Socioeconomic Mobility and Black–White Health Disparities in Midlife: Differential Mobility Patterns or Differential Health Returns?

• In Event: Inequality, Poverty, and Mobility Section Roundtables
  In Refereed Roundtable (60 minute): 5. Inequality and Health

Abstract

Prior work documents both racial gaps in status mobility and differential health returns to SES trajectories, but few studies quantify their relative contributions to Black–White health disparities. Using data from the Panel Study of Income Dynamics (PSID), this study applies a randomized interventional causal decomposition and simulation approach to estimate how childhood socioeconomic position and intergenerational income mobility mediate Black–White gaps in midlife self-rated health, stroke, and heart attack. Results show that SES trajectories account for more than 90% of the gap in self-rated health. The primary mediated pathway operates through childhood income (including its downstream influence on mobility) rather than mobility alone, indicating the long-term impact of early-life resource deprivation. Further decomposition identifies two mechanisms driving health inequities: unequal exposure to lifetime SES trajectories and unequal health associations with these socioeconomic patterns, with the former playing a more significant role. For self-rated health and stroke, the mediated Black–White gap associated with status mobility stems almost entirely from compositional racial differences rather than differences in health returns to similar mobility patterns. For heart attack, however, we observe a suppression pattern where the protective effects associated with favorable SES and mobility patterns are offset by comparable, risk-increasing mediated interactions. This offsetting pattern is consistent with the physiological “weathering” costs of achieving upward mobility under structural racism. These results emphasize the need to address both structural barriers to socioeconomic advancement and the racism-related conditions that diminish its health benefits.

Author

• Yajie Xiong, University of Maryland-College Park