Different Shades of Health: The Joint Consequences of Skin Color, Race, Gender, and Social Class in a Life Course Context

Abstract

While the social stratification of health is well-documented, a majority of studies have focused on the independent or additive consequences of social statuses—namely race/ethnicity, gender, and socioeconomic status (SES). Prior research has therefore assumed that dimensions of stratification are autonomous structures of inequality that do not condition the effects of each other on health. Furthermore, the extent to which other dimensions of inequality, particularly skin color and age, influence health remains uncertain. The relationship between skin color and health is an especially crucial topic given social and population trends that are making skin color an increasingly important marker of inequality and status in the U.S. Additionally, assuming that the health consequences of multiple social statuses do not change with age limits our understanding of the dynamic nature of health inequality across the life course.

This dissertation combines multiple-hierarchy stratification, colorism, and life course perspectives to investigate the extent to which skin color, race/ethnicity, gender, and SES intersect to shape trajectories of health across adolescence, early adulthood, and mid-life. Using panel data from the National Longitudinal Survey of Youth and the Coronary Artery Risk Development in Young Adults Study, findings indicate that skin tone and racial/ethnic inequalities in health are gendered, as health inequalities and the rate of health decline with age tend to be greater among women compared to men. Additionally, results suggest that darker skin tones are associated with poorer health across multiple outcomes for African American women, but not men.

Findings also indicate that higher SES is less beneficial for health among blacks, particularly lighter-skinned blacks, and Mexican Americans compared to their white and darker-skinned black counterparts. Lastly, the intersecting health consequences of social statuses tend to change with age, consistent with cumulative disadvantage and aging-as-leveler processes. Overall, findings from this dissertation highlight the utility of combining multiple-hierarchy stratification, colorism, and life course perspectives for understanding complex patterns of health inequality and identifying marginalized groups that experience the disproportionate burden of health risks.