Skip to main content
SpringerLink
Log in

Disaggregating Heterogeneity among Non-Hispanic Whites: Evidence and Implications for U.S. Racial/Ethnic Health Disparities

  • Original Article
  • Published:
Population Research and Policy Review Aims and scope Submit manuscript

Abstract

Research has made strides in disaggregating health data among racial/ethnic minorities, but less is known about the extent of diversity among Whites. Using logistic regression modeling applied to data on respondents aged 40+ from the 2008 to 2016 American Community Survey, we disaggregated the non-Hispanic White population by ancestry and other racial/ethnic groups (non-Hispanic Black, non-Hispanic Asian, and Hispanic) by common subgroupings and examined heterogeneity in disability. Using logistic regression models predicting six health outcome measures, we compared the spread of coefficients for each of the large racial/ethnic groups and all subgroupings within these large categories. The results revealed that health disparities within the White population are almost as large as disparities within other racial groups. In fact, when Whites were disaggregated by ancestry, mean health appeared to be more varied among Whites than between Whites and members of other racial/ethnic groups in many cases. Compositional changes in the ancestry of Whites, particularly declines in Whites of western European ancestry and increases in Whites of eastern European and Middle Eastern ancestry, contribute to this diversity. Together, these findings challenge the oft-assumed notion that Whites are a homogeneous group and indicate that the aggregate White category obscures substantial intra-ethnic heterogeneity in health.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Notes

  1. The U.S. Census defines Arabs as persons who trace their ancestry to one of the following 16 countries in the Middle East and North Africa (MENA): Algeria, Bahrain, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Qatar, Saudi Arabia, Syria, Tunisia, United Arab Emirates, and Yemen.

  2. While the ACS includes ancestry variables for respondents’ first and second ancestry responses, we only use the first response in our analyses given the large percentage of unreported ancestries for the second response. In tabulations not shown, 13.55% of respondents do not report a first ancestry, whereas 69.90% of respondents do not report a second ancestry.

  3. Location not specified. Some respondents may be of western or eastern European descent.

References

  • AHRQ. (2015). National Healthcare Quality and Disparities Report. Agency for Healthcare Research and Quality: U.S. Department of Health and Human Services. http://www.ahrq.gov/research/findings/nhqrdr/index.html.

  • Ajrouch, K. J., Zahodne, L. B., & Antonucci, T. C. (2017). Arab American cognitive aging: Opportunities for advancing research on Alzheimer’s disease disparities. Innovation in Aging, 1(3), igx034.

    Google Scholar 

  • Akresh, I. R., & Frank, R. (2008). Health selection among new immigrants. American Journal of Public Health, 98(11), 2058–2064.

    Google Scholar 

  • Almeida, J., Biello, K. B., Pedraza, F., Wintner, S., & Viruell-Fuentes, E. (2016). The association between anti-immigrant policies and perceived discrimination among Latinos in the US: A multilevel analysis. Social Science & Medicine-Population Health, 2, 897–903.

    Google Scholar 

  • Altman, B. M., Madans, J., & Weeks, J. D. (2017). An evaluation of the American Community Survey indicators of disability. Disability and Health Journal, 10(4), 485–491.

    Google Scholar 

  • Ameri, M., Schur, L., Adya, M., Bentley, S., McKay, P., & Kruse, D. (2017). The disability employment puzzle: A field experiment on employer hiring behavior. ILR Review, 71(2), 329–364.

    Google Scholar 

  • Bakalian, A., & Bozorgmehr, M. (2009). Backlash 9/11: Middle Eastern and Muslim Americans Respond. Berkeley and Los Angeles: University of California Press.

    Google Scholar 

  • Bergmans, R., Soliman, A. S., Ruterbusch, J., Meza, R., Hirko, K., Graff, J., & Schwartz, K. (2014). Cancer incidence among Arab Americans in California, Detroit, and New Jersey Seer Registries. American Journal of Public Health, 104(6), e83–e91.

