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Cited by 507Racial and Ethnic Identity ResearchHealth disparities and outcomesPublic Health and Social Inequalities

Miles to Go before We Sleep: Racial Inequities in Health

Open access
Williams, David R.·2012·Journal of Health and Social Behavior
DOI 10.1177/0022146512455804PMC PMC3712789
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Abstract

Large, pervasive, and persistent racial inequalities exist in the onset, courses, and outcomes of illness. A comprehensive understanding of the patterning of racial disparities indicates that racism in both its institutional and individual forms remains an important determinant. There is an urgent need to build the science base that would identify how to trigger the conditions that would facilitate needed societal change and to identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities.

Verified 2026-10-09 · 6 references not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

This review documents large, pervasive, and persistent racial inequities in U.S. health and argues that institutional and individual racism, alongside socioeconomic inequality, are key drivers. It calls for a science base to guide societal and health-care interventions to reduce these inequities.

Key findings

  • In 2007, blacks had an overall death rate 30% higher than whites and higher death rates than whites for 10 of the 15 leading causes of death; the 2007 life expectancy gap was almost five years (73.6 vs. 78.4 years).
  • Minorities experience earlier onset and faster progression of disease: incident heart failure before age 50 was 20 times more common in blacks than whites in CARDIA, with average onset at 39 years for African Americans; 28% of cardiovascular disease deaths among blacks occurred before age 65 versus 13% among whites.
  • Race captures more than SES: high-income blacks and whites lived 7.1 and 6.8 years longer, respectively, than low-income counterparts, with black-white differences at every income level; infant mortality for college-educated African American women was more than 2.5 times that of similarly educated whites and Hispanics.
  • Perceived discrimination is linked to poor health: audit studies found a white applicant with a criminal record was more likely to be offered a job than a black applicant with a clean record, and white-named resumes were 50% more likely to get callbacks; among 5,147 fifth graders, 7% of whites, 15% of Hispanics, and 20% of blacks reported racial discrimination, associated with increased risk of depression, ADHD, oppositional defiant disorder, and conduct disorder.

Methods

  • Narrative review/overview of current knowledge on racial inequities in health, drawing on national mortality and life-expectancy data, epidemiological studies, audit experiments, and policy/intervention evidence.
  • No new primary data collection or formal systematic review/meta-analysis is described; the paper synthesizes published evidence and outlines promising areas for future research and intervention.

Limitations

  • Stated: mortality statistics are more accurate for blacks and whites than for other racial populations due to numerator and denominator problems; misclassification of Asians, Hispanics, and especially American Indians as white on death certificates yields reported rates lower than actual rates.
  • Stated: age-adjusted death rates are not accurate measures of actual risk and can distort the magnitude of disparities; combining Pacific Islander data with Asian data obscures elevated risks, and there is important heterogeneity within OMB racial categories.
  • Stated: current knowledge is even more limited regarding the most effective strategies to reduce health inequities. Evident from the text: as a narrative overview, it does not report a systematic search strategy, inclusion criteria, or quantitative synthesis, so conclusions rely on selected evidence.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1177/0022146512455804

Cites

100 of 106 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

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  • Premisenone given

    African Americans had higher death rates than whites for 10 of the 15 leading causes of death.

    “African Americans had higher death rates than whites for 10 of the 15 leading causes of death.”
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  • Premisecitation

    Middle-aged U.S.-born Mexican Americans and Mexican immigrants with long-term residence in the U.S. had higher levels of allostatic load than recent Mexican immigrants, despite being higher in SES, and even after adjustment for health practices and medical care.

    “middle-aged U.S.-born Mexican Americans and Mexican immigrants with long-term residence in the U.S., had higher levels of allostatic load (a summary measure of biological dysregulation) than recent Mexican immigrants, despite being higher in SES, and even after adjustment for health practices and medical care”
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    • cites Kaestner et al. 2009

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    Morbidity data reveal elevated rates of illness for American Indians compared to whites for multiple conditions.

