-4411, University of California, Berkeley), Anu Manchikanti Gomez
Year2021
Volume285
Pages114292
Publication date2021-09-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSocial Science & Medicine (JOURNAL)
Journal identifiersISSN: 0277-9536 • E-ISSN: 1873-5347
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.socscimed.2021.114292
PMID34411968
OpenAlexW3192489097
LanguageEN
Citations received7
References cited66

Despite increasing awareness of the importance of political determinants of health, place-based research has not interrogated one of the most common political statuses: the impact of living in a community without municipal incorporation. In 2010 an estimated 37% of the U.S. population lived in an unincorporated area; despite their ubiquity, unincorporated communities are largely absent from the public health literature. Residents of unincorporated areas typically do not have their own local (e.g., city or municipal) government. This lack of representation leads to political exclusion and diminished access to resources, especially for low-income communities of color, Furthermore, by not disaggregating health data to unincorporated communities, residents are subsumed into county or census tract data that may not be reflective of their community's composition or context. Without jurisdictional distinction in research, there is no accountability for the manufacturing of health inequities in unincorporated communities . In the absence of empirical research on unincorporated communities, this paper uses the Commission on Social Determinants of Health (CSDH) Framework of the World Health Organization to argue that lack of municipal status is a structural determinant of health responsible for social conditions which generate cumulative health risks for residents. This includes using existing evidence on social conditions typical of unincorporated communities to describe patterns of residential segregation, neighborhood disadvantage, and environmental hazards that may increase residents' exposure to unhealthy environments in unincorporated communities. Finally, we provide an agenda for future public health research that can begin to address this health and racial equity gap for low-income unincorporated communities of color who have, until now, been absent in health equity discourse

Context (archaeology · Environmental health · Geography · Health equity · Political science · Politics · Population · Public health · Social determinants of health · Sociology · Environmental Justice and Health Disparities · Food Security and Health in Diverse Populations · Health disparities and outcomes · Medicine

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