Questions – answer all three questions below:
1.
What health disparities did Du Bois find between black and white communities in
Philadelphia in the late 1800s? What did Du Bois identify as contributing factors to these
health disparities?
2.
Considering that the racial wealth gap is rooted in histories of segregation (Shapiro et.
al. 2013), how does the racial wealth gap constitute social disadvantage as defined by
Braverman et. al. 2011? According to Braverman et. al. 2011, how does social
disadvantage produce health disparities?
3A: To what extent does the Affordable Care Act (ACA aka Obamacare) reflect
the principles of social justice outlined in Braverman et. al. 2011 (i.
e. that the
purpose of government policy should be to maximize the wellbeing of the most
disadvantaged)? Explain. For overviews of ACA, I recommend the following
resources:
i. Chapter Nine (“The Ethical Vision of the Affordable Care Act of 2010 (Obamacare)”). Reinhardt, Uwe E. 2019.
Priced Out: The Economic and
Ethical Costs of American Health Care
. NJ: Princeton University Press (the
text on canvas in the module “Social Protection Perspectives”)
ii.
“Summary of the Affordable Care Act,” Kaiser Family Foundation (link:
https://www.kff.org/health-reform/fact-sheet/summary-of-the-
affordable-care-act/
TOWARDS ENVIRONMENTAL JUSTICE AND HEALTH EQUITY
Health Disparities and Health Equity: The Issue Is Justice
Eliminating health disparities is a Healthy People goal. Given the diverse
and sometimes broad definitions of health disparities
commonly used, a subcommittee convened by the
Secretary’s Advisory Committee for Healthy People
2020 proposed an operational definition for use in
developing objectives and
targets, determining resource allocation priorities,
and assessing progress.
Based on that subcommittee’s work, we propose
that health disparities are
systematic, plausibly avoidable health differences adversely affecting socially
disadvantaged groups; they
may reflect social disadvantage, but causality need
not be established. This definition, grounded in ethical
and human rights principles, focuses on the subset
of health differences reflecting social injustice,
distinguishing health disparities from other health
differences also warranting
concerted attention, and
from health differences in
general.
We explain the definition,
its underlying concepts, the
challenges it addresses, and
the rationale for applying it to
United States public health
policy. (Am J Public Health.
2011;101:S149–S155. doi:10.
2105/AJPH.2010.300062)
Paula A. Braveman, MD, MPH, Shiriki Kumanyika, PhD, MPH, Jonathan Fielding, MD, MPH, MA, MBA,
Thomas LaVeist, PhD, Luisa N. Borrell, DDS, PhD, Ron Manderscheid, PhD,
and Adewale Troutman, MD, MPH, MA
ONE OF 2 OVERARCHING
goals of Healthy People 20101 was
‘‘to eliminate health disparities
among different segments of the
population.’’ A similar goal to
‘‘achieve health equity and eliminate health disparities’’ was proposed by the Health and Human
Services Secretary’s Advisory
Committee (SAC) for Healthy People 2020.2 Healthy People 2010
noted that health disparities ‘‘include differences that occur by
gender, race or ethnicity, education or income, disability, living in
rural localities, or sexual orientation.’’1 However, the rationale for
identifying disparities in relation
to these particular population
groups was not articulated. The
National Institutes of Health defined health disparities as ‘‘differences in the incidence, prevalence,
mortality, and burden of diseases
and other adverse health conditions that exist among specific
population groups in the United
States’’3,4; several other federal
agencies have similarly broad
definitions.5 The lack of explicit
criteria for identifying disparities
in Healthy People 20101 and the
relatively nonspecific definitions
of disparities used by federal
agencies3,4 leave considerable
room for ambiguity as to what
other groups might also be relevant.
Furthermore, there has been
controversy as to whether definitions of health disparities should
imply injustice or simply reflect
differences in health outcomes
that might apply to any United
States population segment.6—8 Different ethical, philosophical, legal,
Supplement 1, 2011, Vol 101, No. S1 | American Journal of Public Health
cultural, and technical perspectives may generate different definitions of health disparities or inequalities (the most comparable
term outside the United States).9—21
For example, in the United Kingdom, Whitehead defined health
inequalities as differences that are
unnecessary, avoidable, and unfair.21 This definition is widely
used internationally, where
‘‘health inequalities’’ are assumed
to be socioeconomic differences
unless otherwise specified; in the
United States, however, ‘‘health
disparities’’ more often refer to
racial or ethnic differences.
