Race by Gender Group Differences in the Protective Effects of Socioeconomic Factors Against Sustained Health Problems Across Five Domains
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Despite the existing literature on the central role of socioeconomic status (SES; education and income) for maintaining health, less is known about group differences in this effect. Built on the intersectionality approach, this study compared race by gender groups for the effects of baseline education and income on sustained health problems in five domains: depressive symptoms, insomnia, physical inactivity, body mass index (BMI), and self-rated health (SRH).
Data came from waves 7, 8, and 10 of the Health and Retirement Study (HRS), which were collected in 2004, 2006, and 2010, respectively. The study followed 37,495 white and black men and women above age 50 for up to 6 years. This number included 12,495 white men, 15,581 white women, 3839 black men, and 5580 black women. Individuals reported their depressive symptoms (Center for Epidemiological Studies-Depression (CES-D) 11), insomnia, physical inactivity, BMI, and SRH across all waves. Multigroup structural equation modeling (SEM) was used to compare black men, black women, white men, and white women for the effects of education and income in 2004 on sustained health problems from 2004 to 2010.
In the pooled sample, higher education and income at baseline were associated with lower sustained health problems across all five domains. However, race by gender group differences were found in the effects of education and income on sustained insomnia, physical inactivity, and BMI, but not depressive symptoms and SRH. The protective effects of education against insomnia, physical inactivity, and BMI were not found for black men. For black women, the effect of education on BMI was not found. Income had a protective effect against sustained high BMI among white and black women but not white and black men.
The intersection of race and gender alters the protective effects of social determinants on sustained health problems such as insomnia, physical inactivity, and BMI. Social groups particularly vary in the operant mechanisms by which SES contributes to maintaining health over time. The health effects are less universal for education than income. Race by gender groups differ more in SES determinants of BMI, insomnia, and physical inactivity than depressive symptoms and SRH.
KeywordsEthnic groups Blacks Whites Gender Depression Activity Obesity Body mass index Education Income
A public use dataset was used, available at the study website at University of Michigan. The Health and Retirement Study (HRS) is conducted by the Survey Research Center, Institute for Social Research, University of Michigan. The National Institute on Aging (NIA) provided funding for the Health and Retirement Study (U01 AG09740).
Compliance with Ethical Standards
Source of Support
Shervin Assari is supported by the Heinz C. Prechter Bipolar Research Fund and the Richard Tam Foundation at the University of Michigan Depression Center.
Conflict of Interest
All authors declare that they do not have any conflicts of interest.
The study received IRB approval from University of Michigan. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) with the Helsinki Declaration of 1975, as revised in 2000.
Informed consent was obtained from all participants included in the study.
No animal studies were carried out by the authors for this article.
- 3.Pamuk E, editor. Health United States 1998: with socioeconomic status and health chart book. PA, USA: DIANE Publishing; 1999.Google Scholar
- 4.Mare R.D.. “Socio-economic careers and differential mortality among older men in the U.S.”. In: Vallin J, D’Souza S, Palloni A, editors. Measurement and Analysis of Mortality—New Approaches. Oxford: Clarendon; 1990. p. 362–387.Google Scholar
- 6.Pappas G. et 72 Socioeconomic disparities health affairs ~ Volume 21, Number 2 SES & Health on June 16, 2016 by HW Team Health Affairs by http://content.healthaffairs.org/. Downloaded from al., “The Increasing Disparity in Mortality between Socioeconomic Groups in the United States, 1960 and 1986”. N Engl J Med. 1993;329(2):103–9.CrossRefPubMedGoogle Scholar
- 14.Assari S, Lankarani MM. Education and alcohol consumption among older Americans; black-white differences. Front Public Health. 2016;4:–67. doi: 10.3389/fpubh.2016.00067.eCollection 2016.
- 16.Assari S. Combined racial and gender differences in the long-term predictive role of education on depressive symptoms and chronic medical conditions. J Racial Ethn Health Disparities. 2016.Google Scholar
- 22.Hauser RM, Willis RJ. Survey design and methodology in the health and retirement study and the Wisconsin longitudinal study. In: Waite LJ, editor. Aging, health, and public policy: demographic and economic perspectives. New York: The Population Council, Inc; 2005. p. 209–35.Google Scholar
- 23.Heeringa SG, Connor JH. Technical description of the health and retirement survey sample design. 1995. Available from: http://www.hrsonline.isr.umich.edu/sitedocs/userg/HRSSAMP.pdf.
