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

Williams, David R.; Mohammed, Selina A.; Leavell, Jacinta P; Collins, Chiquita

doi:10.1111/j.1749-6632.2009.05339.x

Cited by 1,152 publications

(1,047 citation statements)

References 156 publications

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“…Further, SES measures such as educational attainment may not be commensurate between different racial groups [45], and individual-level SES measures do not capture neighborhood-and community-level socioeconomic and health environmental factors. For example, at the same level of income and education, Black populations are less wealthy and may live in environments such as food deserts that do not promote health [46]. In terms of child populations, Acevedo-Garcia and colleagues [47] found that 76 % of Black children live under worse conditions than the worst off White children (defined as being the 25 % percent living in the highest-poverty White neighborhoods).…”

Section: Discussionmentioning

confidence: 99%

Chronic Psychological Stress and Racial Disparities in Body Mass Index Change Between Black and White Girls Aged 10–19

Tomiyama¹,

Puterman²,

Epel³

et al. 2012

ann. behav. med.

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Section: Discussionmentioning

confidence: 99%

Chronic Psychological Stress and Racial Disparities in Body Mass Index Change Between Black and White Girls Aged 10–19

Tomiyama¹,

Puterman²,

Epel³

et al. 2012

ann. behav. med.

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“…The physical impact of stressors may reflect coping patterns, the physiological accumulation of psychosocial stressors (i.e., 'wear and tear' on the body), or the indirect consequences of regularly confronting barriers to health-promoting factors, such as appropriate employment or adequate medical care (Williams et al, 2010). Stress is associated with obesity (Dallman et al, 2003), with at least one of the mechanisms being chronic inflammation in the body (Fuligni et al, 2009;Robles et al, 2005).…”

Section: Acculturative Stressorsmentioning

confidence: 99%

Duration of U.S. stay and body mass index among Latino and Asian immigrants: A test of theoretical pathways

Bostean

2015

Social Science & Medicine

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Studies find that longer-term immigrants have higher body mass index (BMI) than their more recently-arrived counterparts. Most interpretations of these health patterns by duration of U.S. residence rely on theories of immigrant integration; they posit that with increasing time in the United States, immigrants incorporate economically, socially, and culturally into aspects of U.S. society, and that these changes impact health. Few studies empirically examine whether these aspects of integration are indeed mediators of the association between duration of U.S. stay and BMI, and if their patterns differ across immigrant subgroups. This study examines data from the National Latino and Asian American Survey, using path analytic methods to simultaneously test six hypothesized mediators between duration and BMI: household income, English language ability, ethnic identity, family cohesion, acculturative stress and discrimination for both Latino and Asian immigrants, stratified by gender. We find little evidence for an association between duration and BMI for either Latino or Asian men. For women, duration and BMI have a significant and positive relationship, although the pathways differ between the two ethnic groups.For Latina women, household income and acculturative stress are significant indirect pathways, although they work in opposing directions. For Asian women, English proficiency and discrimination are significant indirect pathways. Our findings reveal complex pathways between duration and BMI that vary by ethnicity and gender and highlight limitations in the negative acculturation theory, which suggests that exposure to the United States should have a net negative impact on health. In contrast, our findings suggest not all groups show declining health with longer duration, as measured by BMI, and that integration processes do not always translate into health differences in the expected directions. Future research on duration patterns may need to consider alternative explanations beyond incorporation-based processes, such as cross-national health theories or age, period, cohort effects.3

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“…Largely separate literatures address racial and ethnic disparities and socioeconomic disparities. Studies that have data on both variables often use one as the control for the other and rarely consider how their joint functioning affects health or how each is entwined with other threats to good health (70). Health.…”

Section: Rigor and Vigor: Measurement Issuesmentioning

confidence: 99%

Rigor, vigor, and the study of health disparities

Adler

Bush²,

Pantell

2012

Proc. Natl. Acad. Sci. U.S.A.

104

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Health disparities research spans multiple fields and methods and documents strong links between social disadvantage and poor health. Associations between socioeconomic status (SES) and health are often taken as evidence for the causal impact of SES on health, but alternative explanations, including the impact of health on SES, are plausible. Studies showing the influence of parents' SES on their children's health provide evidence for a causal pathway from SES to health, but have limitations. Health disparities researchers face tradeoffs between "rigor" and "vigor" in designing studies that demonstrate how social disadvantage becomes biologically embedded and results in poorer health. Rigorous designs aim to maximize precision in the measurement of SES and health outcomes through methods that provide the greatest control over temporal ordering and causal direction. To achieve precision, many studies use a single SES predictor and single disease. However, doing so oversimplifies the multifaceted, entwined nature of social disadvantage and may overestimate the impact of that one variable and underestimate the true impact of social disadvantage on health. In addition, SES effects on overall health and functioning are likely to be greater than effects on any one disease. Vigorous designs aim to capture this complexity and maximize ecological validity through more complete assessment of social disadvantage and health status, but may provide less-compelling evidence of causality. Newer approaches to both measurement and analysis may enable enhanced vigor as well as rigor. Incorporating both rigor and vigor into studies will provide a fuller understanding of the causes of health disparities.methodology | social determinants of health | cumulative risk G ood health and longevity are unequally distributed in populations. Although some unavoidable variations in health emanate from individual differences in vulnerability to disease, others are linked to membership in socially disadvantaged groups. The latter are unjust and have been the focus of considerable research and policy (1). Research on these health disparities has demonstrated consistent graded associations between various components of socioeconomic status (SES) and a wide range of health indicators; at each step up the social ladder, whether indexed by higher income, education, and/or occupational level, rates of morbidity and mortality decrease (2). The prevailing understanding of this relationship is that SES is a "fundamental cause" of health status (3), which operates through physical and/or psychosocial resources that are more readily available as SES increases, and hardships and adverse exposures that are more intense and frequent as SES decreases.Evidence for the SES-health gradient comes primarily from cross-sectional data linking contemporaneous measures of SES in adulthood with prevalence of disease, poor health, or mortality. Smaller literatures have established associations between socioeconomic conditions in childhood and childhood health, and betwe...

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

Cited by 1,152 publications

References 156 publications

Chronic Psychological Stress and Racial Disparities in Body Mass Index Change Between Black and White Girls Aged 10–19

Chronic Psychological Stress and Racial Disparities in Body Mass Index Change Between Black and White Girls Aged 10–19

Duration of U.S. stay and body mass index among Latino and Asian immigrants: A test of theoretical pathways

Rigor, vigor, and the study of health disparities

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