Neighborhood, Segregation, and School Choice

Over the past few decades, school choice has been a widely debated issue around the globe, following the development of pluralism, liberty, and democracy. In many countries, school choice systems were preceded by residence-based school assignment systems, creating a strong connection between a neighborhood and its schools’ demographic compositions. However, schools often remain highly segregated. School segregation is thus seen as a major problem and is supposedly driven by three main factors: residential segregation, parental school choice, and schools’ selection of pupils. This paper aims to shed light on what research should be focusing on as regards school choice and residential segregation with the following two research questions: What are the links between neighborhood and school choice in the literature? How are neighborhood and school choice connected to school segregation in the literature? Two main findings emerged: (1) the neighborhood-based social networks that parents developed had limited their school choices and (2) neighborhood segregation is one of the most important factors that contributes to school segregation and is related to multi-ethnic and socioeconomic contexts.

Exclusion in Upscaling Institutions: The Reproduction of Neighborhood Segregation in an Urban Church

This paper examines the intersection of neighborhood change and parish reconfiguration in Charlestown, MA. The merger of two Roman Catholic churches has unsettled the congregational cultures, just as gentrification is unsettling broader neighborhood dynamics. Based on findings from 28 in–depth interviews and participant–observation, I examine the spatial reproduction of neighborhood segregation in the sanctuary of St. Mary's church. Affluent newcomers and “Townies”–stalwart residents who have weathered earlier waves of neighborhood upscaling–form power alliances that result in the exclusion of the poorest residents in the shared space of this urban church. By paying attention to the seating arrangements and other social interactions of churchgoers, I discover that the new parish vision of the merged church–albeit one that purported to celebrate the diverse residents of the neighborhood–resulted in the cultural exclusion of Latinos. Institutional decisions, the desire to maintain ethnic enclaves, and tacit messages of group exclusion reify the race and class divisions of the neighborhood within the walls of the church. I conclude with an exploration of the strategies of resilience to gentrification and merger evident in this case by attending to the actions of the disadvantaged in relation to the changing institution.

Neighborhood disparities in timeliness of treatment for early stage lung cancer patients.

e19017 Background: Lung cancer is the second most commonly diagnosed cancer and the leading cause of cancer-related death in the United States, accounting for approximately 25% of all cancer deaths. The National Comprehensive Cancer Network (NCCN) provides evidence-based cancer treatment recommendations. Evidence suggests that a patient’s receipt of guideline-concordant treatment (GCT) increases survival, especially for screen-detected, earlier stage cancers. Neighborhoods are key determinants of health and the neighborhood social and built environments can influence cancer treatment and outcomes. Minority segregated neighborhoods often have limited health resource availability. The objective of this study is to estimate the relationship between neighborhood segregation on racial and ethnic disparities in timely receipt of GCT in early-stage lung cancer patients in California. Methods: We studied 22,903 patients diagnosed with stage I/II non-small cell lung cancer (2006-2015) in the California Cancer Registry. The primary outcome of the study is receipt of GCT according to the 2016 NCCN guidelines defined as the administration of proper initial and adjuvant treatment(s) according to cancer site and stage, and measured using surgery type, chemotherapy type, and radiation type. The secondary outcome was timely receipt of care as defined as the initiation of surgery, radiation, or chemotherapy within 45 days of diagnosis for initial treatment and the initiation of chemotherapy +/- radiation within 6 months of initial surgery for N1 patients for adjuvant treatment. Multivariable hierarchical logistic regression will be used to estimate the effect of neighborhood segregation on timely receipt of GCT, adjusting for individual- and neighborhood-level covariates, and stratified by patient race/ethnicity. Results: Overall, 81.39% of patients received GCT; 57.63% of them within 45 days of diagnosis. Under-treatment and treatment delay were more frequent in patients who were black or Hispanic, had public insurance, and were of lower socioeconomic status. We hypothesize that increased neighborhood segregation will decrease a patient’s likelihood of adherence to GCT and timely GCT. Conclusions: This research is vital to improving our understanding of cancer-related health disparities and promoting health in vulnerable neighborhoods. With rising numbers of early stage lung cancers due to screening smokers, administration of timely proper treatment is critical.