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. 2016 Dec:170:63-76.
doi: 10.1016/j.socscimed.2016.10.008. Epub 2016 Oct 11.

The role of socioeconomic factors in Black-White health inequities across the life course: Point-in-time measures, long-term exposures, and differential health returns

Courtney Boen  1
Affiliations

The role of socioeconomic factors in Black-White health inequities across the life course: Point-in-time measures, long-term exposures, and differential health returns

Courtney Boen. Soc Sci Med. 2016 Dec.

Abstract

Research links Black-White health disparities to racial differences in socioeconomic status (SES), but understanding of the role of SES in racial health gaps has been restricted by reliance on static measures of health and socioeconomic well-being that mask the dynamic quality of these processes and ignore the racialized nature of the SES-health connection. Utilizing twenty-three years of longitudinal data from the Panel Study of Income Dynamics (1984-2007), this study uses multilevel growth curve models to examine how multiple dimensions of socioeconomic well-being-including long-term economic history and differential returns to SES-contribute to the life course patterning of Black-White health disparities across two critical markers of well-being: body mass index (N = 9057) and self-rated health (N = 11,329). Findings indicate that long-term SES exerts a significant influence on both body mass index and self-rated health, net of point-in-time measures, and that Black-White health gaps are smallest in models that adjust for both long-term and current SES. I also find that Blacks and Whites receive differential health returns to increases in SES, which suggests that other factors-such as neighborhood segregation and exposure racial discrimination-may restrict Blacks from converting increases in SES into health improvements in the same way as Whites. Together, these processes contribute to the life course patterning of Black-White health gaps and raise concerns about previous misestimation of the role of SES in racial health disparities.

Keywords: Body mass index; Life course; Longitudinal analysis; Racial health disparities; Self-rated health; Socioeconomic status.

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Figures

Figure 1
Figure 1. Age Trajectory of Body Mass Index by Race (N=9,057)
Note: Figure based on results from Model 5a (the fully adjusted model) of Table 1.
Figure 2
Figure 2. Age Trajectories of “Poor” and “Excellent” Self-Rated Health by Race (N=11,329)
Note: Figure based on results from Model 5a (the fully adjusted model) of Table 2.
Figure 3
Figure 3. Age Trajectory of BMI by Race and Education (N=9,057)
Note: Figure based on results from Model 5a (the fully adjusted model) of Table 1.
See this image and copyright information in PMC

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