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Racial disparities in self-rated health: Trends, explanatory factors, and the changing role of socio-demographics

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  • Beck, Audrey N.
  • Finch, Brian K.
  • Lin, Shih-Fan
  • Hummer, Robert A.
  • Masters, Ryan K.

Abstract

This paper uses data from the U.S. National Health Interview Surveys (N = 1,513,097) to describe and explain temporal patterns in black-white health disparities with models that simultaneously consider the unique effects of age, period, and cohort. First, we employ cross-classified random effects age–period–cohort (APC) models to document black-white disparities in self-rated health across temporal dimensions. Second, we use decomposition techniques to shed light on the extent to which socio-economic shifts in cohort composition explain the age and period adjusted racial health disparities across successive birth cohorts. Third, we examine the extent to which exogenous conditions at the time of birth help explain the racial disparities across successive cohorts. Results show that black-white disparities are wider among the pre-1935 cohorts for women, falling thereafter; disparities for men exhibit a similar pattern but exhibit narrowing among cohorts born earlier in the century. Differences in socioeconomic composition consistently contribute to racial health disparities across cohorts; notably, marital status differences by race emerge as an increasingly important explanatory factor in more recent cohorts for women whereas employment differences by race emerge as increasingly salient in more recent cohorts for men. Finally, our cohort characteristics models suggest that cohort economic conditions at the time of birth (percent large family, farm or Southern birth) help explain racial disparities in health for both men and women.

Suggested Citation

  • Beck, Audrey N. & Finch, Brian K. & Lin, Shih-Fan & Hummer, Robert A. & Masters, Ryan K., 2014. "Racial disparities in self-rated health: Trends, explanatory factors, and the changing role of socio-demographics," Social Science & Medicine, Elsevier, vol. 104(C), pages 163-177.
  • Handle: RePEc:eee:socmed:v:104:y:2014:i:c:p:163-177
    DOI: 10.1016/j.socscimed.2013.11.021
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    4. Hicken, Margaret T. & Kravitz-Wirtz, Nicole & Durkee, Myles & Jackson, James S., 2018. "Racial inequalities in health: Framing future research," Social Science & Medicine, Elsevier, vol. 199(C), pages 11-18.
    5. Jason L. Cummings, 2023. "Entangled Inequalities: U.S. Trends in Self-Rated Health at the Intersection of Gender and Race, 1972–2018," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 169(3), pages 759-774, October.
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    7. Millicent N. Robinson, 2022. "Pushing Past Limits: How Efficacious Is High-Effort Coping for Self-Rated Health among African American and Caribbean Black Women?," IJERPH, MDPI, vol. 19(20), pages 1-16, October.
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    9. Belinda L. Needham & Soojung Kim & Erica Concors & Jeffrey J. Wing, 2017. "Trends in Gender Differences in Self-Rated Health in Korea: Evidence from the Korean National Health and Nutrition Examination Survey, 2001-2012," Global Journal of Health Science, Canadian Center of Science and Education, vol. 9(5), pages 196-196, May.
    10. Eduardo Bernabé & Aubrey Sheiham, 2014. "Tooth Loss in the United Kingdom – Trends in Social Inequalities: An Age-Period-and-Cohort Analysis," PLOS ONE, Public Library of Science, vol. 9(8), pages 1-8, August.
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    12. Joshua C. Hall & Brad R. Humphreys & Jane E. Ruseski, 2015. "Economic Freedom, Race, and Health Disparities: Evidence from US States," Working Papers 15-43, Department of Economics, West Virginia University.
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