Health Disparities and the Black Middle Class: Overview, Empirical Findings, and Research Agenda

Health disparities may follow along a series of “…events signified by a difference in (1) environment, (2) access to, utilization of, and quality of care, (3) health status, or (4) a particular health outcome that deserves scrutiny” (Carter-Pokras and Baquet 2002: 427). This chapter focuses on three types of health disparities assessed by evaluating the gap in health status or a given health outcome. First, we describe Black–White differences across health and refer to these patterns as general health disparities. Second, we present some research demonstrating the standard SES-health gradient where those at the top of the economic hierarchy are in much better health than those at the bottom of the economic hierarchy. We focus specifically on the health of African Americans since our ultimate goal is to better understand differences within this population. Third, we emphasize a more recent disparity highlighted by some health scholars – that of a paradox among the Black middle class. These inequalities are surprising (and hence referred to as paradoxical) because the patterns are counter-intuitive to the SES-health gradient.

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Introduction

Black–White Health Inequalities in Canada

Health Disparities

Notes

The number of individuals who identify as Black may be decreasing as more Blacks adopt a biracial or immigrant identity (Korgen 1998; Rockquemore and Brunsma 2002; Waters 1996, 1999).

In another series of studies of overall birth weight, African-born Black women experienced lower rates of very low birth weight compared to African American women (Williams and Collins 1995), and Black Caribbean (75% from Jamaica, Haiti, Belize) women immigrants gave birth to heavier infants than African-American women (Pallotto et al. 2000).

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Authors and Affiliations

1. Department of Sociology, Indiana University, Ballantine 744, Bloomington, IN, 47405, USA Pamela Braboy Jackson

1. Pamela Braboy Jackson