Whats Black About It?: Insights to Increase Your Share of a Changing African-American Market

What's Black about It?: Insights to Increase Your Share of a Changing African-American Market

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Sociologists have also been contributors to several landmark publications on race in the last several decades. These include A Common Destiny: There is abundant evidence of the continued existence of racial differences in health.

Table 1 provides an example of the magnitude and trends of these inequities. It shows racial differences in life expectancy at birth for men and women from to the present. Gender is an important social status category and there is need for increased attention to how health is distributed by multiple social status categories simultaneously.

The racial gap in health is large and persistent over time. White men and women outlived their black counterparts by 7. Although life expectancy has increased for all groups over the last half century, in white men still lived 6 years longer than African American men and white women had a 4 year advantage over their black peers. And as Du Bois noted over a century ago, the patterns are gendered.

The racial gap in health is larger for men than for women and there have been larger reductions in the racial gap in life expectancy for women than for men over time, reflecting the fact that, of the four racial and gender groups considered, black women have had the largest absolute gains in life expectancy between and Moreover, since , the gender difference in life expectancy has been larger for blacks than for whites, with African American women enjoying a higher level of life expectancy than white men.

Other research reveals that African Americans and American Indians have higher age-specific death rates than whites from birth through retirement Williams et al Hispanics or Latinos have elevated rates of some leading causes of death such as diabetes, hypertension, liver cirrhosis and homicide. Moreover, the elevated rates of disease and death for minorities compared to whites reflect the earlier onset of illness, greater severity of disease and poorer survival Williams et al.

Even when African Americans have a lower rate of illness than whites, they have a prognosis that is considerably worse than those of their white counterparts. For example, a recent national study found that although blacks have lower current and lifetime rates of major depression than whites, the cases of depression among blacks were more likely to be persistent, severe, disabling, and untreated Williams, Gonzalez et al.

Early research on racial differences in health viewed all observed disparities as reflecting biological differences between racial groups Krieger Sociologists have long shown that established racial classification systems are arbitrary and evolved from systems of stratification, power and ideology Frazier ; Blauner, ; Omi and Winant In critiques of the conceptual, methodological and conceptual implications of using race as a variable in health research, sociologists have rejected the dominant view of the last century that racial disparities in health primarily reflect biological differences between racial groups Wilkinson and King ; Williams ; American Sociological Association Troy Duster , for example, has shown how an emphasis on the genetic sources of racial disparities in health can serve important ideological functions in society.

Views of race that focus on biology can divert attention from the social origins of disease, reinforce social norms of racial inferiority, and promote the maintenance of the status quo. If racial differences in health are caused by inherent genetic differences, then social policies and structures that initiate and sustain the production of disease are absolved from responsibility. Sociologists have also emphasized that science is not value free and that preconceived opinions, political agendas and cultural norms, consciously or unconsciously, can shape scientific research by determining which research questions are asked and which projects are funded Duster Sociologists have also noted a recent trend on the part of some geneticists to use current racial categories to capture genetic differences between population groups Frank These researchers argue that data from multiple loci on the human genome can provide fairly accurate characterization of individuals into continental ancestral groups that approximate our current racial categories Risch et al.

However, Serre and Pablo have shown that sampling biases play a key role in conclusions regarding the continental clustering of populations. Sociologists also emphasize that although the contribution of genetics to racial variations in major chronic diseases is likely to be small, research on racial differences in health should seek to understand how social exposures combine with biology to affect the social distribution of disease Williams et al.

However, all conclusions about the contribution of genetics should be based on explicit tests of genetic traits. In addition, researchers should pay more attention to issues of population sampling when making inferences to larger populations about observed genetic variation and to genetic variation within race, as well as, differences across racial groups. Most importantly, sociologists and other social scientists need to devote more concerted and systematic attention to developing valid and reliable measures of the relevant aspects of the social environment for the study of gene-environment interactions.

Research indicates that even in the case of single gene disorders, the severity and timing of genetic expression are affected by environmental triggers, and that established genetic risks can be exacerbated or become protective in the presence of specific environmental exposures Shields, Fullerton and Olden Recent sociological research illustrates how gene environment interactions can potentially shed light on the mechanisms linking the social environment to disease.

