WHO GETS SICK AND WHY?: HOW RACIAL INEQUALITY “GETS UNDER THE SKIN"

While it is well established that racial minorities in the U.S. live shorter and less healthy lives than their white counterparts, we know relatively little about the mechanisms and macro-level drivers of racial inequalities in health. Against this backdrop, I will present two studies that address these knowledge gaps. The first study examines underlying candidate mechanism of racial inequality by using data from the Health and Retirement Study (HRS) and robust methods—e.g., moderated mediation—to formally quantify the contributions of socioeconomic adversity and stress processes to racial inequalities in health. The findings show, among other things, that unequal access to socioeconomic resources and racialized exposure to stressors account for a substantial portion of racial inequalities in health. The second study conceptualizes and measures macro-level structural racism and its impact on the health of Blacks and Whites in the U.S. This study draws on administrative data from numerous sources to measure state-level racial stratification across multiple domains (political participation, education, economics, housing, and the judicial system) as indicators of macro-level structural racism. This data is then linked with individual-level health and demographic data from the HRS. Results reveal that state-level structural racism is harmful for the health of Blacks—but not Whites, highlighting the utility of structural approaches to understanding racialized health inequality.