It's about time

Racial/ethnic health disparities conditional on socioeconomic status among US women, 1978–2018

Bibliographic Data

ID19488689
AuthorsJolene Tan (0000-0003-4968-3482, Princeton University, corresponding author), Beza Taddess (Princeton University), A Mojola (0000-0002-2610-2625, Princeton University)
Year2026
Volume34
Pages101930
Publication date2026-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSSM - Population Health (JOURNAL)
Journal identifiersISSN: 2352-8273 • E-ISSN: 2352-8273
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.ssmph.2026.101930
PMID42181745
OpenAlexW7160665713
LanguageEN
References cited68

This study explores temporal patterns in racial/ethnic and socioeconomic disparities in health among US women. While prior research has shown that socioeconomic gains often yield smaller health benefits for racially marginalized populations, less is known about how these patterns vary across historical periods, age groups, and birth cohorts. Using data from the National Health Interview Survey 1978–2018 ( N = 1,416,652), we examine how education, income, and employment status are linked to self-rated health across intersecting time dimensions. We find that health returns of socioeconomic resources tend to peak in midlife and are particularly limited for women racialized as Black and American Indian/Alaska Native. For example, among middle-aged women, self-rated health is higher for those living above the poverty threshold than those living below it, with larger differences for women racialized as White (3.77 vs. 3.15) than for women racialized as Black (3.43 vs. 3.05) or American Indian/Alaska Native (3.42 vs. 3.00). Over time, sociopolitical shifts appear to benefit women racialized as White more than women racialized as Black, with larger health advantages associated with socioeconomic resources under both Democratic (e.g., Carter: 3.70 vs. 3.33; Obama: 3.80 vs. 3.54) and Republican (e.g., Reagan: 3.81 vs. 3.44; Trump: 3.79 vs. 3.55) administrations. Across successive birth cohorts, health differences associated with socioeconomic resources have narrowed, with smaller gaps between advantaged and disadvantaged groups in income, education, and employment among Millennials than among Baby Boomers. These findings highlight the importance of historical and social context in shaping health disparities. • Higher socioeconomic status yields unequal health returns across racial/ethnic groups. • Biosocial, institutional, and sociocultural mechanisms are commonly used to explain these disparities. • We use age, period, and cohort as proxies for these mechanisms to examine temporal variation. • Temporal context helps identify when and how disparities emerge, which can inform equity-focused health strategies

Ethnic group · Health equity · Population · Public health · Race (biology) · Socioeconomic status · Health disparities and outcomes · Racial and Ethnic Identity Research · Sex and Gender in Healthcare