The author makes the argument that many racial disparities in health are rooted in political economic processes that undergird racial residential segregation at the mesolevel—specifically, the neighborhood. The dual mortgage market is considered a key political economic context whereby racially marginalized people are isolated into degenerative ecological environments. A multilevel root-cause conceptual framework, the racism-race reification process (R3p), is proposed and preliminarily tested to delineate how institutional conditions shape the health of racially marginalized individuals through the reification of race. After reviewing and critiquing the conceptual and theoretical roots of R3p, the key components of the synergistic framework are detailed and applied to clarify extant understandings of the upstream (i.e., macrolevel) factors informing racial health disparities. Using aggregated data from the 1994 Home Mortgage Disclosure Act and Neighborhood Change Database merged at the mesolevel (i.e., the neighborhood cluster) with microlevel data from the Project on Human Development in Chicago Neighborhoods, exploratory analysis is presented that links dual mortgage market political economies to ethnoracial residential segregation at the mesolevel and to childhood health inequalities at the microlevel. The author concludes by considering how racial inequality is an artifact of the political economic reality of race and racism manifested from the neighborhood-level down.