Health Disparities due to Diminished Return among Black Americans: Public Policy Solutions

TLDR

Health disparities between Black Americans and non‑Hispanic Whites are persistent, and the phenomenon of diminished gain—where socioeconomic and psychological resources confer smaller health benefits to Blacks—has historically been overlooked as a key mechanism. The article investigates how diminished gain contributes to racial health disparities, reviews its causes—including structural racism—and proposes policy solutions to mitigate it. The authors review existing literature on diminished gain, examine structural racism as a causal factor, and outline policy interventions to reduce it. Robust evidence shows diminished gain consistently affects multiple resources, assets, outcomes, settings, cohorts, and age groups.

Abstract

Abstract There are persistent and pervasive disparities in the health of Black people compared to non‐Hispanic Whites in the United States. There are many reasons for this gap; this article explores the role of “Blacks’ diminished gain” as a mechanism behind racial health disparities. Diminished gain is a phenomenon wherein the health effects of certain socioeconomic resources and psychological assets are systematically smaller for Blacks compared to Whites. These patterns are robust, with similar findings across different resources, assets, outcomes, settings, cohorts, and age groups. However, the role of diminished gain as a main contributing mechanism to racial health disparities has been historically overlooked. This article reviews the research literature on diminished gain and discusses possible causes for it, such as the societal barriers created by structural racism. Policy solutions that may reduce Blacks’ diminished gain are discussed.