    “Morbidity data also reveal elevated rates of illness for American Indians compared to whites for multiple conditions”
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    American Indians served by the Indian Health Service, some 60% of that population, have a markedly worse health profile than that of American Indians nationally.

    “American Indians served by the Indian Health Service (IHS, some 60% of that population) have a markedly worse health profile than that of American Indians nationally”
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    • cites Indian Health Service 2009 [ISH]

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    Age-specific black/white mortality ratios are larger than the overall age-adjusted ratio of 1.3 from birth through age seventy-four.

    “age specific black/white mortality ratios are larger than the overall age-adjusted ratio of 1.3 from birth through age seventy-four”
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    • cites Williams et al. 2010

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    Premisecitation

    Among first-generation immigrants, making race salient enhances academic performance, while it reduces academic performance for the second generation.

    “Among first generation immigrants, making race salient enhances academic performance while it reduces academic performance for the second generation”
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    In a study of Chicago adults, foreign-born Hispanics had levels of illness and stress similar to whites, while U.S.-born Hispanics were similar to African Americans on these indicators.

    “a study of Chicago adults found that foreign born Hispanics had level of illness and stress similar to whites while U.S.-born Hispanics were similar to African Americans on these indicators”
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    • cites Sternthal, Slopen, and Williams 2011

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    American Indians had elevated mortality rates for accidents and hypertension.

    “American Indians also had elevated mortality rates for accidents and hypertension.”
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    Immigrants of all racial groups tend to have better health than their native-born peers, but their health declines with increasing length of stay and generational status.

    “Immigrants of all racial groups tend to have better health than their native-born peers but their health declines with increasing length of stay and generational status”
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    • cites Singh and Miller 2004

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    Age-adjusted death rates are useful metrics for comparison but are not accurate measures of actual risk.

    “although age-adjusted death rates are useful metrics for comparison, they are not accurate measures of actual risk”
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    • cites NCHS 2011

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    The lifetime rate of psychiatric disorders is 19% for black Caribbean immigrants, compared to 31% for African Americans and 37% for whites; this rate increases to 35% in the second generation and 55% in the third.

    “compared to a lifetime rate of psychiatric disorders that is 31% for African Americans and 37% for whites (Miranda et al. 2008), the rate is 19% for black Caribbean immigrants (Williams et al. 2007b). This rate increases to 35% in the second generation and 55% in the third.”
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    • cites Miranda et al. 2008

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    American Indians have higher age-specific death rates than whites from birth through age fifty-four, in contrast to an overall age-adjusted rate that is lower than whites.

    “in contrast to an overall age-adjusted rate that is lower than whites, American Indians have higher age-specific death rates than whites from birth through age fifty-four”
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    Premiseown data

    In 2007, blacks had an overall death rate 30% higher than that of whites, while rates for all other groups were lower than that of whites.

    “In 2007, blacks had an overall death rate that was 30% higher than that of whites while the rates for all other groups were lower than that of whites (Table 1).”
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    Interpretationnone given

    Large, pervasive and persistent racial inequalities exist in the onset, course and outcomes of illness.

    “Large, pervasive and persistent racial inequalities exist in the onset, course and outcomes of illness.”
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    Premisecitation

    The extent of health inequalities over time varies by the use of absolute versus relative measures of inequality, and an exclusive use of relative measures can obscure progress.

    “the extent of health inequalities over time varies by the use of absolute versus relative measures of inequality and that an exclusive use of relative measures can obscure progress”
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    • cites Williams 2005

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    African Americans have lower lifetime and current rates of depression than whites.

    “African Americans have lower lifetime and current rates of depression than whites”
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    • cites Williams et al. 2007a

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    Depressed blacks are more likely than their white peers to have higher levels of impairment, more severe symptoms, to be chronically depressed and to not receive any treatment.

    “depressed blacks are more likely than their white peers to have higher levels of impairment, more severe symptoms, to be chronically depressed and to not receive any treatment”
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    In contrast to a protective effect for whites, there was no beneficial effect of moderate alcohol consumption on all-cause mortality for blacks.