Effective public policies require
clear and contextually relevant
operational definitions to support
the development of objectives and
specific targets, determine priorities for use of limited resources,
and assess progress. The need for
clear definitions is particularly
compelling given the lack of progress toward reducing racial/ethnic
and socioeconomic disparities in
medical care22 and health.23—25
Recognizing the practical implications of lack of clarity on this
critical issue, the SAC convened
a subcommittee to define ‘‘health
disparity’’ and ‘‘health equity’’ for
use in Healthy People 2020.2 The
subcommittee members, including
both SAC members and external
experts, wrote this paper to elaborate on the definitions and explain their rationale.2,26 These definitions (see the box on the next
page) and the rationale presented
are substantively consistent with
those adopted by the SAC and recently published in Healthy People
2020,2 but reflect some changes in
wording. Clarifying these concepts
will enable medical and public
health practitioners and leaders to
be more effective in reducing disparities in medical care and in
advocating for social policies (e.g.,
in child care, education, housing,
labor, and urban planning) that
can have major impacts on population health.27
UNDERLYING VALUES AND
PRINCIPLES
The concepts of health disparities and health equity are rooted
in deeply held American social
values and pragmatic considerations, as well as in internationally
recognized ethical and human
rights principles.9 Drawing on
ethical and human rights concepts,
key principles underlying the
concepts of health disparities and
health equity include the following:
All people should be valued
equally. This concept was articulated by Jones et al.28 as foundational to the concept of equity. Equal worth of all human
beings is at the core of the
human rights principle that all
human beings equally possess
certain rights.29,30
Health has a particular value for
individuals because it is essential
to an individual’s well-being
and ability to participate fully in
the workforce and a democratic
society. Ill health means potential
suffering, disability, and/or loss
of life, threatens one’s ability to
earn a living, and is an obstacle
to fully expressing one’s views
and engaging in the political
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process. The Nobel Laureate
economist Amartya Sen31
viewed health as a fundamental
capability required to function
in society; similarly, ill health
can be a barrier to fully realizing one’s human rights.
Because ill health can be an
obstacle to overcoming disadvantages, health disparities,
which further disadvantage socially disadvantaged groups,
seem particularly unfair.
Nondiscrimination and equality.
Every person should be able to
achieve his/her optimal health
status, without distinction based
on race or ethnic group, skin
color, religion, language, or nationality; socioeconomic resources or position; gender,
sexual orientation, or gender
identity; age; physical, mental,
or emotional disability or illness; geography; political or
other affiliation; or other characteristics that have been linked
historically to discrimination or
marginalization (exclusion from
social, economic, or political
opportunities). The groups represented by these characteristics
substantively agree with those
specified by the United Nations
Committee on Economic, Social
and Cultural Rights as vulnerable groups whose rights are at
particular risk of being unrealized, due to historic discrimination.32 This directly reflects the
human rights principles of
nondiscrimination and equality;
nondiscrimination includes
not only intentional but also
unintentional or de facto
discrimination, meaning discriminatory treatment embedded in structures and institutions, regardless of whether
there is conscious intent to discriminate.32,33 The late philosopher John Rawls19 advanced
the concept of a society’s ethical
Health Disparities and Health Equity
Health disparities are health differences that adversely affect socially disadvantaged groups.
Health disparities are systematic, plausibly avoidable health differences according to race/ethnicity,
skin color, religion, or nationality; socioeconomic resources or position (reflected by, e.g., income,
wealth, education, or occupation); gender, sexual orientation, gender identity; age, geography,
disability, illness, political or other affiliation; or other characteristics associated with discrimination
or marginalization. These categories reflect social advantage or disadvantage when they determine
an individual’s or group’s position in a social hierarchy (see the box on the next page).
Health disparities do not refer generically to all health differences, or even to all health differences
warranting focused attention. They are a specific subset of health differences of particular relevance
to social justice because they may arise from intentional or unintentional discrimination or
marginalization and, in any case, are likely to reinforce social disadvantage and vulnerability.
