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Cited by 116Health disparities and outcomesRacial and Ethnic Identity ResearchPublic Health Policies and Education

Civil rights as determinants of public health and racial and ethnic health equity: Health care, education, employment, and housing in the United States

Open access
Hahn, R.A., Truman, B.I., Williams, D.R.·2018·SSM - Population Health
DOI 10.1016/j.ssmph.2017.10.006PMC PMC5730086
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Abstract

This essay examines how civil rights and their implementation have affected and continue to affect the health of racial and ethnic minority populations in the United States. Civil rights are characterized as social determinants of health. A brief review of US history indicates that, particularly for Blacks, Hispanics, and American Indians, the longstanding lack of civil rights is linked with persistent health inequities. Civil rights history since 1950 is explored in four domains-health care, education, employment, and housing. The first three domains show substantial benefits when civil rights are enforced. Discrimination and segregation in housing persist because anti-discrimination civil rights laws have not been well enforced. Enforcement is an essential component for the success of civil rights law. Civil rights and their enforcement may be considered a powerful arena for public health theorizing, research, policy, and action.

AI snapshot

Written from the paper’s full text.

TL;DR

This essay argues that civil rights laws and their enforcement are social determinants of health, using US history and selected evidence from health care, education, employment, and housing. It finds substantial health and social benefits when civil rights are enforced, but housing discrimination and segregation persist because enforcement has been weak.

Key findings

  • Civil rights laws and enforcement affect health by shaping other social determinants—health care, education, employment, and housing—and their public health benefits can be large and long term; enforcement is essential, because “unless implemented, civil rights are promises without benefit.”
  • In health care, Title VI of the Civil Rights Act and Medicare desegregation were associated with a 40% decline in nonWhite infant mortality from 1965 to 1971 (40 to 28 per 1,000 live births), a fall in the nonWhite:White infant mortality ratio from 1.90 to 1.65, and an estimated 38,600 Black infant deaths prevented between 1965 and 2002.
  • In education, court-ordered desegregation reduced the school dissimilarity index from 0.83 to 0.20 within 7 years; a $1000 per-student funding increase was associated with 1.4 additional years of completed education, 58% higher wages, $18,635 higher annual family income, 34% lower adult poverty, 2.1% lower adult incarceration, and a one-third to one-half reduction in the Black-White adult self-assessed health gap; each year in a desegregated school increased high school graduation likelihood by 2%.
  • In employment, after the 1972 Equal Employment Opportunity Act, relative employment of Black men increased by 0.5%–1.1% per year; Black women’s household service work in the South fell from >50% to <20%, white-collar employment rose by about 200% in the South and 300% in the North, wages rose from 64% of White women’s in 1960 to almost equal by 1980, and life expectancy at age 35 for Black women increased 2.6 years versus 1.5 years for White women from 1966 to 1975. In housing, enforcement remained weak: in the 2012 HUD survey, Black interviewers were informed of 17% fewer homes and shown 17.7% fewer homes than Whites, Asians were informed of 15.5% fewer and shown 18.8% fewer, about 1,760,000 annual discrimination incidents against Black home-seekers were estimated versus fewer than 4,000 racial discrimination claims in 2014 (about 0.2%), and Black homeownership was 25% lower than White homeownership, with the gap increasing slightly from 1970 to 2001.

Methods

  • This is an essay/review that proposes a framework for civil rights as a social determinant of health, reviews US civil rights history and major laws/court decisions, and presents illustrative evidence in four domains: health care, education, employment, and housing.
  • The author conducted searches for civil rights and health by subtopic in PubMed, Google, and Google Scholar, and searched reference lists; the paper states that few studies were found and none indicated negative health effects of civil rights laws or rulings.
  • The paper is not a systematic review; it reports health outcomes when assessed and also reports intermediate social determinants such as educational achievement, income, and employment, with most studies found examining effects on Black populations.

Limitations

  • The paper states that a systematic review of the topic is needed, that its goal is to provide illustrative examples rather than an exhaustive review, that few studies were found, and that most studies examined effects on Black populations.
  • The paper states that enforcement of civil rights has been uneven and incomplete, and that housing civil rights laws have been minimally enforced; it also notes that public health law literature has largely not examined the effects of civil rights laws and their enforcement.
  • Evident from the text: the evidence relies on selected observational and natural-experiment studies rather than a systematic synthesis, and the strength of evidence varies by domain, with housing showing persistent discrimination despite legal protections.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.ssmph.2017.10.006

Cites

59 of 59 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 82 cited sources checked · 0 supported · 0 flagged

  • Findingcitation

    Published literature has not examined the effects of civil rights laws and their enforcement.