    “in contrast to a protective effect for whites, there was no beneficial effect of moderate alcohol consumption on all-cause mortality for blacks”
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    Although levels of cigarette smoking are similar for blacks compared to whites, a given level of tobacco use has a more adverse impact on blacks compared to whites.

    “Although levels of cigarette smoking are similar for blacks compared to whites a given level of tobacco use has a more adverse impact on blacks compared to whites.”
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    Interpretationcitation

    Minorities get sick at younger ages and die sooner than whites.

    “Minorities also get sick at younger ages and die sooner than whites.”
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    Premisecitation

    Black Caribbean men have a current rate of depression that is higher than Caribbean women, despite women generally having higher rates of major depression than men.

    “Women generally have higher rates of major depression than men but Black Caribbean men have a current rate of depression that is higher than Caribbean women”
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    Black women with breast cancer are more likely than their white peers to have tumors that grow quickly, recur more often, are resistant to treatment, and kill more frequently.

    “they are more likely than their white peers to have tumors that grow quickly, recur more often, are resistant to treatment, and kill more frequently”
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    Black Caribbean men have a higher prevalence of current and lifetime mental disorders than Caribbean women and higher current and lifetime rates of mood disorders than African American men.

    “They have a higher prevalence of current and lifetime mental disorders than Caribbean women and current and lifetime rates of mood disorders than African American men”
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    Premisecitation

    Geronimus (1992) showed that national infant death rates were lower for white and Mexican American women who delayed first births to their twenties compared to those who gave birth in their teens, while the opposite pattern was evident for black and Puerto Rican women.

    “Geronimus 1992) showed that national infant death rates were lower for white and Mexican American women who delayed first births to their twenties compared to those who gave birth in their teens. The opposite pattern was evident for black and Puerto Rican women”
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    • cites Geronimus 1992

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    White women have a higher incidence of breast cancer than blacks, but under the age of 40 African American women have a higher incidence than their white peers.

    “White women have a higher incidence of breast cancer than blacks, but the opposite pattern exists under the age of 40, where African American women have a higher incidence than their white peers”
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    • cites Anderson et al. 2008

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    Premisecitation

    Geronimus (1992) argued that the infant mortality pattern was due to 'weathering'-early physiological deterioration due to the cumulative impact of multiple social disadvantages.

    “Geronimus 1992) argued that this pattern was due to ‘weathering’ -- early physiological deterioration due to the cumulative impact of multiple social disadvantages.”
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    In a 20-year follow-up of adults in the CARDIA study, incident heart failure before the age of fifty was 20 times more common in blacks than whites, with the average age of onset being 39 years old for African Americans.

    “a 20 year follow-up of adults in the CARDIA study found that incident heart failure before the age of fifty was 20 times more common in blacks than whites, with the average age of onset being 39 years old for African Americans”
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    • cites Bibbins-Domingo et al. 2009

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    Blacks were more likely than whites to score high on allostatic load (high on 4 or more indicators) at all ages, and the size of the black-white gap increased with age.

    “They found that blacks were more likely than whites to score high on allostatic load (high on 4 or more indicators) at all ages and the size of the black-white gap increased with age.”
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    • cites Geronimus et al. 2006

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    Interpretationcitation

    Although black women are less likely to get breast cancer in any given year, they are more likely to die from it.

    “Thus, although black women are less likely to get breast cancer in any given year, they are more likely to die from it.”
    Quote in the paperSubstantial claim

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    Premisecitation

    Although the racial gap has narrowed, there is still an almost five-year gap in life expectancy in 2007 (73.6 vs. 78.4 years).

    “although the racial gap has narrowed, there is still an almost five-year gap in life expectancy in 2007 (73.6 vs. 78.4 years).”
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    • cites NCHS 2011

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    Life expectancy has been improving for both groups over time, but it was not until 1990 that blacks achieved the life expectancy that whites had in 1950.

