US Socioeconomic and Racial Differences in Health: Patterns and Explanations

TLDR

Recent studies show a widening socioeconomic status differential and an expanding racial gap in health, with African Americans experiencing worsening health status over time. The study examines how socioeconomic status and race interact to shape health inequalities and identifies determinants of the magnitude of SES disparities over time. The authors analyze how social structures—racism, acculturation, work, migration, childhood SES—and constrained resources generate health inequalities, while addressing measurement issues and outlining policy implications. The analysis confirms a widening SES health differential and an expanding racial gap, with African Americans experiencing deteriorating health status over time.

Abstract

This chapter reviews recent studies of socioeconomic status (SES) and racial differences in health. It traces patterns of the social distribution of disease over time and describes the evidence for both a widening SES differential in health status and an increasing racial gap in health between blacks and whites due, in part, to the worsening health status of the African American population. We also describe variations in health status within and between other racial populations. The interactions between SES and race are examined, and we explore the link between health inequalities and socioeconomic inequality both by examining the nature of the SES gradient and by identifying the determinants of the magnitude of SES disparities over time. We consider the ways in which major social structures and processes such as racism, acculturation, work, migration, and childhood SES produce inequalities in health. We also attend to the ways in which other intervening factors and resources are constrained by social structure. Measurement issues are addressed, and implications for health policy and future research are described.