- 33.Allison PD. Structural equation modeling with Amos: basic concepts, applications, and programming. 2 ed. New York, NY: Taylor and Francis Group; 2002.Google Scholar
- 34.Arbuckle JL. Amos 18 user's guide. Chicago, IL: Amos Development Corporation; 2009.Google Scholar
- 35.Kline RB. Principles and practice of structural equation modeling. 3 ed. New York: Guilford press; 2011.Google Scholar
- 37.Dion PA. Interpreting structural equation modeling results: a reply to Martin and Cullen. J Bus Ethics. 2008;83(3):365–8.Google Scholar
- 39.Tabachnick BG, Fidell LS. Using multivariate statistics. 3 ed. New York: Harper Collins; 1996.Google Scholar
- 40.King M. Occupational segregation by race and gender, 1940–1989. Monthly Labor Rev. 1992;115(4):30–7.Google Scholar
- 42.Spalter-Roth R. Race and ethnicity in the labor market; employer practices and worker strategies. In: Hernan V, Feagin JR, editors. Handbooks of the Sociology of Racial and Ethnic Relations. USA: Springer; 2007. p. 263–83.Google Scholar
- 43.Altonji JG, Blank RM. Race and gender in the labor market. In: Ashenfelter O, Card D, editors. Handbook of labor economics, vol. Vol. 3C. Amsterdam: Elsevier Science; 1999. p. 3143–259.Google Scholar
- 44.Proudford KL, Nkomo S. Race and ethnicity in organizations. In: Konrad A, Prasad P, Pringle J, editors. Handbook of workplace diversity. London: SAGE; 2006. p. 323–44.Google Scholar
- 49.England P, Karen C, Reid L. Gender, race, ethnicity, and wages. In: Browne I, editor. Latinas and African American women at work: race, gender, and economic inequality. New York: Russell Sage Foundation; 1999. p. 139–82.Google Scholar
- 54.Crimmins EM, Hayward MD, Seeman TE. Race/ethnicity, socioeconomic status, and health. Critical perspectives on racial and ethnic differences in health in late life. Washington, DC: National Academies Press; 2004. p. 310–52.Google Scholar
- 56.Assari S. Racial disparities in the link between education and mortality in United States. JAMA. Under review. 2016.Google Scholar
- 60.Marmot M. The health gap: the challenge of an unequal world. Bloomsbury Publishing; 2015 Sep 10.Google Scholar
- 65.IWPR. Importance of social security by gender, race/ethnicity, and marital status. The Institute for Women’s Policy Research (IWPR). 2010. Available from: http://www.iwpr.org/publications/pubs/importance-of-social-security-by-gender-race-ethnicity-and-marital-status-2010. Accessed March 2016
- 66.Jencks C, Mayer SE. Residential segregation, job proximity, and black job opportunities. Inner-City poverty in the United States. Washington, DC: National Academy Press; 1990. p. 187–222.Google Scholar
- 68.Kalleberg A, Knoke D, Marsden P, Spaeth J. Organizations in America: analyzing their structures and human resources practices. Thousand Oaks, CA: Sage; 1996.Google Scholar
- 71.Mackenbach JP, Kulhánová I, Bopp M, Deboosere P, Eikemo TA, Hoffmann R, et al. Variations in the relation between education and cause-specific mortality in 19 European populations: a test of the “fundamental causes” theory of social inequalities in health. Soc Sci Med. 2015;127:51–62. doi: 10.1016/j.socscimed.2014.05.021.CrossRefPubMedGoogle Scholar
- 76.Assari S, Lankarani MM. Stressful life events and risk of depression 25 years later: race and gender differences. Front Public Health. 2016:4–49. doi: 10.3389/fpubh.2016.00049.
- 77.Assari S, Moazen-Zadeh E, Lankarani MM, Micol-Foster V. Race, depressive symptoms, and all-cause mortality in the United States. Front Public Health. 2016:4–40. doi: 10.3389/fpubh.2016.00040.
- 78.Assari S, Sonnega A, Pepin R, Leggett A. Residual effects of restless sleep over depressive symptoms on chronic medical conditions: race by gender differences. J Racial Ethn Health Disparities. 2016. doi: 10.1007/s40615-015-0202-z.