    “Life expectancy has been improving for both groups over time but it was not until 1990 that blacks achieved the life expectancy that whites had in 1950.”
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    For both racial groups, as income levels rise, health improves in a stepwise manner, but there are black-white differences in life expectancy at every level of income.

    “For both racial groups, as income levels rise, health improves in a stepwise manner, but there are black-white differences in life expectancy at every level of income.”
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    Interpretationcitation

    The pattern of racial inequities in health in the U.S. mirrors those in other countries and suggests the potential of common societal causes across national and cultural contexts.

    “The pattern of racial inequities in health in the U.S. mirror those in other countries and suggest the potential of common societal causes across national and cultural contexts.”
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    Premisecitation

    Engels argued that British society was committing 'social murder' by exposing workers to living and working conditions that made it difficult to be healthy and live to an advanced age.

    “He argued that British society was committing “social murder” by exposing workers to living and working conditions that made it difficult to be healthy and live to an advanced age.”
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    Health is affected not only by one's current SES but by exposure to social and economic adversity over the life course.

    “health is affected not only by one’s current SES but by exposure to social and economic adversity over the life course.”
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    Interpretationcitation

    Geronimus and colleagues' (2006) analysis of allostatic load scores parallels the life expectancy data and illustrates how race and SES reflect two related but not interchangeable systems of inequality.

    “Geronimus and colleagues (2006) analysis of allostatic load scores parallel the life expectancy data and further illustrate how race and SES reflect two related but not interchangeable systems of inequality.”
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    • cites Geronimus et al. 2006

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    For both blacks and whites, allostatic load scores were higher for the poor than non-poor, but blacks had higher scores than whites at comparable income levels.

    “For both blacks and whites, allostatic load scores were higher for the poor than non-poor, but blacks had higher scores than whites at comparable income levels”
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    • cites Geronimus et al. 2006

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    Premisecitation

    Friedrich Engels noted that the upper classes in Liverpool, England had an average life expectancy of 35 years compared to 15 years for day laborers.

    “Friedrich Engels ([1845] 1984) had noted that the upper classes in Liverpool, England had an average life expectancy of 35 years compared to 15 years for day laborers.”
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    Interpretationreasoning

    Race and SES combine in complex ways to affect health.

    “However, race and SES combine in complex ways to affect health.”
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    Interpretationreasoning

    Historical and contemporary racial discrimination created and perpetuates both racial inequities in SES and racial inequality in health status.

    “historical and contemporary racial discrimination created and perpetuates both racial inequities in SES and racial inequality in health status.”
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    Premisenone given

    There are large racial differences in SES and they account for a substantial part of observed racial differences in health.

    “There are large racial differences in SES and they account for a substantial part of observed racial differences in health.”
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    Interpretationnone given

    Location in social structure reflects differential power and differential exposure to psychological, social, physical and chemical exposures in occupational, residential and other societal contexts.

    “Location in social structure reflects differential power and differential exposure to psychological, social, physical and chemical exposures in occupational, residential and other societal contexts.”
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    Premisecitation

    A recent national study of Jewish Americans found that Jews had higher levels of income and education than other whites, but they reported poorer health status than other whites once the association is adjusted for SES.

    “A recent national study of Jewish Americans, a white ethnic group with a history of structural disadvantage and stigmatization, found that Jews had higher levels of income and education than other whites, but they reported poorer health status than other whites once the association is adjusted for SES”
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    • cites Pearson and Geronimus 2011

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    Premisenone given

    Discrimination has also been associated with delays in seeking treatment, lower adherence to medical regimes, and lower rates of follow-up.

    “Discrimination has also been associated with delays in seeking treatment, lower adherence to medical regimes, and lower rates of follow-up.”
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    Premisecitation

    Public sector employment has been a key to black upward mobility and the development of the black middle class.

    “Public sector employment has been a key to black upward mobility and the development of the black middle class”
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    • cites Wilson 2011

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    Premisenone given

    Extant studies include all major racial/ethnic groups in the U.S. and non-dominant racial groups in New Zealand, South Africa and Australia, and immigrants in Canada, Hong Kong and many countries in Europe.