Disparities in health and its determinants are the metric for assessing health equity, the principle
underlying a commitment to reducing disparities in health and its determinants; health equity is
social justice in health.
obligation to maximize the wellbeing of those worst off. An
aversion to discrimination is
also firmly rooted in United
States policies, as exemplified by
the Civil Rights Act of 1964
prohibiting discrimination on
the basis of race, color, or national origin; the 1954 Brown
vs. Board of Education decision
desegregating schools; the Hill
Burton Act of 1946 prohibiting
hospitals receiving federal funds
from discriminating on the basis
of race, color, or creed; and the
Americans with Disabilities Acts
of 1990 and 2008 prohibiting
discrimination on the basis of
physical or mental disability.
Health is also of special importance for society because a nation’s prosperity depends on the
entire population’s health.
Healthy workers are more productive and generate lower annual medical care costs.34—36
A healthier population has
more workers available for the
workforce. Health can facilitate
political participation, which
is essential for democracy.
Rights to health and to a standard
of living adequate for health. International human rights agreements, to which virtually all
countries are signatories, obligate
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governments to respect, protect,
fulfill, and promote all human
rights of all persons, including
the ‘‘right to the highest attainable standard of health’’ and the
right to a standard of living
adequate for health and wellbeing. Governments must demonstrate good faith in progressively removing obstacles to realizing these rights.29 The United
States signed but did not ratify
the International Covenant on
Economic, Social, and Cultural
Rights, which articulated the
right to health. Signing a treaty,
however, is considered an endorsement of its principles and
reflects acceptance of a good
faith commitment to honor its
contents. The ‘‘right to health’’
(i.e., ‘‘the right of everyone to the
enjoyment of the highest attainable standard of physical and
mental health’’37) is ‘‘not to be
understood as a right to be healthy,’’ because too many factors
beyond states’ control influence
health. Rather, it is ‘‘the right to
a system of health protection
which provides equality of opportunity to enjoy the highest
attainable level of health.’’ It includes the right to equal access to
cost-effective medical care as
well as to child care, education,
housing, environmental protection, and other factors that are
also crucial to health and wellbeing.38
Health differences adversely affecting socially disadvantaged
groups are particularly unacceptable because ill health can be
an obstacle to overcoming social
disadvantage. This consideration
resonates with common sense
notions of fairness, as well as
with ethical concepts of justice,
notably, the concept that need
should be a key determinant of
resource allocation for health,
and Rawls’ notion of the obligation to maximize the wellbeing of those worst off.39
Sen noted as a ‘‘particularly serious . . . injustice . . . the lack
of opportunity that some may
have to achieve good health
because of inadequate social
arrangements. . . .’’40 Sen argued
that health is a prerequisite for
the capability to function normally in society.31 It is therefore
particularly unjust that those
who are socially disadvantaged
should also experience additional obstacles to opportunity
based on having worse health.
Ratifying human rights agreements obliges governments to
direct special effort toward
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equalizing the rights of vulnerable groups facing more obstacles to realizing their rights. A
nonexhaustive list of vulnerable
groups is specified in human
rights documents on nondiscrimination and equality.32,37,41,42
The resources needed to be
healthy (i.e., the determinants of
health, including living and
working conditions necessary for
health, as well as medical care)
should be distributed fairly. To
do so requires considering need
(along with capacity to benefit16
and efficiency17) rather than
ability to pay or influence in
society.17 This principle, along
with principles cited previously,
reflects the ethical notion of
distributive justice (a just distribution of resources needed for
health) and the human rights
principles of nondiscrimination
and equality, as well as the
right to a standard of living adequate for health. Investments
in medical care intended to
reduce disparities must be
weighed against other potentially more effective investments that address disparities
in other health determinants.38
Health equity is the value underlying a commitment to reduce and
ultimately eliminate health disparities. It is explicitly mentioned in the Healthy People
2020 2 objectives. Health equity means social justice with
respect to health and reflects the
ethical and human rights concerns articulated previously.
Health equity means striving to
equalize opportunities to be
healthy. In accord with the
other ethical principles of beneficence (doing good) and
nonmalfeasance (doing no
harm), equity requires concerted effort to achieve more
rapid improvements among
those who were worse off to
start, within an overall strategy
to improve everyone’s health.
Closing health gaps by worsening advantaged groups’ health is
not a way to achieve equity.
Reductions in health disparities
(by improving the health of the
socially disadvantaged) are the
metric by which progress toward health equity is measured.
although a causal link need not be
demonstrated. Differences among
groups in their levels of social
advantage or disadvantage, which
can be thought of as where
groups rank in social hierarchies,
are indicated by measures
reflecting the extent of wealth,
political or economic influence,
prestige, respect, or social acceptance of different population
groups.