For example, analysis of data for adolescents in the Add Health Study found that genetic traits interacted with family processes e. In contemporary society, racial groups differ on a broad range of social, behavioral, nutritional, psychological, residential, occupational and other variables.

And given that biology is not static but is adaptive to the environmental conditions in which the human organism exists, there are likely to be interactions between the social environment with both innate and acquired biological factors. Thus, although variation in gene frequency is unlikely to play a major role in accounting for racial disparities, differences in gene expression linked to the occupancy of different environmental contexts could play a critical role.

Epigenetics refers to changes in gene expression that are not caused by changes in the nucleotide sequences of the DNA. Recent research reveals that exposure to risk factors and resources in the social environment can produce changes in gene expression Williams et al. Future research on racial inequities in health needs to more systematically explore the extent to which the distinctive residential and occupational environments of racial minorities can give rise to patterns of social exposures that can produce epigenetic changes in gene expression and tissue and organ function Kuzawa and Sweet Sociological research has long explored the role of social structure and social stratification as a key determinant of health.

Social structure refers to enduring patterns of social life that shape an individual's attitudes and beliefs; behaviors and actions; and material and psychological resources.

Among the social structures investigated within sociology, social class, usually operationalized as socioeconomic status SES , has proven particularly relevant for understanding racial disparities in health. In a seminal study in the s, Engels showed how life expectancy in Liverpool, England varied by the occupation of the residents. Moreover, he showed how specific exposures in both occupational and residential environments were related to the elevated risk of particular diseases. More recent sociological research has found that SES is inversely associated with high quality health care, stress, exposure to social and physical toxins, social support, and healthy behaviors.

Accordingly, SES remains one of the strongest known determinants of variations in health status Williams and Collins Sociological work on class informs the study of racial disparities in health, because as Du Bois noted at the turn of the century, race is strongly intertwined with SES. However, sociologists have emphasized that race and SES are two related but not interchangeable systems of social ordering that jointly contribute to health risks Navarro ; Williams and Collins Accordingly, attention needs to be given to both race- and class-based factors that undergird racial health disparities.

Table 2 illustrates the complex relationship between race and SES by presenting national data on life expectancy at age by race and education. It shows that there is a 5 year racial difference in life expectancy at age 25 but an even larger difference, within each race by education. It also indicates that the racial differences in health cannot be simply reduced to SES because there are residual racial differences at every level of education. The life expectancy data at age 25 also reveal that the racial gap in life expectancy is greater at the higher levels of education compared to the lowest level.

This pattern exists for some but not all health outcomes. Sociologists have also shown that race and SES can combine with gender and other social statuses, in complex ways, to create patterns of interaction and intersectionality Schulz and Mullings Sociological work on social class has also contributed to our understanding of racial disparities by underscoring the multidimensionality of SES indicators Hauser Sociologists have shown that it requires assessing the multiple dimensions to SES to fully characterize its contribution to racial disparities in health. Moreover, all of the indicators of SES are non-equivalent across race.

For example, compared to whites, blacks and some other racial minorities have lower income at every level of education, less wealth net assets at every level of income, higher rates of unemployment at all levels of education, higher exposure to occupational hazards even have adjusting for job experience and education and less purchasing power because of higher costs of goods and services in their residential contexts Williams and Collins Sociological research has also highlighted the role of SES at the community level as captured by neighborhood level markers of economic hardship, social disorder and concentrated disadvantage Wilson ; Massey and Denton While income captures the flow of economic resources such as wages into the household, wealth captures the economic reserves that are reflected in savings, home equity, and other financial assets.

National data reveal, that for every dollar of wealth that white individuals have, blacks have 9 cents and Hispanics have 12 cents Orzechowski These striking disparities exist at every level of income. For example, for every dollar of wealth that poor whites in the lowest quintile of income have, poor blacks have one penny and poor Latinos have two pennies.

What's Black About It? by Pepper Miller and Herb Kemp

Sociological research has also shed important light on how factors linked to race contribute to racial differences in health. This work has identified multiple ways in which racism initiates and sustains health disparities Williams and Mohammed This research explicitly draws on the larger literature in sociology on racism and conceptualizes it as a multilevel construct, encompassing institutional and individual discrimination, racial prejudice and stereotypes as well as internalized racism Feagin and McKinney ; Bonilla-Silva, ; Massey and Denton At the institutional level, sociological research has underscored the role of residential racial segregation as a primary institutional mechanism of racism and a fundamental cause of racial disparities in health Massey and Denton ; LaVeist ; Williams and Collins and has helped shape local and federal policies.

