Do rising tides lift all boats? Racial disparities in health across the lifecourse among middle-class African-Americans and Whites.
Do rising tides lift all boats? Racial disparities in health across the lifecourse among middle-class African-Americans and Whites.
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DOI：
10.1016/j.ssmph.2018.07.004
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发表时间：
2018-12
期刊：
影响因子：
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通讯作者：
Boettner BL
中科院分区：
文献类型：
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作者：
Colen CG;Krueger PM;Boettner BL
虽然健康方面的种族不平等有充分的文献记载，但人们对创造和维持这些人口模式的潜在机制知之甚少，特别是在非贫困亚群体中。使用来自收入动态面板研究（PSID）的20波数据，我们估计了中等收入，工作年龄（18-65）成年人中黑人/白色自评健康差距的大小，并探讨了这种差距的潜在来源。多层次回归模型的结果表明，家庭收入的代际收益导致中产阶级非裔美国人的自我评价健康状况的改善明显小于同样情况的白人。我们还注意到，儿童时期的劣势预测成年后的健康轨迹，但并没有解释家庭收入和自我评价的健康之间的关联的黑人/白色差距。我们的结论是，中产阶级的地位提供了有限的健康回报，以向上流动的非洲裔美国人，这种差异的关系不能解释为更多的暴露于早期生活的劣势。我们使用20波数据来调查美国中产阶级健康状况的生命周期波动。结果表明，代际流动性与不同种族的健康结果不相等有关。对于白人来说，随着时间的推移，家庭收入增加10%，健康状况一般/较差的几率会降低9.7%。对于黑人来说，家庭收入的类似增加导致健康状况一般或较差的几率明显减少。这种种族差异不能用儿童社会经济劣势的不同暴露来解释。
Although racial inequalities in health are well documented, much less is known about the underlying mechanisms that create and sustain these population patterns, especially among nonpoor subgroups. Using 20 waves of data from the Panel Study of Income Dynamics (PSID), we estimate the magnitude of the Black/White gap in self-rated health among middle-income, working-age (18–65) adults and explore potential sources of this disparity. Findings from multilevel regression models suggest that intragenerational gains in family income result in significantly smaller improvements in self-rated health for middle-class African-Americans than similarly situated Whites. We also note that childhood disadvantage predicts subsequent health trajectories in adulthood, but does little to explain the Black/White gap in the association between family income and self-rated health. We conclude that middle-class status provides restricted health returns to upward mobility for African-Americans and this differential relationship cannot be accounted for by greater exposure to early life disadvantage. We use 20 waves of data to investigate lifecourse fluctuations in health among middle-class Americans. Results suggest intragenerational mobility is associated with nonequivalent health outcomes across race. For Whites, a 10% increase in family income over time reduces the odds of being in fair/poor health by 9.7%. For Blacks, similar increases in family income resulted in significantly smaller reductions in the odds of fair or poor health. This racial disparity cannot be explained by differential exposure to childhood socioeconomic disadvantage.