HEALTH DISPARITIES:
DEFINITION AND
RATIONALE
Systematic But Not
Necessarily Causal Links With
Social Disadvantage
We briefly define health disparities and health equity (see the
box on the previous page), elaborating further and explaining in
this section. We also discuss social
disadvantage, a key concept for
understanding disparities and equity (see the box on this page).
Health disparities are systematic,
plausibly avoidable health differences adversely affecting socially
disadvantaged groups. They
may reflect social disadvantage,
As noted by Starfield,45 health
disparities are systematic, that is,
not isolated or exceptional findings. Health disparities are systematically linked with social disadvantage, and may reflect social
disadvantage, although a causal
link does not need to be demonstrated. Whether or not a causal
link exists, health disparities adversely affect groups who are already disadvantaged socially, putting them at further disadvantage
with respect to their health,
thereby making it potentially more
difficult to overcome social disadvantage. This reinforcement or
compounding of social disadvantage is what makes health disparities relevant to social justice even
when knowledge of their causation is lacking. It is important to
define health disparities without
requiring proof of causality, because there are important health
disparities for which the causes
have not been established, but
which deserve high priority based
on social justice concerns. For
example, the large Black—White
disparity in low birth weight
and premature birth strongly predicts disparities in infant mortality
and child development, and
likely in adult chronic disease.46
Although the causes of racial
disparity in birth outcomes are
not established,46 credible scientific
sources have identified biological mechanisms that plausibly
contribute to the disparities,46—50
which reflect phenomena shaped
by social contexts and thus are, at
least theoretically, avoidable.
Social Disadvantage
Health disparities and health equity cannot be defined without defining social disadvantage.
Social disadvantage refers to the unfavorable social, economic, or political conditions that some
groups of people systematically experience based on their relative position in social hierarchies.
It means restricted ability to participate fully in society and enjoy the benefits of progress. Social
disadvantage is reflected, for example, by low levels of wealth, income, education, or occupational
rank, or by less representation at high levels of political office. Criteria for social disadvantage can
be absolute (e.g., the federal poverty threshold in the United States is based on an estimate of the
income needed to obtain a defined set of basic necessities for a family of a given size)43 or relative
(e.g., poverty levels in a number of European countries are defined in relation to the median
income, e.g., less than 50% of the median income).44
Not all members of a disadvantaged group will necessarily be (uniformly) disadvantaged, and not all
socially disadvantaged groups will necessarily manifest measurable adverse health consequences.
The extent (whether in a single or multiple domains), depth (severity), and duration (e.g., across
multiple generations) of disadvantage matter. Social disadvantage is different from unavoidable
physical disadvantage due to, for example, an unavoidable physical disability. However, when
disabled persons are put at an unnecessary disadvantage in society due to lack of feasible
supports (e.g., accessible public buildings and transportation) or to discrimination against them in
hiring for work that they could perform, this would constitute social disadvantage,
reflecting discriminatory treatment, whether intentional or unintentional.
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Plausibly Avoidable
Differences in Health Given
Sufficient Political Will
and efficiently to reduce important
disparities.
Disadvantaged Groups Are
Not Necessarily Uniformly
Disadvantaged
It must be plausible, but not
necessarily proven, that policies
could reduce the disparities, including not only policies affecting
medical care but also social policies addressing important nonmedical determinants of health
and health disparities, such as a
decent standard of living; a level of
schooling permitting full social
participation, including participation in the workforce and political
activities; health-promoting living
and working conditions, including both social and physical environments; and respect and social
acceptance.23,51 This criterion
addresses the issue of avoidability,
which is central to Whitehead’s
definition of health inequalities; it
strives for more specificity about
avoidability and to clarify the burden of proof regarding causality.21
Avoidability can be highly subjective. For example, one person
may believe that ill health caused
by poverty is avoidable; another,
however, may believe that both
poverty and ill health among the
poor are inevitable; hence, these
disparities are unavoidable. According to the proposed definition,
the criterion is whether the given
condition is theoretically avoidable,
based on current knowledge of
plausible causal pathways and biological mechanisms, and assuming
the existence of sufficient political
will. The more solid the knowledge, the more reasonable and
politically viable it will be to invest
resources in interventions; feasibility, costs, and potentially harmful unintended consequences
must be considered. Without firm
knowledge to guide specific interventions, pursuing health equity
would require supporting research
on how to intervene effectively
Worse Health Among Socially
Disadvantaged Groups
Internationally recognized human rights documents provide
guidance on which groups are
disadvantaged. Although health
disparities are systematic, a socially disadvantaged group will
not necessarily fare worse on all
health indicators, and might fare
better on some. For example, nonHispanic European American or
White (hereafter ‘‘White’’) women
over age 40 have higher incidence
of breast cancer than non-Hispanic African American or Black
(hereafter ‘‘Black’’) women,54 and
babies born to Hispanic immigrant
women often have more favorable
birth weights than those born to
non-Hispanic Whites.55 Neither of
these differences––although both
deserve public health attention––
would be a health disparity by the
proposed definition. Regardless
of this type of exception in relation
to a health outcome, Whites as
a group are more socially advantaged than Blacks and Hispanics,
as data on income, wealth, education, occupations, and political
office have documented.56—58
Furthermore, on most health indicators, including breast cancer mortality, White women are healthier
than Black women.59 Similarly,
higher rates of a preventable
illness in 1 of 2 affluent geographic
regions would warrant public
health action, but not as a health
disparities concern.
