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abstract We used data from the Medical Expenditure Panel Survey to explore potential explanations for racial/ethnic disparities in coronavirus disease 2019 (COVID-19) hospitalizations and mortality. Black adults in every age group were more likely than White adults to have health risks associated with severe COVID-19 illness. However, Whites were older, on average, than Blacks. Thus, when all factors were considered, Whites tended to be at higher overall risk compared with Blacks, with Asians and Hispanics having much lower overall levels of risk compared with either Whites or Blacks. We explored additional explanations for COVID19 disparities-namely, differences in job characteristics and how they interact with household composition. Blacks at high risk for severe illness were 1.6 times as likely as Whites to live in households containing health-sector workers. Among Hispanic adults at high risk for severe illness, 64.5 percent lived in households with at least one worker who was unable to work from home, versus 56.5 percent among Black adults and only 46.6 percent among White adults.

Bridging research in social psychology with scholarship on racialized organizations, this article shows how individual bias and organizational demographic composition can operate together to shape the degree of discrimination in schools. To understand Black and Latino boys’ higher rates of discipline that persist net of differences in behavior, I combine an original video experiment involving 1,339 teachers in 295 U.S. schools with organizational data on school racial/ethnic and socioeconomic composition. In the experiment, teachers view and respond to a randomly assigned video of a White, Black, or Latino boy committing identical, routine classroom misbehavior. I find that, compared to White boys, Black and Latino boys face a double jeopardy. They experience both (1) individual-level teacher bias, where they are perceived as being more “blameworthy” and referred more readily for identical misbehavior, and (2) racialized organizational climates of heightened blaming, where students of all races/ethnicities are perceived as being more “blameworthy” for identical misbehavior in schools with large minority populations versus in predominantly White schools. This study develops a more comprehensive understanding of the production of racial/ethnic inequality in school discipline by empirically identifying a dual process that involves both individual teacher bias and heightened blaming that is related to minority organizational composition.

Comparative research on racial classification has often turned to Latin America, where race is thought to be particularly fluid. Using nationally representative data from the 2010 and 2012 America's Barometer survey, the authors examine patterns of self-identification in four countries. National differences in the relation between skin color, socioeconomic status, and race were found. Skin color predicts race closely in Panama but loosely in the Dominican Republic. Moreover, despite the dominant belief that money whitens, the authors discover that status polarizes (Brazil), mestizoizes (Colombia), darkens (Dominican Republic), or has no effect (Panama). The results show that race is both physical and cultural, with country variations in racial schema that reflect specific historical and political trajectories.

For 40 years, the Tuskegee Study of Untreated Syphilis in the Negro Male passively monitored hundreds of adult black men with syphilis despite the availability of effective treatment. The study’s methods have become synonymous with exploitation and mistreatment by the medical profession. To identify the study’s effects on the behavior and health of older black men, we use an interacted difference-in-difference-in-differences model, comparing older black men to other demographic groups, before and after the Tuskegee revelation, in varying proximity to the study’s victims. We find that the disclosure of the study in 1972 is correlated with increases in medical mistrust and mortality and decreases in both outpatient and inpatient physician interactions for older black men. Our estimates imply life expectancy at age 45 for black men fell by up to 1.5 years in response to the disclosure, accounting for approximately 35% of the 1980 life expectancy gap between black and white men and 25% of the gap between black men and women.

Building on our earlier research (Case and Deaton 2015), we find that mortality and morbidity among white non-Hispanic Americans in midlife since the turn of the century continued to climb through 2015. Additional increases in drug overdoses, suicides, and alcohol-related liver mortality—particularly among those with a high school degree or less—are responsible for an overall increase in all-cause mortality among whites. We find marked differences in mortality by race and education, with mortality among white non-Hispanics (males and females)risingfor those without a college degree, andfallingfor those with a college degree. In contrast, mortality rates among blacks and Hispanics have continued to fall, irrespective of educational attainment. Mortality rates in comparably rich countries have continued their premillennial fall at the rates that used to characterize the United States. Contemporaneous levels of resources—particularly slowly growing, stagnant, and even declining incomes—cannot provide a comprehensive explanation for poor mortality outcomes. We propose a preliminary but plausible story in whichcumulative disadvantagefrom one birth cohort to the next—in the labor market, in marriage and child outcomes, and in health—is triggered by progressively worsening labor market opportunities at the time of entry for whites with low levels of education. This account, which fits much of the data, has the profoundly negative implication that policies—even ones that successfully improve earnings and jobs, or redistribute income—will take many years to reverse the increase in mortality and morbidity, and that those in midlife now are likely to do worse in old age than the current elderly. This is in contrast to accounts in which resources affect health contemporaneously, so that those in midlife now can expect to do better in old age as they receive Social Security and Medicare. None of this, however, implies that there are no policy levers to be pulled. For instance, reducing the overprescription of opioids should be an obvious target for policymakers.

