Journal of Urban Health

, Volume 95, Issue 1, pp 21–35 | Cite as

Blacks’ Diminished Health Return of Family Structure and Socioeconomic Status; 15 Years of Follow-up of a National Urban Sample of Youth

  • Shervin AssariEmail author
  • Alvin Thomas
  • Cleopatra H. Caldwell
  • Ronald B. Mincy


The protective effect of family structure and socioeconomic status (SES) on physical and mental health is well established. There are reports, however, documenting a smaller return of SES among Blacks compared to Whites, also known as Blacks’ diminished return. Using a national sample, this study investigated race by gender differences in the effects of family structure and family SES on subsequent body mass index (BMI) over a 15-year period. This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), in-home survey. This study followed 1781 youth from birth to age 15. The sample was composed of White males (n = 241, 13.5%), White females (n = 224, 12.6%), Black males (n = 667, 37.5%), and Black females (n = 649, 36.4%). Family structure and family SES (maternal education and income to need ratio) at birth were the independent variables. BMI at age 15 was the outcome. Race and gender were the moderators. Linear regression models were run in the pooled sample, in addition to race by gender groups. In the pooled sample, married parents, more maternal education, and income to need ratio were all protective against high BMI of youth at 15 years of age. Race interacted with family structure, maternal education, and income to need ratio on BMI, indicating smaller effects for Blacks compared to Whites. Gender did not interact with SES indicators on BMI. Race by gender stratified regressions showed the most consistent associations between family SES and future BMI for White females followed by White males. Family structure, maternal education, and income to need ratio were not associated with lower BMI in Black males or females. The health gain received from family economic resources over time is smaller for male and female Black youth than for male and female White youth. Equalizing access to economic resources may not be enough to eliminate health disparities in obesity. Policies should address qualitative differences in the lives of Whites and Blacks which result in diminished health returns with similar SES resources. Policies should address structural and societal barriers that hold Blacks against translation of their SES resources to health outcomes.


Ethnic groups Blacks Ethnicity Obesity Body mass index Socioeconomic status Education Income 



Shervin Assari is supported by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation at the University of Michigan.

Authors Contribution

Ronald B. Mincy was the co-principle investigator of the FFCWS. So, he contributed to the design and data collection of the original FFCWS. Shervin Assari designed the current work, analyzed the data, and drafted the manuscript. Cleopatra Caldwell, Alvin Thomas, and Ronald B. Mincy all contributed to interpretation of the findings and drafting and revision of this paper.


The FFCWS is funded by the National Institute of Child Health and Human Development (grant R01HD36916), the California Healthcare Foundation, the Center for Research on Religion and Urban Civil Society at the University of Pennsylvania, the Commonwealth Fund, the Ford Foundation, the Foundation for Child Development, the Fund for New Jersey, the William T. Grant Foundation, the Health care Foundation of New Jersey, the William and Flora Hewlett Foundation, the Hogg Foundation, the Christina A. Johnson Endeavor Foundation, the Kronkosky Charitable Foundation, the Leon Lowenstein Foundation, the John D. and Catherine T. MacArthur Foundation, the A. L. Mailman Family Foundation, the Charles S. Mott Foundation, the National Science Foundation, the David and Lucile Packard Foundation, the Public Policy Institute of California, the Robert Wood Johnson Foundation, the St. David’s Hospital Foundation, the St. Vincent Hospital and Health Services, and the US Department of Health and Human Services.

Compliance with Ethical Standards

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Parental informed consent and assent were obtained from all adolescent participants included in the study.


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Copyright information

© The New York Academy of Medicine 2017

Authors and Affiliations

  1. 1.Department of PsychiatryUniversity of MichiganAnn ArborUSA
  2. 2.Center for Research on Ethnicity, Culture and Health, School of Public HealthUniversity of MichiganAnn ArborUSA
  3. 3.Department of Health Behavior and Health EducationUniversity of MichiganAnn ArborUSA
  4. 4.Palo Alto UniversityPalo AltoUSA
  5. 5.Center for Research on Fathers, Children, and Family Well-BeingNew YorkUSA
  6. 6.Columbia Population Research Center (CPRC)New YorkUSA
  7. 7.Columbia School of Social WorkNew YorkUSA

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