Health Disparities among Middle-Class African Americans: Exposure to Childhood Disadvantage or Diminished Returns to Socioeconomic Status

Cynthia G. Colen, Ohio State University
Patrick M. Krueger, University of Colorado, Denver

Although the existence of racial disparities in health is well documented, much less is known about the underlying mechanisms that create and sustain these divergent trajectories across the lifecourse, especially among nonpoor subpopulations. Using 20 consecutive waves of data from the Panel Study of Income Dynamics (PSID), we seek to determine the extent to which suboptimal levels of self-rated health among college-educated, working-age (18-65) African Americans as opposed to Whites can be attributed to childhood disadvantage or the nonequivalence of socioeconomic status (SES) across race. Findings from multilevel logistic regression models suggest that early life hardship 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 over time. We conclude that racial disparities in health among the Black middle-class are more likely to be the result of restricted returns to upward mobility than exposure to childhood disadvantage.