    “Public health law studies have largely focused on laws explicitly addressing public health, and, published literature has not examined the effects of civil rights laws and their enforcement (Moulton et al., 2009; Gostin, Wiley & Frieden, 2015).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Moulton et al., 2009 source

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    • cites Gostin, Wiley & Frieden, 2015

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  • Findingown data

    Most of the studies the authors found examined effects on black populations.

    “While our hypothesis that the public health benefits of the implementation of civil rights laws can be large and long term probably applies to several racial and ethnic minority populations, most of the studies we found examined effects on black populations.”
    Quote in the paperNot a substantial claim
  • Findingcitation

    Following the 868 school desegregation orders, there was a notable increase in school district integration; the dissimilarity index fell from the 1968 mean of 0.83 to the substantially lower mean of 0.20 within 7 years.

    “Johnson found that, following the 868 school desegregation orders, there was a notable increase in school district integration; the dissimilarity index (ranging from 0—no segregation to 1—complete segregation) fell from the 1968 mean of 0.83 to the substantially lower mean of 0.20 within 7 years.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Johnson (2011)

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  • Findingcitation

    The gap in adult self-assessed health status between Blacks and Whites was reduced by between one third and one half.

    “Finally, the gap in adult self-assessed health status between Blacks and Whites was reduced by between one third and one half.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Johnson (2011)

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  • Findingcitation

    Four years following court-ordered desegregation, there was a mean increase of $1000 in per student expenditures, principally in high proportion Black school districts.

    “Four years following the court-ordered desegregation, there was also a mean increase of $1000 in per student expenditures – principally in high proportion Black school districts.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Johnson (2011)

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  • May combine two claims. 36
  • Classified as probably not a substantial claim. 7

  • May combine two claims.

    Findingown data

    The authors found few studies and none indicating negative health effects of civil rights laws or rulings.

    “We found few studies and none indicating negative health effects of civil rights laws or rulings.2”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingcitation

    The ratio of Black infant mortality rates in Jim Crow versus non Jim Crow states fell from 1.19 from 1960 through 1964 to 1.0 from 1970 until 2000, with no changes in similar comparisons for White infants.

    “The researchers find that the ratio of Black infant mortality rates in Jim Crow versus non Jim Crow states fell from 1.19 from 1960 through 1964 to 1.0 from 1970 until 2000, with no changes in similar comparisons for White infants.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Krieger et al. (2013) source

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    Findingcitation

    The increase of $1000 in school funding per student was associated with an additional 1.4 years of completed education, a 58% increase in wages, an increase of $18,635 in annual family income, a 34% reduction in annual prevalence of adult poverty, and a 2.1% reduction in annual incidence of adult incarceration among Black students, with little change for White students.

    “The increase of $1000 in school funding per student was associated with “an additional 1.4 years of completed education, a 58% increase in wages, an increase of $18,635 in annual family income, a 34% reduction in the annual prevalence of adult poverty, and a 2.1% reduction in the annual incidence of adult incarceration”—among Black students, with little change for White students.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Johnson (2011)

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  • May combine two claims.

    Findingcitation

    Black women born in the late 1960s were less likely to have low birthweight infants or infants with low APGAR scores than women born earlier, while no similar changes were found for White women.

    “Black women born in the late 1960s were less likely to have low birthweight infants or infants with low APGAR scores (indicating poor health and the need for immediate medical care) than women born earlier, while no similar changes were found for White women.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Almond and Chay (2006)

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  • May combine two claims.

    Findingcitation

    In the United States overall, between 1965 and 1971, the infant mortality rate among nonWhites (approximately 99% of whom were Black) fell by 40% from 40 to 28 per 1,000 live births, while the rate among Whites changed little and the nonWhite:White IMR ratio fell from 1.90 to 1.65-the largest decline since World War II.

    “In the United States overall, between 1965 and 1971, the IMR among nonWhites (approximately 99% of whom were Black) fell by 40% from 40 to 28 per 1,000 live births (Fig. 2), while the rate among Whites changed little and the nonWhite:White IMR ratio fell from 1.90 to 1.65—the largest decline since World War II Almond et al., (2006).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Almond et al., (2006)

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  • May combine two claims.

