Sociologists have also identified multiple pathways through which segregation can adversely affect health (Morenoff 2003; Williams and Collins 2001; Schulz et al. 2002). First, segregation restricts SES attainment by limiting access to quality elementary and high school education, preparation for higher education and job opportunities. Second, the residential conditions of concentrated poverty and social disorder created by segregation make it difficult for residents to eat nutritiously, exercise regularly and avoid advertising for tobacco and alcohol. For example, the lack of recreation facilities and concerns about personal safety can discourage leisure time physical exercise. Third, the concentration of poverty can lead to exposure to elevated levels of financial stress and hardship as well as other chronic and acute stressors at the individual, household and neighborhood level. Fourth, the weakened community and neighborhood infrastructure in segregated areas can also adversely affect interpersonal relationships and trust among neighbors. Fifth, the institutional neglect and disinvestment in poor, segregated communities contributes to increased exposure to environmental toxins, poor quality housing and criminal victimization. Finally, segregation adversely affects both access to care and the quality of
