Race, socioeconomic status, and health: Complexities, ongoing challenges, and research opportunities

TLDR

Race reflects multiple dimensions of social inequality, with socioeconomic status indicators capturing only limited aspects, and migration history and status also influencing health, highlighting the need to understand their complex interactions. The paper reviews racial health disparities, identifies socioeconomic status as a major contributor, and outlines research priorities to comprehensively characterize how social environments, migration, medical care, and genetics interact to affect health across the life course. The review concludes that socioeconomic status differences across racial groups are a major driver of racial health disparities.

Abstract

This paper provides an overview of racial variations in health and shows that differences in socioeconomic status (SES) across racial groups are a major contributor to racial disparities in health. However, race reflects multiple dimensions of social inequality and individual and household indicators of SES capture relevant but limited aspects of this phenomenon. Research is needed that will comprehensively characterize the critical pathogenic features of social environments and identify how they combine with each other to affect health over the life course. Migration history and status are also important predictors of health and research is needed that will enhance understanding of the complex ways in which race, SES, and immigrant status combine to affect health. Fully capturing the role of race in health also requires rigorous examination of the conditions under which medical care and genetic factors can contribute to racial and SES differences in health. The paper identifies research priorities in all of these areas.