    Findingcitation

    There is an association between birth in states with Jim Crow laws and rates of estrogen negative breast cancer among black, but not among white women, suggesting a negative effect of the absence of civil rights enforcement.

    “Krieger similarly reports an association between birth in states with Jim Crow laws and rates of estrogen negative breast cancer among black, but not among white women (Krieger, Jahn & Waterman, 2017), thus again suggesting a negative effect of the absence of civil rights enforcement.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Krieger, Jahn & Waterman, 2017

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    The Fourteenth Amendment (1868) established that every individual born or naturalized in the United States is a citizen, and ensured that states may not deprive a citizen or resident of civil rights, including due process of law and equal protection.

    “The Fourteenth Amendment (1868) established that every individual born or naturalized in the United States is a citizen, and ensured that states may not deprive a citizen or resident of civil rights, including due process of law and equal protection Chemerinsky (2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Chemerinsky (2006)

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    Premisecitation

    The quality of educational opportunity varies greatly by community income level, and residential location affects access to educational resources and their long-term health consequences.

    “The quality of educational opportunity varies greatly by community income level, and residential location also powerfully affects access to educational resources and their long term health consequences Reardon and Owens (2014).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Reardon and Owens (2014)

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Although segregation in education was ruled illegal in Brown, the practice persisted.

    “Although segregation in education was ruled illegal, the practice persisted Fiel (2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fiel (2013) source

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  • May combine two claims.

    Interpretationcitation

    All domains of civil rights are mutually reinforcing when in place, and mutually harmful when unenforced.

    “Moreover, it is likely that all domains of civil rights are mutually reinforcing when in place, and mutually harmful when unenforced Reskin (2012).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Reskin (2012) source

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  • May combine two claims.

    Premisecitation

    Social determinants, including civil rights laws and their enforcement, affect health by affecting intermediate factors such as housing, employment, and transportation, which in turn affect the distribution of health risk and protective factors and the resources for prevention and treatment.

    “Social determinants, including civil rights laws and their enforcement, affect health by affecting intermediate factors such as housing, employment, and transportation which, in turn, affect the distribution of health risk and protective factors, such as pathogens and environmental toxins, and the resources for prevention and treatment (Hahn, 1995, Williams et al., 2008, Braveman and Gottlieb, 201”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Hahn, 1995

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    • cites Williams et al., 2008 source

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    • cites Braveman and Gottlieb, 2014 source

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  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationreasoning

    The public health benefits of the implementation of civil rights laws can be large and long term.

    “While our hypothesis that the public health benefits of the implementation of civil rights laws can be large and long term probably applies to several racial and ethnic minority populations, most of the studies we found examined effects on black populations.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The illustrative examples selected are sufficient to support the paper's general conclusions about the public health effects of civil rights laws.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisereasoning

    Governmental and official law enforcement efforts to deny Black Americans their civil rights guaranteed by the Constitution persisted at least until the 1950s when, beginning with Brown, organized efforts to dismantle Jim Crow laws began to work.

    “Governmental and official law enforcement efforts to deny Black Americans their civil rights guaranteed by the Constitution persisted at least until the 1950s when, beginning with Brown, organized efforts to dismantle Jim Crow laws began to work.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In the expansion of civil rights in U.S. history, states have played leading roles.

    “In the expansion of civil rights in U.S. history, states have played leading roles (Tarr, 1990, Hudnut, 1985, Brennan, 1977).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Tarr, 1990

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    • cites Hudnut, 1985

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    • cites Brennan, 1977 source

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  • May combine two claims.

    Premisecitation

    Racial and ethnic minority populations were excluded from civic participation and restricted in immigration and mobility, income and employment, marriage, and more, with substantial health consequences.

    “These racial and ethnic minority populations were excluded from civic participation and restricted in immigration and mobility, income and employment, marriage, and more, with substantial health consequences Steckel (1986).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Steckel (1986) source

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  • May combine two claims.

    Premisecitation

    Individuals and groups with predominant power and resources divide the world into categories such as "races" and allocate power and resources to some groups while withholding power and resources from others, rationalized by questionable ideologies of merit, capacity, or other criteria.

    “Individuals and groups with predominant power and resources divide the world into categories, such as “races”(Hill, 1996, Omi and Winant, 2014, Waldstreicher, 2010) and allocate power and resources to some groups while withholding power and resources from others, rationalized by questionable ideologies of merit, capacity, or other criteria.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Hill, 1996

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    • cites Omi and Winant, 2014

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    • cites Waldstreicher, 2010

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  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    The effects of civil rights law on public health are likely to also apply in other civil domains, such as justice, civic participation, and transportation.