Sociologists have documented how segregation produces the concentration of poverty, social disorder and social isolation, and creates pathogenic conditions in residential environments Massey ; Schulz et al. For example, an examination of the largest cities found that the worst urban context in which white individuals lived was better than the average context of black neighborhoods Sampson, and Wilson These differences in neighborhood quality and community conditions are driven by residential segregation by race — a neglected but enduring legacy of institutional racism in the U.

Considerable evidence suggests that because of segregation, the residential conditions under which African Americans, American Indians and an increasing proportion of Latinos live are distinctive from those of the rest of the population. Sociologists have also identified multiple pathways through which segregation can adversely affect health Morenoff ; Williams and Collins ; Schulz et al.

First, segregation restricts SES attainment by limiting access to quality elementary and high school education, preparation for higher education and job opportunities. Second, the residential conditions of concentrated poverty and social disorder created by segregation make it difficult for residents to eat nutritiously, exercise regularly and avoid advertising for tobacco and alcohol. For example, the lack of recreation facilities and concerns about personal safety can discourage leisure time physical exercise.

Third, the concentration of poverty can lead to exposure to elevated levels of financial stress and hardship as well as other chronic and acute stressors at the individual, household and neighborhood level. Fourth, the weakened community and neighborhood infrastructure in segregated areas can also adversely affect interpersonal relationships and trust among neighbors. Fifth, the institutional neglect and disinvestment in poor, segregated communities contributes to increased exposure to environmental toxins, poor quality housing and criminal victimization. Finally, segregation adversely affects both access to care and the quality of care.

Research has linked residential segregation to an elevated risk of illness and death and shown that it contributes to the racial disparities in health Williams and Collins ; Acevedo-Garcia et al. Segregation probably has a larger impact on the health of African Americans than other groups because blacks currently live under a level of segregation that is higher than that of any other immigrant group in U.

In addition, the association between segregation and SES varies by minority racial group. For Latinos and Asians, segregation is inversely related to household income but segregation is high at all levels of SES for blacks Massey At the individual level, experiences of discrimination have been shown to be a source of stress that adversely affects health Williams and Mohammed Research has documented elevated levels of exposure to both chronic and acute measures of discrimination for socially stigmatized racial and immigrant groups in the U.

Exposure to discrimination has been shown to be associated with increased risk of a broad range of indicators of physical and mental illness. In addition, discrimination, like other measures of social stress, adversely affects patterns of health care utilization and adherence behaviors and is predictive of increased risk of using multiple substances to cope with stress including tobacco, alcohol and illicit drugs.

Several studies have found that, in multiple national contexts, racial discrimination makes an incremental contribution to SES, in accounting for observed racial disparities in health Williams and Mohammed While much research has focused on the pervasive role of racism in perpetuating health disparities, sociologists have also enhanced our understanding of the complex ways communities respond to discrimination.

Some research has explored the harmful health effects of internalized racism—in which minority groups accept the dominant society's ideology of their inferiority as accurate Williams and Mohammed Other research has identified cultural and psychosocial resources that foster resilience. For example, sociological research has found that religious involvement can enhance health in the face of racial discrimination and also buffer the negative effects of interpersonal discrimination on health Bierman ; Ellison, Musick, and Henderson Other research indicates that ethnic identity can serve as a resource in the face of discrimination Mossakowski Having a sense of ethnic pride and engaging in ethnic practices can enhance mental health directly and the strength of ethnic identification can reduce the stress of discrimination on mental health.

Asians and Latinos have lower overall age adjusted mortality rates than whites. In the U. Processes linked to migration make an important contribution to the observed mortality rates for these groups. National data reveal that immigrants of all racial groups have lower rates of adult and infant mortality than their native born counterparts Hummer et al.

Moreover, across multiple immigrant groups, with increasing exposure to American society, health tends to decline.