    “Extant studies include all major racial/ethnic groups in the U.S. and non-dominant racial groups in New Zealand, South Africa and Australia, and immigrants in Canada, Hong Kong and many countries in Europe.”
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    Premisereasoning

    Environmental exposures are one potential contributor to epigenetic changes, reflecting the reality that biology is not static but adapts to environmental conditions.

    “Environmental exposures are one potential contributor to epigenetic changes, reflecting the reality that biology is not static but adapts to environmental conditions.”
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    Premisereasoning

    Although the majority of poor persons in the U.S. are white, poor white families are not concentrated in contexts of economic and social disadvantage and with the absence of an infrastructure that promotes opportunity in the ways that poor blacks and Latinos are.

    “Although the majority of poor persons in the U.S. are white, poor white families are not concentrated in contexts of economic and social disadvantage and with the absence of an infrastructure that promotes opportunity in the ways that poor blacks and Latinos are.”
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    Premisereasoning

    The neighborhoods where minority children live have lower income, education and home ownership rates and higher rates of poverty and unemployment compared to those where white children reside.

    “The neighborhoods where minority children live have lower income, education and home ownership rates and higher rates of poverty and unemployment compared to those where white children reside.”
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    Premisecitation

    There are higher levels of college completion for women than men in all racial groups in the U.S., but the gap is largest among blacks.

    “there are higher levels of college completion for women than men in all racial groups in the U.S., but the gap is largest among blacks.”
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    Limited evidence indicates that whites understand questions about discrimination in ways similar to blacks and that their emotional reactions and reported stress responses are similar to those of African Americans.

    “Limited evidence indicates that whites understand questions about discrimination in ways similar to blacks and that their emotional reactions and reported stress responses are similar to those of African Americans”
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    • cites Williams et al. 2012

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    Premisecitation

    Although their levels of discrimination are lower than those of blacks, discrimination also adversely affects the health of whites.

    “although their levels of discrimination are lower than those of blacks, discrimination also adversely affects the health of whites”
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    • cites Williams and Mohammed 2009

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    Premisecitation

    The median wealth of whites is 20 times that of blacks and 18 times that of Hispanics.

    “Thus the median wealth of whites is 20 times that of blacks and 18 times that of Hispanics.”
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    • cites Pew Research Center 2011b

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    Premisecitation

    Residential segregation by race, a mechanism of institutional discrimination, can restrict socioeconomic attainment and lead to group differences in SES and health.

    “Residential segregation by race, a mechanism of institutional discrimination, can restrict socioeconomic attainment and lead to group differences in SES and health.”
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    • cites Williams and Collins 2001

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    Premisecitation

    Residential segregation creates pathogenic neighborhood conditions with minorities living in markedly more health-damaging residential environments than whites and facing higher levels of acute and chronic stressors.

    “It also creates pathogenic neighborhood conditions with minorities living in markedly more health-damaging residential environments than whites and facing higher levels of acute and chronic stressors.”
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    • cites Williams and Collins 2001

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    Premisenone given

    Minority group members are aware of at least some experiences of discrimination and such incidents can be a source of stress.

    “Minority group members are aware of at least some experiences of discrimination and such incidents can be a source of stress.”
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    Premisecitation

    Wilson (2011) indicates that these challenges will be especially acute for black males.

    “Wilson (2011) also indicates that these challenges will be especially acute for black males.”
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    • cites Wilson 2011

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    Premisecitation

    In 2011, the Republican edge over democrats among whites was 13 points (52% to 39%), compared to a two point edge (46% to 44%) in 2008.

    “in 2011, the Republican edge (Republicans or Independents leaning Republican) over democrats among whites was 13 points (52% to 39%), compared to a two point edge (46% to 44%) in 2008.”
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    • cites Pew Research Center 2011a

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    Premisecitation

    Gains in life expectancy for working-age black women during 1965-74 exceeded those of other race and sex groups and were three times as large as those in the prior decade.