    Google Scholar 

  • Brown, T. H. (2018). Racial stratification, immigration, and health inequality: A life course-intersectional approach. Social Forces, 96(4), 1507–1540

    Google Scholar 

  • Brown, S. D., Ehrlich, S. F., Kubo, A., Tsai, A.-L., Hedderson, M. M., Quesenberry, C. P., Jr., & Ferrara, A. (2016). Lifestyle behaviors and ethnic identity among diverse women at high risk for type 2 diabetes. Social Science & Medicine, 160, 87–93.

    Google Scholar 

  • Coleman, D. (2006). Immigration and ethnic change in low-fertility countries: A third demographic transition. Population and Development Review, 32(3), 401–446.

    Google Scholar 

  • Cook, W. K., Tseng, W., Tam, C., John, I., & Lui, C. (2017). Ethnic-group socioeconomic status as an indicator of community-level disadvantage: A study of overweight/obesity in Asian American adolescents. Social Science & Medicine, 184, 15–22.

    Google Scholar 

  • Dallo, F. J., & Kindratt, T. B. (2015). Disparities in vaccinations and cancer screening among U.S.- and foreign-born Arab and European American non-Hispanic White Women. Women’s Health Issues, 25(1), 56–62.

    Google Scholar 

  • Dallo, F. J., & Kindratt, T. B. (2016). Disparities in chronic disease prevalence among non-Hispanic Whites: Heterogeneity among foreign-born Arab and European Americans. Journal of Racial and Ethnic Health Disparities, 3(4), 590–598.

    Google Scholar 

  • Dallo, F. J., Snih, S. A., & Ajrouch, K. J. (2009). Prevalence of disability among US- and foreign-born Arab Americans: Results from the 2000 US Census. Gerontology, 55(2), 153–161.

    Google Scholar 

  • Dallo, F. J., Booza, J., & Nguyen, N. D. (2015). Functional limitations and nativity status among older Arab, Asian, Black, Hispanic, and White Americans. Journal of Immigrant and Minority Health, 17(2), 535–542.

    Google Scholar 

  • de la Cruz, G. P., & Brittingham, A. (2003). The Arab population: 2000—Census 2000 brief. Washington, D.C.: U.S. Department of Commerce, Economics and Statistics Administration. https://www.census.gov/prod/2003pubs/c2kbr-23.pdf.

  • Elo, I. T., Mehta, N. K., & Huang, C. (2011). Disability among native-born and foreign-born Blacks in the United States. Demography, 48(1), 241–265.

    Google Scholar 

  • Erickson, W., Lee, C. G., & Von Schrader, S. (2018). 2016 Disability status report: United States. Vol. Ithaca, NY: Cornell University Yang Tan Institute on Employment and Disability.

  • Farley, R. (1991). The new census question about ancestry: What did it tell us? Demography, 28(3), 411–429.

    Google Scholar 

  • Fenelon, A., Chinn, J. J., & Anderson, R. N. (2017). A comprehensive analysis of the mortality experience of Hispanic subgroups in the United States: Variation by age, country of origin, and nativity. Social Science & Medicine-Population Health, 3, 245–254.

    Google Scholar 

  • Fuller-Thomson, E., Brennenstuhl, S., & Hurd, M. (2011). Comparison of disability rates among older adults in aggregated and separate Asian American/Pacific Islander subpopulations. American Journal of Public Health, 101(1), 94–100.

    Google Scholar 

  • Gee, G. C., & Ponce, N. (2010). Associations between racial discrimination, limited English proficiency, and health-related quality of life among 6 Asian ethnic groups in California. American Journal of Public Health, 100(5), 888–895.

    Google Scholar 

  • Green, S. E., Davis, C., Karshmer, E., Marsh, P., & Straight, B. (2005). Living stigma: The impact of labeling, stereotyping, separation, status loss, and discrimination in the lives of individuals with disabilities and their families. Sociological Inquiry, 75(2), 197–215.

    Google Scholar 

  • Hamilton, T. G. (2014). Selection, language heritage, and the earnings trajectories of Black immigrants in the United States. Demography, 51(3), 975–1002.