How We Reach Out

This pattern is especially surprising for Latinos. Hispanic immigrants, especially those of Mexican background, have high rates of poverty and low levels of access to health insurance in the United States. However, their levels of health are equivalent and sometimes superior to that of the white population. This pattern has been called the Hispanic paradox Markides and Eschbach Sociological research has shed important light on the complex association between migration and health.

First, research has shown that when a broad range of health outcomes are considered, a complex pattern emerges. For example, although Hispanics have comparable levels of infant mortality to whites, women of all Hispanic groups have a higher risk of low birth weight and prematurity than whites Frisbie, Forbes, and Hummer Similarly, in the California Health Interview Survey CHIS , virtually all immigrants reported better physical health status, such as chronic physical conditions than the native born Williams and Mohammed In contrast, for psychological distress, many immigrant groups most Latino groups, Pacific Islanders and Koreans reported worse health than the native born, while other immigrants groups blacks, Puerto Ricans and Filipinos had better health and still others Vietnamese, Japanese and Chinese did not differ from their native born counterparts.

Second, sociological research has shown that migration status combines in complex ways with SES to affect health. For example, Asian and African immigrants have markedly higher levels of education than other immigrant groups and U. In contrast, immigrants from Mexico, have low levels of education at the time of migration to the U. Sociological research has shown that these differences in SES importantly affect patterns and trajectories of health. For immigrant populations largely made up of low SES individuals, traditional indicators of SES tend to be unrelated to health in the first generation but exhibit the expected associations in health by the second generation Angel, Buckley, and Finch In addition, the SES of immigrants upon arrival to the U.

For example, the gap in mortality between immigrants and the native born is smaller for Asians than for whites, blacks and Hispanics Singh and Miller and recent national data reveal that declines in mental health for subsequent generations were less marked for Asians Takeuchi et al. Thus, although black, Latino and Asian first generation immigrants all have lower disorder rates than the general population of blacks and whites, by the third generation the disorder rates of Latino and black but not Asian immigrants are higher Alegria et al.

One of the factors contributing to the good health profile of immigrants is their selection on the basis of health. Recent sociological research has shown that differences in the SES of immigrant streams is the key determinant of variations in health selection among immigrants with immigrants to the U. That is, the surprisingly good health of immigrants from Mexico is not primarily due to the better health of Mexican immigrants relative to Mexicans who did not migrate. Future research is needed to clearly identify the relative contribution of various factors to the health status of immigrants and how these may vary across various immigrant populations.

Third, sociological research has began to characterize how risk factors and resources in immigrant populations such as the stressors and strains associated with migration and adaptation, inadequate health care in the country of origin and factors linked to larger social structures and context, such as institutional racism and interpersonal discrimination can affect the health of immigrants Angel and Angel For example, a study of adult migrant Mexican workers in California found that stressors linked to discrimination, legal status and problems speaking English were inversely related to self-reported measures of physical and mental health and partially accounted for the declines in these health indicators with increasing years in the U.

Finch, Frank, and Vega Finally, sociologists have also shown that a full understanding of the health effects of migration requires an assessment of the ways in which migration impacts the health of sending communities. For example, a study of infant health in two high migration sending states in Mexico found that infants born to fathers who had migrated to the U.

This study also found that women with partners in the U. These findings highlight the importance of attending to the bi-directional effects of migration processes. At the same time, the good health profile of immigrants highlights how much we still need to learn regarding the determinants of health and the needed policies to improve the health of all Americans and reduce inequities in health across population groups.

Especially striking and intriguing are the data for Mexican immigrants. These data emphasize that health is not primarily driven by medical care but by other social contextual factors. However, precisely what these social determinants of health are, and how they may operate in the absence of high levels of SES, and why they change over time is less clear.

Accordingly, for both research and policy reasons, there is an urgent need to identify the relevant factors that shape the association between migration status and health for Mexicans and other immigrants. Moreover, we need to identify and implement the interventions, if any, that can avert or reverse the downward health trajectory of immigrants with increasing length of stay in the U.

Sociological research on racial disparities in health has many important lessons for policies that seek to address social inequities in health. First, there are implications for how data on social inequalities in health are reported. For over years, the U. Instructively, although SES differences in health are typically larger than racial ones, health status differences by SES are seldom reported and only very rarely are data on health status presented by race and SES simultaneously.