The fact that not all members
of a disadvantaged group (e.g.,
Blacks) appear to be severely disadvantaged (e.g., we have a Black
United States President, and
some Blacks are highly educated,
in high professional positions,
and/or wealthy) does not contradict considering that group as
generally disadvantaged. The
Socially disadvantaged groups
are defined a priori, according to
criteria consistent with human
rights principles regarding nondiscrimination and equality.
Health disparities and equity
should be central considerations
for public policy relevant to
health, but they are not the only
considerations. Other legitimate
considerations include the magnitude of impact and proportion
of the population affected, as
well as efficiency in the use of
resources. If a more socially
advantaged group happens to
fare worse on a particular health
indicator, this may be a very important issue that public health
or other sectors should energetically address; but it is not part of
a ‘‘health disparities’’ agenda,
which focuses on improving the
health of socially disadvantaged
groups.
The Need to Reduce
Disparities in the
Determinants of Health
Health determinants include
not only medical care but also the
quality of the social and physical
conditions in which people live,
work, learn, and play.23,51,52
Evidence of disparities in health
determinants is thus relevant to
assessing disparities in health.
Society will generally be more
motivated to address health differences that appear to result
from modifiable circumstances
over which individuals may have
little control21,53; for example,
the quality of local schools, exposure to pollution or crime,
or absence of stores selling nutritious food in one’s neighborhood.
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issue is whether the group has been
on the whole more disadvantaged
than Whites. Ample evidence has
documented a longstanding pattern
of less wealth,60,61 lower incomes,
lower educational attainment, and
under-representation in positions
of high occupational rank56 and
financial and political power62
among Blacks as a group compared with Whites. Despite an end
to legal racial segregation decades
ago, racial residential segregation
persists and with it, de facto educational segregation, condemning
many Black children to poor
quality schools. This reduces their
chances of obtaining good jobs
with adequate income as adults,
perpetuating social disadvantage
across generations.63,64
Similarly, although many
United States women are affluent
and some now hold high professional and political offices, as
a group, they are more likely
than men to be poor,65 to earn
less at a given educational level,66
and to be underrepresented in
high political office.67 Human
rights documents on nondiscrimination explicitly name women as
a vulnerable group warranting
special protection from discrimination. Patterns suggesting clinically unjustified underreceipt of
certain cardiac treatments by
women compared with men68
would reflect a gender disparity
in a determinant of health
(medical care, in this instance).
Shorter life expectancy among
men in general, if likely avoidable, would clearly be an issue of
public health importance based
on the magnitude of potential
population impact. However,
men as a group have more
wealth, influence, and prestige, so
this difference would not be
a social injustice and, therefore,
not a health disparity or equity
issue.
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Health Disparities as the
Metric to Assess Progress
Toward Health Equity
The stated criteria permit the
assessment of measurable progress toward greater health equity.