    Google Scholar 

  • Hamilton, T. G., & Hummer, R. A. (2011). Immigration and the health of U.S. Black adults: Does country of origin matter? Social Science & Medicine, 73(10), 1551–1560.

    Google Scholar 

  • Hamilton, T. G., & Green, T. L. (2017). Intergenerational differences in smoking among West Indian, Haitian, Latin American, and African Blacks in the United States. Social Science & Medicine-Population Health, 3, 305–317.

    Google Scholar 

  • Hendi, A. S., Mehta, N. K., & Elo, I. T. (2015). Health among Black children by maternal and child nativity. American Journal of Public Health, 105(4), 703–710.

    Google Scholar 

  • Hixson, L., Hepler, B. B., & Kim, M. O. (2011) The White population: 2010—2010 Census briefs. Washington, D.C.: US Department of Commerce, Economics and Statistics Administration. http://www.census.gov/prod/cen2010/briefs/c2010br-05.pdf.

  • Jamal, A. A., & Naber, N. C. (2008). Race and Arab Americans before and after 9/11: From invisible citizens to visible subjects. Syracuse, NY: Syracuse University Press Inc.

    Google Scholar 

  • Killewald, A., & Bryan, B. (2018). Falling behind: The role of inter- and intragenerational processes in widening racial and ethnic wealth gaps through early and middle adulthood. Social Forces, 97(2), 705–740.

    Article  Google Scholar 

  • Levy, B. S., & Sidel, V. W. (2013). Adverse health consequences of the Iraq War. The Lancet, 381(9870), 949–958.

    Google Scholar 

  • Lichter, D. T. (2013). Integration or fragmentation? Racial diversity and the American future. Demography, 50(2), 359–391.

    Google Scholar 

  • Lippert, A. M., & Damaske, S. (2018). Finding jobs, forming families, and stressing out? Work, family, and stress among young adult women in the United States. Social Forces, 98(2), 885–914.

    Google Scholar 

  • Malat, J., Mayorga-Gallo, S., & Williams, D. R. (2018). The effects of whiteness on the health of whites in the USA. Social Science & Medicine, 199, 148–156.

    Google Scholar 

  • Martin, L. G., & Schoeni, R. F. (2014). Trends in disability and related chronic conditions among the forty-and-over population: 1997–2010. Disability and Health Journal, 7(1 Suppl), S4–S14.

    Google Scholar 

  • Mehta, N. K., & Elo, I. T. (2012). Migrant selection and the health of U.S. immigrants from the Former Soviet Union. Demography, 49(2), 425–447.

    Google Scholar 

  • Murillo, R., Echeverria, S., & Vasquez, E. (2016). Differences in neighborhood social cohesion and aerobic physical activity by Latino subgroup. Social Science & Medicine-Population Health, 2, 536–541.

    Google Scholar 

  • Office of Management and Budget. (1997). Revisions to the standards for the classification of federal data on race and ethnicity. Washington, D.C.: Executive Office of the President, Office of Management and Budget (OMB), Office of Information and Regulatory Affairs. https://obamawhitehouse.archives.gov/omb/fedreg_1997standards.

  • Olshansky, S. J., Antonucci, T., Berkman, L., Binstock, R. H., Boersch-Supan, A., Cacioppo, J. T., et al. (2012). Differences in life expectancy due to race and educational differences are widening, and many may not catch up. Health Affairs, 31(8), 1803–1813.

    Article  Google Scholar 

  • Read, J. G. (2013). Measuring ethnicity with U.S. Census data: Implications for Mexicans and Arabs. Population Research and Policy Review, 32(4), 611–631.

    Google Scholar 

  • Read, J. G., & Gorman, B. K. (2006). Gender inequalities in US adult health: The interplay of race and ethnicity. Social Science & Medicine, 62(5), 1045–1065.

    Google Scholar 

  • Read, J. G., & Reynolds, M. M. (2012). Gender differences in immigrant health: The case of Mexican and Middle Eastern immigrants. Journal of Health and Social Behavior, 53(1), 99–123.

