Author's School

Brown School

Author's Department

Public Health

Language

English (en)

Date of Award

Winter 12-15-2021

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Chair and Committee

Michael Sherraden

Committee Members

Shenyang Guo, Jin Huang, Darrell Hudson, Hedwig Lee, Margaret Sherraden

Abstract

Racial wealth inequity is one of the most pressing social and economic issues in the United States, historically and contemporarily. Primarily due to unequal distribution of opportunity for economic advancement and mobility in addition to the accumulation of historic disadvantage endured by Black and Latinx Americans, U.S. racial wealth inequity leads to substantial racial health disparities. It is widely acknowledged that socioeconomic position (SEP) is a fundamental cause of disease and health disparities. Centering around three key constructs—race/ethnicity, wealth, and health—this dissertation had two overarching aims: (a) to investigate the relationship between wealth and health, delineating the effects of wealth on health by adjusting for other common SEP indicators (e.g., income, education); (b) to determine whether there are racial/ethnic differences in the relationship between wealth and health.Data were drawn from the National Longitudinal Survey of Youth (1997), which consists of a nationally representative sample of 8,984 youth who were aged 12 to 16 years in 1997. Using hierarchical generalized linear models, ordinary least square regressions, and binary logistic regressions, this dissertation comprises three empirical papers investigating racial/ethnic differences in the relationship between wealth and health. The first paper examines the racial/ethnic differences in the time-varying wealth–health associations during young adulthood from age 20 to 30. The second paper examines racial/ethnic heterogeneity in the relationship between parental wealth and substance use behaviors, including cigarette smoking, heavy episodic drinking, and use of cannabis. The third paper examines how US adults’ wealth components (financial assets, nonfinancial assets, secured debt, and unsecured debt) at age 30 were associated with physical and mental health at ages 30–36, as well as if the associations differed by race/ethnicity. Overall, positive relationships were found between wealth and health. Adding wealth significantly attenuates the association between income, education, and racial/ethnic differences in health. Significant racial/ethnic heterogeneities were found across three studies. Together, these three papers offer a more nuanced understanding of the complex relationship among race/ethnicity, wealth, and health. The findings could inform inclusive, progressive asset-building policies, racial/ethnic tailored public health interventions, as well as wealth and health integrated services.

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