Health, behavior, and health care disparities: disentangling the effects of income and race in the United States.
Abstract
The literature on health disparities in the United States typically focuses on race/ethnicity or on socioeconomic status (SES) separately, but not often together. The purpose of the study was to assess the separate effects of race/ethnicity and SES on health status, health behaviors, and health care utilization. Cross-sectional analyses were conducted using the 2008 National Health Interview Survey (n = 17,337 non-elderly adults). SES disparities within specific racial groups were examined, as were race disparities within high and low SES groups. Within each racial/ethnic group, a greater proportion of low versus high SES individuals were in poor health, a lower proportion had healthy behaviors, and a lower proportion had access to care. In both SES groups, blacks and Hispanics had poorer health outcomes than whites. While whites were more likely to exercise than blacks and Hispanics, they are more likely to be smokers and less likely to have no or moderate alcohol consumption. Blacks had similar or better health care use than whites, especially for cancer screening; Hispanics had lower use within each SES group. Race/ethnicity disparities among adults of similar incomes, while important, were dwarfed by the disparities identified between high- and low-income populations within each racial/ethnic group.
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Between Black and White individuals, age-adjusted death rates narrowed from 1993 to 2015, but the gap began widening after 2016.
“Age-adjusted death rates by race and ethnicity between Black individuals and White individuals narrowed from 1993 to 2015, but since 2016 the gap began widening.”
From Trends in Differences in Health Status and Health Care Access and Affordability by Race and Ethnicity in the United States, 1999–2018 (2021) · cites this paper as [5]
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- Authors
- Dubay, L. C., & Lebrun, L. A.
- Affiliations
- Urban Institute (US)
- Corresponding author
- Dubay, Lisa C.
- ORCID
- Dubay, Lisa C.
- Venue
- International Journal of Health Services
- Publisher
- SAGE Publications
- Published
- 2012-10
- Volume
- 42
- Issue
- 4
- Pages
- 607-625
- ISSN
- 0020-7314 (ISSN-L)
- 1541-4469
- OpenAlex
- W2135561977
- Cited by
- 139
- References
- 32
- Citations by year
- 2026: 3 · 2025: 9 · 2024: 11 · 2023: 18 · 2022: 16 · 2021: 12 · 2020: 10 · 2019: 12 · 2018: 8 · 2017: 7 · 2016: 9 · 2015: 10 · 2014: 8 · 2013: 6
- FWCI
- 8.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Health Services (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Johns Hopkins University
- Johns Hopkins Bloomberg School of Public Health
- National Institute on Minority Health and Health Disparities
- Topics
- Social Sciences › Health › Health disparities and outcomes
- Social Sciences › Health › Public Health and Social Inequalities
- Social Sciences › Sociology and Political Science › Racial and Ethnic Identity Research
- Keywords
- health care disparities, socioeconomic status, race and ethnicity, income inequality, health behavior, health care utilization, health care access, cancer screening, smoking, alcohol consumption, physical activity, Black people, Hispanic adults, White adults, non-elderly adults
- MeSH terms
- Adolescent, Adult, Alcohol Drinking, Female, Humans, Income, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Patient Acceptance of Health Care, Smoking, United States, Health Behavior, Exercise, Racial Groups, Health Status Disparities, Healthcare Disparities, Early Detection of Cancer, Young Adult
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.
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.
What counts as a claim ›How we measure confidence ›How we check this ›
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