    Google Scholar 

  • Read, J. G., Ajrouch, K. J., & West, J. S. (2019). Disparities in functional disability among Arab Americans by nativity, immigrant arrival cohort, and country of birth. SSM-Population Health, 7, 100325.

    Google Scholar 

  • Read, J. G., West, J. S., & Kamis, C. (2020). Immigration and health among non-Hispanic Whites: The impact of arrival cohort and region of birth. Social Science & Medicine, 246, 112754.

    Article  Google Scholar 

  • Reynolds, M. M., Chernenko, A., & Read, J. G. (2016). Region of origin diversity in immigrant health: Moving beyond the Mexican case. Social Science & Medicine, 166, 102–109.

    Google Scholar 

  • Ro, A., Geronimus, A., Bound, J., Griffith, D., & Gee, G. (2015). Cohort and duration patterns among Asian immigrants: Comparing trends in obesity and self-rated health. Biodemography and Social Biology, 61(1), 65–80.

    Google Scholar 

  • Rogers, R. G., Hummer, R. A., & Nam, C. B. (2000). Living and dying in the USA: Behavioral health, and social differentials in adult mortality. San Diego, CA: Academic Press.

    Google Scholar 

  • Steven, R., Genadek, K., Goeken, R., Grover, J., & Sobek, M. (2017) Integrated public use microdata series: Version 7.0 [American Community Survey, 2008–2016]. Minneapolis: University of Minnesota.

  • Shandra, C. L. (2018). Disability as inequality: Social disparities, health disparities, and participation in daily activities. Social Forces, 97(1), 157–192.

    Google Scholar 

  • Silva, F. (2018). The Strength of Whites’ Ties: How employers reward the referrals of Black and White jobseekers. Social Forces, 97(2), 741–768.

    Article  Google Scholar 

  • U.S. Census Bureau. (2015). 5-Year American Community Survey (ACS) 2011–2015. https://factfinder.census.gov/faces/tableservices/jsf/pages/productview.xhtml?pid=ACS_15_5YR_DP02&src=pt.

  • Vega, W. A., & Amaro, H. (1994). Latino outlook: Good health, uncertain prognosis. Annual Review of Public Health, 15, 39–67.

    Google Scholar 

  • Verissimo, A. D., Otiniano, C. E., Grella, H. A., & Gee, G. C. (2014). Discrimination and substance use disorders among Latinos: The role of gender, nativity, and ethnicity. American Journal of Public Health, 104(8), 1421–1428.

    Google Scholar 

  • Vierboom, Y. C., Preston, S. H., & Hendi, A. S. (2019). Rising geographic inequality in mortality in the United States. SSM-Population Health, 9, 100478–100578.

    Google Scholar 

  • Waters, M. C., & Pineau, M. G. (Eds.). (2015). The integration of immigrants into American Society. Washington, D.C.: National Academies Press.

    Google Scholar 

  • Yi, S. S., Kwon, S. C., Sacks, R., & Trinh-Shevrin, C. (2016). Commentary: Persistence and health-related consequences of the model minority stereotype for Asian Americans. Ethnicity and Disease, 26(1), 133–138.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Sociology, Global Health Institute, Duke University, 417 Chapel Drive, Durham, NC, 27708, USA

    Jen’nan Ghazal Read

  2. Department of Sociology, Duke University, Durham, NC, USA

    Scott M. Lynch & Jessica S. West

Authors
  1. Jen’nan Ghazal Read
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Scott M. Lynch
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jessica S. West
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jen’nan Ghazal Read.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 67 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Read, J.G., Lynch, S.M. & West, J.S. Disaggregating Heterogeneity among Non-Hispanic Whites: Evidence and Implications for U.S. Racial/Ethnic Health Disparities. Popul Res Policy Rev 40, 9–31 (2021). https://doi.org/10.1007/s11113-020-09632-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11113-020-09632-5

Keywords

Search

Navigation