The Significance of Socioeconomic Status in Explaining the Racial Gap in Chronic Health Conditions

TLDR

Black Americans live fewer years than whites and more years with chronic health problems, yet the origins of this racial gap remain ambiguous. The study examines the pervasiveness of the racial health gap across chronic medical and disabling conditions in middle‑aged adults and explores alternative hypotheses about how fundamental social conditions of disease differentiate black and white health, underscoring the need for further research on health and achievement across the life cycle. The authors investigate alternative hypotheses regarding how fundamental social conditions of disease differentiate black and white health. Results show that socioeconomic conditions—not health risk behaviors—are the primary drivers of the racial health gap across all domains, that blacks and whites do not differ in converting socioeconomic resources into health, and that continued research is needed on the link between health and achievement across the life course.

Abstract

Black Americans live fewer years than whites and live more years with chronic health problems. The origins of this racial gap are ambiguous. This study examines the pervasiveness of this gap across chronic medical and disabling conditions among middle-aged persons. Alternative hypotheses about how fundamental social conditions of disease differentiate the health of blacks and whites are also examined. Results show that the racial gap in health is spread across all domains of health, and that socioeconomic conditions, not health risk behaviors, are the primary origins of the racial stratification of health. No evidence was found in support of the idea that blacks and whites differ in their ability to transform socioeconomic resources into good health. The results point to the importance of continued research on how health and achievement processes are linked across childhood, adolescence, adulthood, and old age. Such studies are needed to enrich work on the inequality of health and life cycle achievement.