    “Those effects are likely to also apply in other civil domains, such as justice, civic participation, and transportation.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The illustrative examples selected are sufficient to support the paper's general conclusions about the public health effects of civil rights laws.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Implementation of the Fifteenth Amendment was impeded for almost a century (1870-1970) as poll taxes, qualification tests, and other requirements limited access to the vote.

    “Implementation of the Fifteenth Amendment was impeded for almost a century (1870–1970) as poll taxes, qualification tests, and other requirements limited access to the vote Zinn (2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Zinn (2014)

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  • May combine two claims.

    Interpretationreasoning

    Civil rights laws and their enforcement affect other social determinants of health, such as education, housing, transportation, employment, and the system of justice, which causally affect the societal distribution of resources that in turn affect disease, injury, and health.

    “Civil rights laws and their enforcement are social determinants of health because they affect other social determinants of health, that is, elements of a society’s organization and process, such as education, housing, transportation, employment, and the system of justice, that causally affect the societal distribution of resources that in turn affect disease, injury, and health (Fig. 1).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The location and condition of housing affect occupants' safety, distance from polluted environments, access to community resources, and basic conditions of shelter.

    “The location and condition of housing affect occupants’ safety, distance from polluted environments, access to community resources, including transportation, food, recreation, employment, and financial institutions, as well as basic conditions of shelter (Galobardes et al., 2006a, Galobardes et al., 2006b).”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Galobardes et al., 2006a

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    • cites Galobardes et al., 2006b

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  • May combine two claims.

    Premisereasoning

    The civil rights and constitutional protections guaranteed to White Americans were theoretically available to Black Americans and other racial-ethnic minority Americans; for American Indians, only those not living in "Indian territories" were included.

    “Thus the civil rights and constitutional protections guaranteed to White Americans in the Constitution and amendments were theoretically available to Black Americans and other racial-ethnic minority Americans; for American Indians, only those not living in “Indian territories” were included.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    Overall, Black home ownership in the U.S. is 25% lower than that of Whites and the gap increased slightly from 1970 to 2001; only among those with the highest income did the gap decrease (from 13.9% to 11.9%).

    “Overall, Black home ownership in the U.S. is 25% lower than of that of Whites and the gap increased slightly from 1970 to 2001; only among those with the highest income did the gap decrease (from 13.9% to 11.9%) Herbert (2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Herbert (2005)

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  • May combine two claims.

    Premisecitation

    In contrast, white-collar employment among White women increased by 17% in the south and 7% in the rest of the nation.

    “In contrast, white-collar employment among White women increased by 17% in the south and 7% in the rest of the nation Kaplan et al. (2008).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kaplan et al. (2008)

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  • May combine two claims.

    Study design and conductcitation

    Johnson controlled for an array of potential confounding, comparing siblings exposed and not exposed to court-ordered desegregation, and also controlled for policies related to the War on Poverty, Head Start, and community political affiliations associated with segregationist policies.

    “Johnson controlled for an array of potential confounding, comparing siblings exposed and not exposed (having completed school prior to desegregation) to court ordered desegregation, also controlled for policies related to the War on Poverty, and Head Start, and community political affiliations associated with segregationist policies.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Johnson (2011)

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  • May combine two claims.

    Premisecitation

    There was little change in school segregation following Brown until the late 1960s, followed by a substantial decline in segregation at least until the mid-1980s.

    “There was little change in school segregation following Brown until the late 1960s, followed by a substantial decline in segregation at least until the mid-1980s Reardon and Owens (2014).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Reardon and Owens (2014)

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  • May combine two claims.

    Premisecitation

    While in 1960, the wages of Black women were 64% of those of White women, by 1980, wages were almost equal.

    “Similarly, while in 1960, the wages of Black women were 64% of those of White women, by 1980, wages were almost equal.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kaplan et al. (2008)

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  • May combine two claims.

    Premisecitation

    The proportion of Black women reporting household service work in southern states declined from >50% to <20%, and by 1980 the proportion of Black women reporting white-collar employment had increased by approximately 200% in the south and 300% in the north.