    “In turn, the gains in life expectancy for working-age black women during 1965-74 exceeded those of other race and sex groups and were three times as large as those in the prior decade (Kaplan et al. 2008).”
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    • cites Kaplan et al. 2008

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    Interpretationreasoning

    The evidence reviewed here documents the persistence of inequality and discrimination and suggests that anti-discrimination programs may be crucial for ensuring racial equality.

    “the evidence reviewed here document the persistence of inequality and discrimination and suggest that anti-discrimination programs may be crucial for ensuring racial equality.”
    Quote in the paperNot a substantial claim

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    Premisecitation

    Civil Rights policies narrowed the black-white economic gap, with gains greater for women than for men.

    “Civil Rights policies narrowed the black-white economic gap with the gains being greater for women than for men (Kaplan, Ranjit, and Burgard 2008).”
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    • cites Kaplan, Ranjit, and Burgard 2008

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    Premisecitation

    40,000 people die in the U.S. annually because of a lack of health insurance.

    “The bottom-line is that 40,000 people die in the U.S. annually because of a lack of health insurance and we need to maximize the potential of health care to reduce disparities (Wilper et al. 2009).”
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    • cites Wilper et al. 2009

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    Interpretationcitation

    These budget cuts weaken the social safety net for vulnerable populations and will likely lead to increased rates of illness, greater numbers of premature deaths and increased healthcare costs.

    “These budget cuts, many of them outside the health sector, weaken the social safety net for vulnerable populations and will likely lead to increased rates of illness, greater numbers of premature deaths and increased healthcare costs”
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    • cites Woolf 2011

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    Premisecitation

    Since President Obama has been elected, there has been marked growth in Republican party membership among White voters that has been particularly pronounced among the young (18-29) and the low income (less than $30k).

    “Since President Obama has been elected, there has been marked growth in Republican party membership among White voters that has been particularly pronounced among the young (18-29) and the low income (less than $30k)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Pew Research Center 2011a

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    At least some types of medical care have the potential to improve health and reduce social inequalities in health.

    “However, several lines of evidence highlight the potential of at least some types of medical care to improve health and reduce social inequalities in health.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In that randomized study, the treatment group had lower out-of-pocket medical expenses, lower medical debt, and lower financial stress than controls.

    “A recent study that randomized uninsured residents to apply for Medicaid services found that, one year later, the treatment group had higher use of health care services (including primary and preventive care), lower out-of-pocket medical expenses, lower medical debt and financial stress, and better self-reported physical and mental health than the control group (Finkelstein et al. 2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Finkelstein et al. 2011

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Several widely used framing strategies-framing diversity as a strength, arguing that disparities for minorities were early warning indicators, and claiming that disparities reflect white privilege or are structurally driven-were ineffective.

    “This research has found that several framing strategies that are widely used such as framing diversity as a strength, arguing that disparities for minorities were early warning indicators (canaries in a coal mine), or claiming that disparities reflect white privilege or are structurally driven were all ineffective (Davey 2009).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Davey 2009

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Both whites who voted for President Obama and those who did not indicate that there is less need to address racial inequality in the U.S. and they would be less supportive of policies to address inequities.

    “Both whites who voted for President Obama and those who did not indicate that there is less need to address racial inequality in the U.S. and they would be less supportive of policies to address inequities”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Williams et al. 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Increased access to health care in Iran led to declines in child and maternal mortality and increases in life expectancy at birth.

    “Although increased access to health care led to declines in child and maternal mortality and increases in life expectancy at birth, the low birthweight rate has not declined (Jafari et al. 2010).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Jafari et al. 2010

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Primary care is associated with better health at the individual and population level.

    “First, primary care, with its emphasis on preventive care and the early management of disease is associated with lower total costs of health services, better health at the individual and population level and smaller social disparities in health (Starfield, Shi, and Macinko 2005).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Starfield, Shi, and Macinko 2005

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    A similar effect was not evident after Obama's election or inauguration, and no effect was found among whites.

