This article explores the relationship between metropolitan fragmentation, as defined by the total number of governmental units within a metropolitan statistical area (local municipalities, special service districts, and school districts), and racial disparities in mortality among Backs and Whites in the 1990s. The presence of numerous governmental jurisdictions in large metropolitan areas in the United States can shape the geography of opportunity, with adverse consequences for health.
The authors conducted a regression analysis using U.S. Census of Government data and Compressed Mortality File data for the country's largest 171 metropolitan statistical areas.
The authors found a link between increased metropolitan area fragmentation and greater racial differences in mortality between Blacks and Whites for both children and working-age adults. Although increasing fragmentation is associated with a higher mortality rate for Blacks, it is not associated with a higher mortality rate for Whites. Their findings suggest that research is needed to understand how governance can positively or negatively influence a population's health and create conditions that generate or exacerbate health disparities.