    “The proportion of Black women reporting household service work in southern states declined from >50% to <20%, and, by 1980 the proportion of Black women reporting white-collar employment had increased by approximately 200% in the south and 300% in the north.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kaplan et al. (2008)

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  • May combine two claims.

    Premisecitation

    From 1966 through 1975, life expectancy for a Black woman aged 35 years increased 2.6 years, while that of White women increased only 1.5 years.

    “From 1966 through 1975, life expectancy for a Black woman aged 35 years increased 2.6 years, while that of White women increased only 1.5 years.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kaplan et al. (2008)

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  • May combine two claims.

    Premisecitation

    Participants in the Gautreaux program who moved to higher income suburbs were more likely to be employed and their children had improved educational outcomes.

    “Participants who moved to higher income suburbs were more likely to be employed and their children had improved educational outcomes Rosenbaum and Zuberi (2010).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Rosenbaum and Zuberi (2010) source

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  • May combine two claims.

    Interpretationreasoning

    Exposure to desegregated schools for 12 years would be expected to result, on average, in a 24% increase in the likelihood of graduation, approximately equivalent to the gap in Black and White graduation rates during the study period.

    “Thus, exposure to desegregated schools for 12 years would be expected to result, on average, in a 24% (i.e., 2%/year over 12 years) increase in the likelihood of graduation--approximately equivalent to the gap in Black and White graduation rates during the study period Trends (2013).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Trends (2013)

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  • May combine two claims.

    Premisecitation

    In the most recent HUD survey (2012), Black interviewers were informed of 17% fewer homes and shown 17.7% fewer homes than Whites; Asians were informed of 15.5% fewer homes and shown 18.8% fewer homes.

    “In the most recent survey (2012), Black interviewers were informed of 17% fewer homes and shown 17.7% fewer homes than Whites Turner (2013). Asians were informed of 15.5% fewer homes and shown 18.8% fewer homes.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Turner (2013)

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  • May combine two claims.

    Premisecitation

    In 2014, there were fewer than 4,000 claims brought for racial discrimination, about 0.2% of Simonson's estimate.

    “in 2014, there were fewer than 4,000 claims brought for racial discrimination (US Development UDoHaU, 2014) — about 0.2% of Simonson’s estimate.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites US Development UDoHaU, 2014

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    • cites Simonson’s estimate

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  • May combine two claims.

    Premisecitation

    Better-designed studies of programs such as Moving to Opportunity have found benefits for low income recipients, including improvements in housing, employment, and reductions in obesity, diabetes risk, and alcohol abuse.

    “Better-designed studies of programs such as Moving to Opportunity have found benefits for low income recipients—including improvements in housing, employment, and reductions in obesity, diabetes risk, and alcohol abuse (Sanbonmatsu et al. 2011; Fauth, Leventhal & Brooks-Gunn, 2004; Ludwig et al., 2011).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Sanbonmatsu et al. 2011

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    • cites Fauth, Leventhal & Brooks-Gunn, 2004 source

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    • cites Ludwig et al., 2011 source

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  • May combine two claims.

    Premisecitation

    Employment is a recognized predictor of self-assessed health and a strong indicator of long term health and mortality; unemployment is a risk factor for mortality.

    “Employment is a recognized predictor of self-assessed health (Ross & Mirowsky, 1995) and a strong indicator of long term health and mortality (Idler & Benyamini); unemployment is a risk factor for mortality Roelfs, Shor, Davidson, and Schwartz (2011).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Ross & Mirowsky, 1995

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    • cites Idler & Benyamini

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    • cites Roelfs, Shor, Davidson, and Schwartz (2011)

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  • May combine two claims.

    Interpretationreasoning

    Available evidence suggests that the CRA greatly affected infant mortality rates among blacks previously excluded from full access to hospital resources and probably affected the health of the succeeding generation as well.

    “Available evidence suggests that the CRA greatly affected infant mortality rates among blacks previously excluded from full access to hospital resources and probably affected the health of the succeeding generation as well.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Following enactment of the 1972 addition of the 15-25 employee category to Title VII, the relative employment of Black men increased by between 0.5% and 1.1% per year more rapidly than prior to the new law, as did the range of their occupations and their wages.

    “Following enactment of the new requirements, the relative employment of Black men increased by between 0.5% and 1.1% per year more rapidly than prior to the new law, as did the range of their occupations and their wages.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Chay (1998) source

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  • May combine two claims.

    Interpretationcitation

    Not only were Black infants born after the CRA healthier than those born before, but their next generation descendants were also healthier.