    “A similar effect not evident after his election or inauguration and no effect was found among whites.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Malat, Timberlake, and Williams 2011

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Interpretationnone given

    Communities vary in their levels of social cohesion and other protective resources, such that community capacity can be an important resource at the local level.

    “In addition, communities vary in their levels of social cohesion and other protective resources such that community capacity can be an important resource at the local level.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Access to employment, opportunities for economic mobility, and other social and economic resources can eliminate disparities in marriage and promote health.

    “Thus, access to employment, opportunities for economic mobility and other social and economic resources can eliminate disparities in marriage and promote health.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    In 1994, black levels of happiness and life satisfaction were at the highest level observed between 1983 and 1995, with the racial gap in psychological well-being eliminated for the first time in history.

    “In 1994, the year that Nelson Mandela was elected, black levels of happiness and life satisfaction were at the highest level observed between 1983 and 1995, with the racial gap in psychological well-being eliminated for the first time in history (Moller 1998).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Moller 1998

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationnone given

    Racial disparities in health are a stark symbol of the historic and ongoing racial inequalities in society.

    “Racial disparities in health are a stark symbol of the historic and ongoing racial inequalities in society.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisecitation

    In 1988, the proportion of blacks reporting that whites wanted to keep blacks down and reports of racial discrimination were at their lowest.

    “That year also marked the lowest proportion of blacks reporting that whites wanted to keep blacks down and the lowest reports of racial discrimination.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Jackson et al. 1996

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Active duty military service promotes marriage over cohabitation, increases the likelihood of first marriage, and leads to greater stability of marriage, and these effects are greater for blacks than for whites.

    “Research reveals that active duty military service promotes marriage over cohabitation, increases the likelihood of first marriage, and leads to greater stability of marriage and that these effects are greater for blacks than for whites (Teachman 2007; Teachman 2009; Teachman and Tedrow 2008).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Teachman 2007

      Not checked in the free run.

    • cites Teachman 2009

      Not checked in the free run.

    • cites Teachman and Tedrow 2008

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    When Obama's stereotype-defying success received considerable media attention, there was improvement in black academic performance and a marked reduction in the negative effects of racial stereotypes on black academic performance.

    “Other research reveals that when President Barak Obama’s stereotype-defying success received considerable media attention (just after his nomination at the Democratic Convention and his election) there was improvement in black academic performance and a marked reduction in the well-documented negative effects of racial stereotypes on black academic performance (Marx, Ko, and Friedman 2009).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Marx, Ko, and Friedman 2009

      Not checked in the free run.

  • May combine two claims.

    Interpretationcitation

    Exposure to protective resources and the particular patterns of response mobilized to deal with potential threats can affect levels of risk factors and minimize the negative effects of particular risks.

    “Both exposure to protective resources and the particular patterns of response that are mobilized to deal with potential threats can affect the levels of risk factors and also minimize the negative effects of particular risks.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    Among both males and females, American Indians and whites have suicide rates comparable to each other and two to three times higher than those of blacks, Asians, and Hispanics.

    “For example, among both males and females, American Indians and whites have suicide rates that are comparable to each other and two to three times higher than those of blacks, Asians and Hispanics (Centers for Disease Control 2011).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Centers for Disease Control 2011

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    States with more generous spending on education, more progressive taxation systems, and more humane TANF and Medicaid program rules had better overall population health.

    “A recent study using cross-sectional data for 50 states for a 10-year period documented that states with more generous spending on education, more progressive taxation systems and more humane (lenient) TANF and Medicaid program rules had better overall population health (Kim and Jennings 2009) with the effects being stronger for overall mortality than for infant mortality.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kim and Jennings 2009

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    The life expectancy for blacks declined from the 1984 level for 5 years in a row while the life expectancy of whites increased slightly during this period.

    “For example, the life expectancy for blacks declined from the 1984 level for 5 years in a row while the life expectancy of whites increased slightly during this period.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Williams and Collins 1995

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S4 (based).