Race remains at the forefront of the public agenda, and understanding how white and black Americans understand race relations and racial issues has become all the more critical. Amid the lively debate surrounding the meaning of the racial resentment scale, we utilize open-ended reactions from white and black Americans to identify the key themes that emerge from how both whites and blacks understand this canonical measure. Based on these reactions, we suggest that the scale should be recast as Structural versus Individual Attributions for Black Americans’ Economic and Social Status (SIA) and advocate further investigation into similarities and differences in black and white public opinion.

Pre-exposure prophylaxis (PrEP) is an effective biomedical HIV prevention method. PrEP uptake has been persistently low among US women, particularly Black women, who account for 61% of new HIV diagnoses among women. Further understanding of barriers to Black women accessing PrEP is needed. This 2017 cross-sectional survey study explored race-based differences in PrEP interest and intention among women and the indirect association between race and comfort discussing PrEP with a healthcare provider through medical mistrust. The sample consisted of 501 adult women (241 Black; 260 White) who were HIV-negative, PrEP-inexperienced, and heterosexually active. Black women reported greater PrEP interest and intention than White women. However, Black women expressed higher levels of medical mistrust, which, in turn, was associated with lower comfort discussing PrEP with a provider. Medical mistrust may operate as a unique barrier to PrEP access among Black women who are interested in and could benefit from PrEP.

Though Hispanics live long lives, whether a “Hispanic paradox “extends to older-age health remains unclear, as do the social processes underlying racial-ethnic and immigrant-native health disparities. Using data from the Health and Retirement Study (2004–2012; N = 6,581), we assess the health of U.S.- and foreign-born Hispanics relative to U.S.-born whites and blacks and examine the socioeconomic, stress, and behavioral pathways contributing to health disparities. Findings indicate higher disability, depressive, metabolic, and inflammatory risk for Hispanics relative to whites and similar health profiles among Hispanics and blacks. We find limited evidence of a healthy immigrant pattern among foreign-born Hispanics. While socioeconomic factors account for Hispanic-white gaps in inflammation, disparities in other outcomes persist after adjustment for socioeconomic status, due in part to group differences in stress exposure. Hispanics may live long lives, but their lives are characterized by more socioeconomic hardship, stress, and health risk than whites and similar health risks as blacks.

While health inequalities related to race/ethnicity, nativity, and age are well documented, it remains unclear how these axes of stratification combine to shape health trajectories, especially in middle and late life. This study addresses gaps in the literature by drawing on both life course and intersectionality perspectives to understand inequalities in morbidity trajectories. Using growth curve models applied to data from the Health and Retirement Study, I examine the life course patterning of health inequalities among US- and foreign-born non-Hispanic whites, non-Hispanic blacks, and Mexican Americans between the ages of 51 and 80 (N = 16,265). Findings are consistent with premature aging and cumulative disadvantage processes: US- and foreign-born blacks and Mexican Americans experience earlier health deterioration than US-born whites, and they also tend to exhibit steeper health declines with age. Moreover, contrary to the common assumption of monolithic healthy immigrant and erosion processes, results show that these processes are contingent on both race/ethnicity and age: compared with US-born whites, white immigrants have a persistent health advantage, while black and Mexican American immigrants experience a health disadvantage that increases with age. These results suggest that among nonwhite immigrants, the immigrant health advantage may be offset by cumulative exposure to racialized immigrant incorporation processes. A wide array of health-related factors including socioeconomic resources, health behaviors, and medical care account for some, but not all, group differences in morbidity trajectories. Findings highlight the utility of life course and intersectionality perspectives for understanding health inequalities.

Objective: During the past decade, the availability of health information online has increased dramatically. We assessed progress toward the Healthy People 2020 (HP2020) health communication and health information technology objective of increasing the proportion of health information seekers who easily access health information online. Methods: We used data from 4 administrations of the Health Information National Trends Survey (HINTS 2008-2017) (N = 18 103). We conducted multivariable logistic regression analysis to evaluate trends over time in experiences with accessing health information and to examine differences by sociodemographic variables (sex, age, race/ethnicity, education, income, metropolitan status) separately for those who used the internet (vs other information sources) during their most recent search for health information. Results: Among US adults who looked for health information and used the internet for their most recent search, the percentage who reported accessing health information without frustration was stable during the study period (from 37.2% in 2008 to 38.5% in 2017). Accessing information online without frustration was significantly and independently associated with age 35-49 (vs age 18-34) (odds ratio [OR] = 1.34; 95% confidence interval [CI], 1.03 -1.73), non-Hispanic black (vs non-Hispanic white) race/ethnicity (OR = 2.15; 95% CI, 1.55-2.97), and annual household income <$20 000 (vs >$75 000) (OR = 0.66; 95% CI, 0.47-0.93). The percentage of adults who used an information source other than the internet and reported accessing health information online without frustration ranged from 31.3% in 2008 to 42.7% in 2017. Survey year 2017 (vs 2008) (OR = 1.61; 95% CI, 1.09-2.35) and high school graduate education (vs college graduate) (OR = 0.69; 95% CI, 0.49-0.97) were significantly and independently associated with accessing health information without frustration from sources other than the internet. Conclusions: The percentage of online health information seekers reporting easily accessing health information did not meet the HP2020 objective. Continued efforts are needed to enable easy access to online health information among diverse populations.