Moreover, striking differences are also evident by sex. Given the patterns of social inequalities and the need to raise awareness of the public and policy makers of the magnitude of these inequities and their social determinants, we strongly urge that health data should be routinely collected, analyzed, and presented simultaneously by race, SES and gender. This will highlight the fundamental contribution of SES to the health of the nation and to racial disparities in health.

Failure to routinely present racial data by stratifying them by SES within racial groups can obscure the social factors that affect health and reinforce negative racial stereotypes. The inclusion of gender must be accompanied by research that seeks to identify how biological factors linked to sex and social factors linked to gender, relate to each other and combine with race and SES to create new identities at the convergence of multiple social statuses that predict differential access to societal resources.

Sociological research indicates that race and SES combine in complex ways to affect health. There has been some debate regarding the advisability of race-specific versus universal initiatives to improve outcomes for vulnerable social groups. Extant research that clearly documents residual effects of race, at every level of SES suggests that race-specific strategies are needed to improve outcomes for disadvantaged racial groups. The research reviewed here indicates that both the legacies of racism and its continued manifestations matter for health. For example, unless and until serious attention is given to addressing institutional racism such as residential segregation, reducing racial inequities in health will likely prove elusive.

More research and policy attention should be given to identifying and implementing individual and especially institutional interventions that would be effective in reducing the levels and consequences of racism in society.

See a Problem?

For instance, state- or federal-level policies that expand the stock of safe, stable, low-income and mixed-income housing or funding for section 8 vouchers could increase access to high-opportunity neighborhoods, while more robust enforcement of housing and financial regulations could help curb predatory lending and housing discrimination practices in minority or underserved neighborhoods. There are many good reasons for reducing societal racism and improving the racial climate of the U.

Better research, better learning, better insights.

The substantial health benefits of such interventions are an important benefit that is not widely recognized. Relatedly, some evidence suggests that many of the most promising efforts to improve health are likely to widen disparities because the most advantaged social groups are likely to extract the greatest benefit from them Mechanic Accordingly, policies are needed that improve the health of vulnerable social groups more rapidly than that of the rest of the population so that health gaps can be narrowed.

The evidence documenting that race is primarily a social rather than a biological category provides insight into the types of interventions that are needed to improve the health of disadvantaged racial populations. Effective interventions will be those that are targeted not at internal biological processes — but those that seek to improve the quality of life in the places where Americans spend most of their time — their homes, schools, workplaces, neighborhoods and places of worship Robert Wood Johnson Foundation Commission, For example, incentive programs for Famer's Markets and full-service grocery stores, along with more stringent regulations on fast food and liquor stores, could increase availability of nutritious, affordable foods in underserved areas.

Other potential interventions include restructured land-use and zoning policies that reduce the concentration of environmental risks e. Historically, sociological research on racial disparities in health has directly contributed to action and debate in the policy arena. These economic costs are a compelling additional policy justification for eliminating health inequities.

Throughout , popular brands witnessed the power of Black Twitter and the brand impact of socially conscious Black consumers. Through social media, Black consumers have brokered a seat at the table and are demanding that brands and marketers speak to them in ways that resonate culturally and experientially—if these brands want their business. Mainstream manufacturers across other industries are also seizing the opportunity to create specific products that appeal to diverse consumers.

In fact, in terms of sheer dollars, African Americans spent considerably more money in the general beauty marketplace last year. For instance, sizable Black spend in health and beauty categories has contributed to a diversification of product offerings that appeal not only to Black consumers, but to the general market as well. Black consumers account for a disproportionate amount of product sales in a number of fast-moving consumer goods categories. More importantly, the data suggests that Black consumer spending already significantly affects the bottom line in many categories and industries, and brands can't afford to lose favor or traction with this segment without potential negative impact.

The enormous buying potential of Black consumers has put a spotlight on many popular brands' ability to navigate the nuances of culturally relevant and socially conscious marketing. As the almost nuclear power of social media collides with an increasingly educated, affluent, tech-savvy black consumer base, there's never been a more critical time for companies to build and sustain deeper, more meaningful connections with black consumers—not only to grow their relationships, but to protect them.

The business case for multicultural outreach is clear.

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