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Cumulative Structural Disadvantage and Racial Health Disparities: The Pathways of Childhood Socioeconomic Influence

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  • Jeremy Pais
Abstract
Cumulative structural disadvantage theory posits two major sources of endogenous selection in shaping racial health disparities: a race-based version of the theory anticipates a racially distinct selection process, whereas a social class-based version anticipates a racially similar process. To operationalize cumulative structural disadvantage, this study uses data from the 1979 National Longitudinal Survey of Youth in a Latent Class Analysis that demographically profiles health impairment trajectories. This analysis is used to examine the nature of selection as it relates to racial differences in the development of health impairments that are significant enough to hinder one’s ability to work. The results provide no direct support for the race-based version of cumulative structural disadvantage theory. Instead, two key findings support the social class–based version of cumulative disadvantage theory. First, the functional form of the different health trajectories are invariant for whites and blacks, suggesting more racial similarly in the developmental process than anticipated by the race-based version of the theory. The extent of the racial disparity in the prevalences across the health impairment trajectories is, however, significant and noteworthy: nearly one-third of blacks (28 %) in the United States experience some form of impairment during their prime working years compared with 18.8 % of whites. Second, racial differences in childhood background mediate this racial health disparity through the indirect pathway of occupational attainment and through the direct pathway of early-life exposure to health-adverse environments. Thus, the selection of individuals into different health trajectories, based largely on childhood socioeconomic background, helps explain racial disparities in the development of health impairments. Copyright Population Association of America 2014

Suggested Citation

  • Jeremy Pais, 2014. "Cumulative Structural Disadvantage and Racial Health Disparities: The Pathways of Childhood Socioeconomic Influence," Demography, Springer;Population Association of America (PAA), vol. 51(5), pages 1729-1753, October.
  • Handle: RePEc:spr:demogr:v:51:y:2014:i:5:p:1729-1753
    DOI: 10.1007/s13524-014-0330-9
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    2. Brady, David & Finnigan, Ryan & Kohler, Ulrich & Legewie, Joscha, 2020. "The Inheritance of Race Revisited: Childhood Wealth and Income and Black–White Disadvantages in Adult Life Chances," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 7, pages 599-627.
    3. Joanna N. Lahey & Douglas R. Oxley, 2021. "Discrimination at the Intersection of Age, Race, and Gender: Evidence from an Eye‐Tracking Experiment," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 40(4), pages 1083-1119, September.
    4. Gulzar H. Shah & John P. Sheahan, 2015. "Local Health Departments’ Activities to Address Health Disparities and Inequities: Are We Moving in the Right Direction?," IJERPH, MDPI, vol. 13(1), pages 1-12, December.

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