    “Thus, not only were Black infants born after the CRA healthier than those born before, but their next generation descendants were also healthier Chay and Greenstone (2000).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Chay and Greenstone (2000)

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  • May combine two claims.

    Interpretationreasoning

    It is possible that much of the gap between Blacks and Whites in academic achievement is attributable to school segregation and that countering segregation is part of the solution to this persistent and consequential problem.

    “Thus, it is possible that much of the infamous gap between Blacks and Whites in academic achievement is attributable to school segregation and that countering segregation is part of the solution to this persistent and consequential problem.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In the early 20th century, substantially different educational resources were provided for black and white children; in Alabama, resources were markedly less for Black than for White students.

    “In the early 20th century, substantially different educational resources were provided for black and white children. For example, in Alabama, resources were markedly less for Black than for White students Margo (1985).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Margo (1985)

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  • May combine two claims.

    Interpretationcitation

    While the scope of efforts to protect civil rights has greatly expanded in recent history, evidence presented here and elsewhere shows that enforcement of civil rights has been uneven and incomplete, and, at least in domains of health care, education, and housing, resistance to civil rights laws and their implementation persists.

    “While the scope of efforts to protect civil rights has greatly expanded in recent history, evidence presented here and elsewhere (Reskin, 2012, Smith, 1999, Chemerinsky, 2002) shows that enforcement of civil rights has been uneven and incomplete, and, at least in domains of health care, education, and housing, resistance to civil rights laws and their implementation persists.”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Reskin, 2012 source

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    • cites Smith, 1999

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    • cites Chemerinsky, 2002

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40 of 40

  • The paper relies on this without support.

    The illustrative examples selected are sufficient to support the paper's general conclusions about the public health effects of civil rights laws.

    “While systematic review of this topic is needed, the goal here is to provide illustrative examples of evidence of the effects of civil rights laws on public health in recent history.”

  • The paper relies on this without support.

    The observed improvements in health and intermediate outcomes among racial/ethnic minorities following civil rights laws are attributable to those laws rather than to other contemporaneous changes.

    “Major trends and contrasts in employment, occupational levels, and wages centered on 1964, the year of the CRA, are consistent with the hypothesis that the CRA substantially benefited the employment opportunities and long term health of Black men and women.”

  • The paper relies on this without support.

    Desegregation of schools contributes to the health and well-being of racial/ethnic minority students.

    “thus slowing the potential contributions of desegregation to the health and well-being of many racial/ethnic minority students.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Fair Housing Act is assigned conflicting title numbers

    Minor

    The text identifies the Fair Housing Act as Title VII, while Table 1 identifies it as Title VIII.

1 of 1

Cites

Flagged first, then by citations

4 of the 63 references couldn’t be matched to a known paper.

Research works printed but not linked: 2

  1. Roisman, 2015, The power of the supreme court’s decision in the fair housing act case, inclusive communities project Inc. v, Texas Department of Housing and Community Affairs Poverty and Race, 24, 17
  2. Tarr, 1990, Constitutional theory and state constitutional interpretation, Rutgers Law J, 22, 841

Cited by

Sorted by citations

Related

Authors
Hahn, R. A., Truman, B. I., & Williams, D. R.
Affiliations
  • Centers for Disease Control and Prevention (US)
  • Harvard University (US)
Corresponding author
Hahn, R.A.
ORCID
Venue
SSM - Population Health
Publisher
Elsevier BV
Published
2018-04
Volume
4
Pages
17-24
ISSN
2352-8273 (ISSN-L)
DOI
10.1016/j.ssmph.2017.10.006
PMC
PMC5730086
OpenAlex
W2765935161
Semantic Scholar
17be203c6551f62a41d41cc5ad383bea5e257710
Cited by
115
References
63
Citations by year
2026: 8 · 2025: 12 · 2024: 8 · 2023: 19 · 2022: 15 · 2021: 19 · 2020: 21 · 2019: 9 · 2018: 3
FWCI
10.04
Type
journal article
Language
en
Open access
Licence
Locations
  • SSM - Population Health (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
National Institutes of Health (CC999999)
Topics
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Health Sciences › Health Professions › General Health Professions › Public Health Policies and Education
Keywords
civil rights, social determinants of health, health disparities, civil rights enforcement, anti-discrimination law, residential segregation, discrimination, health care access, education, employment, African Americans, Hispanic Americans, Native Americans, civil rights history

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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