Department of Sociology and Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Demography. 2022 Oct 1;59(5):1791-1819. doi: 10.1215/00703370-10191675.
This study addresses two questions. First, why do Black Americans exhibit worse health outcomes than White Americans even at higher levels of socioeconomic status (SES)? Second, are diminished health returns to higher status concentrated among Black Americans with darker skin color? Novel hypotheses are tested with biosocial panel data from Add Health, a nationally representative cohort of Black and White adolescents who have transitioned to adulthood. We find that White and light-skin Black respondents report improved health after achieving higher SES, on average, while their darker-skin Black peers report declining health. These patterns persist regardless of controls for adolescent health status and unmeasured between-person heterogeneity. Moreover, increased inflammation tied to unfair treatment and perceptions of lower status helps to account for patterns of diminished health returns for dark-skin Black groups. Our study is the first to document skin tone heterogeneity in diminished health returns and one of few studies to identify life course stress processes underlying such disparities. We consider additional processes that could be examined in future studies, as well as the broader health and policy implications of our findings.
本研究旨在探讨两个问题。首先，为什么即使在更高的社会经济地位（SES）水平下，非裔美国人的健康状况也比白人差？其次，在皮肤颜色较深的非裔美国人中，更高地位的健康回报是否会减少？本研究利用来自“健康与成长追踪调查”（Add Health）的生物社会面板数据检验了新的假设，该调查是一个具有全国代表性的黑人和白人青少年队列，他们已经过渡到成年期。我们发现，白人和浅肤色的黑人受访者平均报告说，在达到更高的 SES 后健康状况有所改善，而他们的深肤色黑人同龄人报告健康状况恶化。这些模式在控制了青少年健康状况和未测量的个体间异质性后仍然存在。此外，与不公平待遇和较低地位认知相关的炎症增加，有助于解释深肤色黑人健康回报减少的模式。本研究首次记录了皮肤色调异质性对健康回报减少的影响，也是少数几个确定导致这种差异的生命历程压力过程的研究之一。我们考虑了未来研究中可能需要检查的其他过程，以及我们研究结果对健康和政策的更广泛影响。
