Health Status by Social Class and/or Minority Status: Implications for Environmental Equity Research

Abstract

Much of the epidemiologic research in the United States has been based only on the categories of age, sex and race; thus, race has often been used in health statistics as a surrogate for social and economic disadvantage. Few multivariate analyses distinguish effects of components of social class (such as economic level) from the relative, joint, and independent effects of sociocultural identifiers such as race or ethnicity. This paper reviews studies of social class and minority status differentials in health, with a particular emphasis on health status outcomes which are known or suspected to be related to environmental quality and conditions which increase susceptibility to environmental pollutants. Sociodemographic data are presented for the U.S. population, including blacks, Asian American/Pacific Islanders, American Indian/Alaska Natives, and Hispanics. Four areas of health status data are addressed: mortality, health of women of reproductive age, infant and child health, and adult morbidity. Conceptual and methodological issues surrounding various measures of position in the system of social strata are discussed, including the multidimensionality of social class, in the context of the importance of these issues to public health research. Whenever possible, multivariate studies that consider the role of socioeconomic status in explaining racial/ethnic disparities are discussed.

Do Mexican Americans perceive environmental issues differently than Caucasians: a study of cross-ethnic variation in perceptions related to water in Tucson.

“…Increasing evidence indicates that disparate environmental and economic conditions have taken their toll on the health of the U.S. Hispanic population (e.g., Mexican Americans) (8)(9)(10)(11)(12). These studies have yielded some very basic facts concerning Hispanics living in the United States.…”

“…Poverty rates among Hispanics are more than 3 times those of Caucasians in the United States (8), and educational attainment is much lower among Hispanics than among Caucasians (8). Second, Hispanics suffer disproportionate rates of environmentally related morbidity and mortality when compared with more affluent and better-educated populations (9)(10)(11)(12). Third, Hispanics often live in environmentally stressed communities in which environmental hazards in the community are prevalent.…”

Residential Proximity to Industrial Sources of Air Pollution: Interrelationships among Race, Poverty, and Age

“…It is possible, if not likely, that interactions among these three sociodemographic variables are important determinants of systematic differences (e.g., exposure, health status, access to health care) among population subgroups and that these differences may increase a subgroup's susceptibility to the adverse effects of environmental exposures. 2,6,[30][31][32][33] The following discussion is based on data from three diverse areas: the industrialized region of the Kanawha Valley, WV; the industrial corridor along the lower Mississippi River from Baton Rouge to New Orleans, LA; and the greater metropolitan area of Baltimore, MD.…”

Blood lead in U.K. children–time for a lower action level?

“…This study showed that although there were statistically significant differences between sexes, ethnic groups and schools, the magnitude reported was unlikely to have had clinical or public health significance. Moreover, while the differences between the ethnic groups and the schools could be a reflection of social class [26], other cultural and environmental factors may also have been involved.…”