The Significance of Socioeconomic Status in Explaining the Racial Gap in Chronic Health Conditions

Black Americans live fewer years than whites and live more years with chronic health problems. The origins of this racial gap are ambiguous. This study examines the pervasiveness of this gap across chronic medical and disabling conditions among middle-aged persons. Alternative hypotheses about how fundamental social conditions of disease differentiate the health of blacks and whites are also examined. Results show that the racial gap in health is spread across all domains of health, and that socioeconomic conditions, not health risk behaviors, are the primary origins of the racial stratification of health. No evidence was found in support of the idea that blacks and whites differ in their ability to transform socioeconomic resources into good health. The results point to the importance of continued research on how health and achievement processes are linked across childhood, adolescence, adulthood, and old age. Such studies are needed to enrich work on the inequality of health and life cycle achievement.