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TABLE 1. United States Life Expectancy, at Age 45 by Family Income (1980 dollars)a

 

Females

Males

Family Income

White

Black

Diff.

White

Black

Diff.

Allb

36.3

32.6

3.7

31.1

26.2

4.9

<$ 10,000

35.8

32.7

3.1

27.3

25.2

2.1

$10,000–$14,999

37.4

33.5

3.9

30.3

28.1

2.2

$15,000–$24,999

37.8

36.3

1.5

32.4

31.3

1.1

≥$25,000

38.5

36.5

2.0

33.9

32.6

1.3

NOTE: Diff. = difference.

a1979–1989; Taken from the National Center for Health Statistics.

b1989–1991; Taken from the National Center for Health Statistics.

that increasingly approach the current biologically attainable maxima. Thus, the major opportunity for improving the health of human populations in the United States and most other societies lies in improving the longevity and health of those of below-average socioeconomic or racial/ethnic status.

Accordingly, the reduction of socioeconomic and racial/ethnic disparities in health has been identified by the U.S. Public Health Service and the National Institutes of Health as a major priority for public health practice and research in the first decade of the twenty-first century (USDHHS, 1999; Varmus, 1999). This will involve some combination of either reducing the degree to which disparities in socioeconomic and racial/ethnic status are converted into health disparities or reducing the extent of socioeconomic or racial/ethnic disparities themselves. This will further entail understanding both (1) the psychosocial and biomedical pathways that translate socioeconomic and racial/ethnic disparities into disparities in health, and (2) the broader social, cultural economic, and political processes that determine the nature and extent of socioeconomic and racial/ethnic disparities in our society, and the ways in which individuals become distributed across socioeconomic levels and defined into racial/ethnic groups.

This paper seeks to elucidate what we already know and need yet to learn about reducing socioeconomic and racial/ethnic disparities in health. We first provide a brief overview of the nature of both socioeconomic and racial/ethnic disparities in health and how they are related to each other. Second, we assess current understanding of the pathways or mechanisms by which the socioeconomic or racial/ethnic status of individuals affects their health and the implications of this understanding for reducing socioeconomic and racial/ethnic disparities in health. Third, we explore what is known about how and why communities and societies come to be stratified both socioeconomically and in terms of race/ethnicity, and how these communal and societal patterns of socioeconomic and racial/ethnic stratification affect the socioeconomic and racial/ethnic status of individuals and their health. Finally, we conclude with an assessment of what we



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