A Two–stage Bayesian Model for Assessing the Geography of Racialized Economic Segregation and Premature Mortality Across US Counties

Racialized economic segregation, a key metric that simultaneously accounts for spatial, social and income polarization in communities, has been linked to adverse health outcomes, including morbidity and mortality. Due to the spatial nature of this metric, the association between health outcomes and racialized economic segregation could also change with space. Most studies assessing the relationship between racialized economic segregation and health outcomes have always treated racialized economic segregation as a fixed effect and ignored the spatial nature of it. This paper proposes a two–stage Bayesian statistical framework that provides a broad, flexible approach to studying the spatially varying association between premature mortality and racialized economic segregation while accounting for neighborhood–level latent health factors across US counties. The two–stage framework reduces the dimensionality of spatially correlated data and highlights the importance of accounting for spatial autocorrelation in racialized economic segregation measures, in health equity focused settings.