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Title:Beyond behavior: An intersectional analysis of the impact of sexual networks, segregation, and incarceration on disparities in STDs
Author(s):Henderson, Loren
Director of Research:Zerai, Assata
Doctoral Committee Chair(s):Mendenhall, Ruby
Doctoral Committee Member(s):Zerai, Assata; Chapa, Jorge; Liao, Tim F.
Department / Program:Sociology
Discipline:Sociology
Degree Granting Institution:University of Illinois at Urbana-Champaign
Degree:Ph.D.
Genre:Dissertation
Subject(s):racial health disparities
intersectionality
sexual networks
residential segregation
ex-offender reentry
Abstract:There are approximately 19 million new cases of sexually transmitted diseases (STDs) in the United States every year (Satterwhite et al., 2008).. Although the entire society is encumbered by the economic impact of STDs, the burden of these diseases is not equally borne along racial and gender lines. In particular, African Americans report substantially higher rates of chlamydia, gonorrhea, and syphilis than do Whites. Generally, women report higher rates of these diseases than do men. Using an intersectional analytical framework, the first part of this research analyzes data from the 2006-2010 National Survey of Family Growth to examine the extent to which sexual network factors matter above and beyond individual-level sexual behavior and sociodemographic factors in accounting for STDs. In addition, it seeks to determine the degree to which sexual network factors account for the gaps in STDs among various race by gender groups. The results from multivariate logistic regression analyses suggest that, net of sociodemographic and behavioral factors, the main effects of the sexual network factors are consistent with the predictions derived from sexual network theory (i.e., four out of five hypotheses). However, factors associated with sexual network theory do not appear to go very far in terms of explaining the racial and gender gaps in STDs. The second part of the research uses an intersectional analytical framework to assess factors consistent with an “American apartheid” perspective. It uses indicators compiled into a single dataset in which county (n=3,089) is the unit of analysis. The analysis examines the relationship of chlamydia rates and gonorrhea rates to racial isolation—a type of residential segregation that measures the extent to which a member of a racial or ethnic group is likely to be in contact with members of this same group (as opposed to members of other groups). The analysis examines the relationship between both black isolation and white isolation and STD rates, net of other community-level factors that are associated with STDs. The analysis also compares the relationship of black isolation and white isolation to chlamydia rates for “white” counties, “integrated” counties, and “disproportionately black” counties. This research lends support to earlier studies that demonstrate that concentrated disadvantage through high black isolation is related to higher STD rates. But this research also adds to the literature by also showing that white isolation is associated with lower rates of chlamydia. Disparities in STD rates between disproportionately black counties and white counties would be greatly diminished if racial isolation were eliminated. Overall rates of chlamydia would decline by more than 33% if black isolation were eliminated. The results illustrate how powerfully residential segregation is related to STDs rates. The third part of the research uses an intersectional analytical framework to examine the relationship between incarceration rates, being a community that serves as a reentry point for those formerly incarcerated, and STD rates. The analysis is based on county-level indicators compiled into a single dataset in which county (n=3,089) is the unit of analysis. The analysis examines the relationship of reentry locations and incarceration rates to STD rates, net of other community-level factors that are associated with STDs. These relationships are examined in disproportionately black communities, white communities, and integrated communities. The results suggest that communities that serve as reentry points for those who have been incarcerated have significantly higher rates of STDs, net of other community-level factors that are associated with STDs. These reentry locations are more likely to be located in disproportionately black communities, and they help explain part of the relationship between racial isolation and STDs. This study remains faithful to the tenets of intersectionality not only because it examines differences in race by gender groups, but also by taking into account residential segregation and contextual variables that are related to disparities in STDs. Moreover, this research looks at reentry locations as a way of measuring the impact of incarceration on the communities to which former prisoners return. This study is first to use national data to examine these factors in this way. Persisting disparities in STDs in the U.S. is a stubborn problem that defies simple explanations. Differences in sexual behaviors do not account for the disparities. When sexual network factors are taken into account, the gaps become even larger. Community-level factors such as racial segregation and incarceration reentry location appear to hold promise.
Issue Date:2014-05-30
URI:http://hdl.handle.net/2142/49810
Rights Information:Copyright 2014 Loren Henderson
Date Available in IDEALS:2014-05-30
2016-09-22
Date Deposited:2014-05


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