    Interpretationreasoning

    Racial disparities in health attest to the enduring effects of the institutionalization of inequality for stigmatized social groups.

    “They attest to the enduring effects of the institutionalization of inequality for stigmatized social groups.”
    Quote in the paperNot a substantial claim
78 of 78

  • The paper relies on this without support.

    Racial inequalities in health are unjust and warrant societal intervention.

    “there is an urgent need to develop a science base to guide societal interventions”

  • The paper relies on this without support.

    Societal interventions can effectively reduce racial health inequities.

    “identify the optimal interventions that would confront and dismantle the societal conditions that create and sustain health inequalities”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Historically stigmatized racial groups-blacks, Native Americans, and Native Hawaiians and Other Pacific Islanders-have worse health than whites.

    “The historically stigmatized racial groups, blacks (or African Americans), Native Americans (or American Indians and Alaska Natives) and Native Hawaiians and Other Pacific Islanders, have worse health than that of whites [1]”

    From Reducing Racial Inequities in Health: Using What We Already Know to Take Action (2019) · cites this paper as [1]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Two different articles share the same publication identifiers

    Minor

    The references assign the same PMID (29887911) and PMCID (PMC5993442) to two articles with different titles and page ranges. At least one set of identifiers is incorrect.

1 of 1

Cites

Flagged first, then by citations

Research works printed but not linked: 10

  1. Almond Douglas, Chay Kenneth Y. 2006. “The Long-Run and Intergenerational Impact of Poor Infant Health: Evidence from Cohorts Born during the Civil Rights Era.” Working Paper: National Bureau of Economic Research, Cambridge, MA.
  2. American Sociological Association, 2003, The Importance of Collecting Data and Doing Scientific Research on Race
  3. Bramley Dale, 2004, New Zealand Medical Journal, 117, U1215
  4. Geronimus Arline T., 1992, Ethnicity and Disease, 2, 207
  5. Jackson James S., 1996, Ethnicity and Disease, 6, 132
  6. Malat Jennifer, 2011, Ethnicity and Disease, 21, 349
  7. Office of Management and Budget, 1997, Federal Register, 62, 58781
  8. Stinson Frederick S., 1996, U.S. Alcohol Epidemiologic Data Reference Manual
  9. Tucker Clyde, 1996, Bureau of Labor Statistical Notes, 40, 1
  10. Xu Jiaquan, 2010, National Vital Statistics Reports, 58, 1

Cited by

Sorted by citations

Related

Authors
Williams, D. R.
Affiliations
Harvard University (US)
Corresponding author
Williams, David R.
ORCID
Williams, David R.
Venue
Journal of Health and Social Behavior
Publisher
SAGE Publications
Published
2012-08-31
Volume
53
Issue
3
Pages
279-295
ISSN
  • 0022-1465 (ISSN-L)
  • 2150-6000
DOI
10.1177/0022146512455804
PMC
PMC3712789
OpenAlex
W2145131361
Cited by
507
References
105
Citations by year
2026: 9 · 2025: 47 · 2024: 40 · 2023: 39 · 2022: 63 · 2021: 73 · 2020: 38 · 2019: 28 · 2018: 33 · 2017: 39 · 2016: 32 · 2015: 26 · 2014: 26 · 2013: 12 · 2012: 2
FWCI
11.31
Type
journal article
Language
en
Open access
Licence
journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
Locations
  • Journal of Health and Social Behavior (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (P50CA148596)
Topics
  • Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
  • Social Sciences › Health › Health disparities and outcomes
  • Social Sciences › Health › Public Health and Social Inequalities
Keywords
racial disparities in health, health disparities, racism, institutional racism, individual racism, social determinants of health, health interventions, social change
MeSH terms
Age Factors, Awareness, Humans, Mortality, Politics, Risk Factors, Socioeconomic Factors, Sociology, Medical, Time Factors, Racial Groups, Health Status Disparities, Healthcare Disparities, Policy, Racism

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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