Systematic associations with social
disadvantage can be identified by
observing a repeated pattern of
correlations between measures of
social disadvantage and a health
outcome. Social advantage and
disadvantage can be measured by
comparing populations on factors
such as levels of wealth, income,
educational attainment, or occupational rank, for example (see the
box on page S151). Demonstrating
that a given disparity is plausibly
avoidable and can be reduced by
policies requires being able to describe, at least in general terms, 1
or more potential causal pathways
that are consistent with current
scientific knowledge; it does not
require definitively establishing
either the causation of the disparity or proving the effectiveness of
existing interventions to reduce
it. Guidelines for measuring health
disparities are available.9,69—73
Increasingly, the term ‘‘health
inequity’’21,74,75––the opposite of
health equity––is being used instead of ‘‘health disparity’’ to capture explicitly the moral dimension
and differentiate health differences
thought to reflect injustice from
health differences in general. Examples of health differences that
would not be considered health
disparities according to our definitions (see the box on page S150)
include: elderly adults generally
having worse health than nonelderly adults; skiers being at higher
risk of long-bone fractures than
nonskiers; and men not having
obstetric problems, whereas
women do. Both ‘‘health disparity’’
and ‘‘health inequity’’ have their
place in the public health lexicon.
Health inequity, however, is a
forceful term tending to imply
a strong judgment about causality,
which may be difficult to support in
many cases that nevertheless deserve attention as health disparities
(i.e., health differences adversely
affecting socially disadvantaged
groups) regardless of their causation. As with health equity, measuring health inequity relies on
health disparities as the metric.
Health Disparity: Not Just
a Health Difference
Interpreting the term ‘‘health
disparities’’ as any health differences among any population
group, as has been done by some
federal agencies, encompasses the
entire domain of epidemiology,
which is the study of the distribution of diseases and risk factors
across different populations. We
have argued that the term health
disparities should be used advisedly, in the spirit of the movement
for social justice from which the
term emerged, to refer to a particular subset of differences in health
that meet well-specified criteria
of specific relevance to social justice. The definitions proposed here
were designed to clarify the concepts of health disparities and
health equity in ways that could
stand up to rigorous conceptual
scrutiny as a basis for guiding
policy and practice and ensuring
accountability, which requires
clear criteria for measurement.9,69,70 To achieve the desired rigor, the full versions of the
proposed definitions are complex
and technical and will not be suitable for all audiences; for many
audiences, it may be most appropriate to define health disparities
simply as worse health among
socially disadvantaged groups
and then elaborate as necessary,
drawing on the more comprehensive form of the definitions.
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Limitations
These definitions do not provide numerical cutoffs for determining disadvantage. Nor do they
remove completely the need to
exercise judgment based on values
that are likely to vary across individuals and societies. It is
difficult to imagine reasonable
definitions of these concepts,
however, that would provide rigid
cutoffs, would completely preclude the exercise of judgment,
and would leave no room for
contention. The proposed definitions do not clarify whether the
reference group for making equity/disparities comparisons
should be the most advantaged
group in one’s country or in the
world; using one’s country as the
reference point may ignore the
better health achieved by advantaged populations in other parts of
the world.
Challenges Addressed
The definitions address major
challenges, such as identifying the
social groups to be compared and
specifying the general criteria for
appropriate reference groups for
these comparisons.18 These challenges have arisen when considering health disparity or equity
issues, with serious implications
for resource allocation. These
definitions remove the need to
establish the causality and avoidability of each health difference for
it to qualify as a health disparity
worthy of special attention. To address the difficult issue of causality,
our definitions acknowledge that
a health disparity may or may not
arise from social disadvantage, but
it must adversely affect members of
socially disadvantaged groups; this
can be assessed using epidemiologic
data revealing repeated and pervasive associations between health
indicators and measures of social
advantage. The causes need not be
known definitively, if it is biologically plausible that the difference
could be reduced by policies.
These definitions also ground the
concepts of health disparities and
health equity in internationally
recognized principles from the
fields of ethics and human rights,
giving them universality and durability. Although human rights
are often honored more in the
breach than in the observance,
they are a powerful resource in
that they represent a global consensus on values. This consensus
can be an important point of reference in national and local debates on policies and practice in
the United States. It would be
naı̈ve to think that achieving consensus on a definition would obviate the need for constant vigilance to ensure that the agenda for
research and action on health disparities remains on track and true
to the essence of the definition;
however, having a clear definition
is crucial.
The Issue is Justice
Could this approach––putting
health disparities within the
broader context of ethics and human rights––jeopardize the limited
resources allocated to specifically
address racial/ethnic disparities,
by spreading these resources more
thinly among other disadvantaged
groups? Would broadening the
definition make the concept too
abstract and therefore less compelling to the public and policymakers? We concluded that the
struggle for racial justice, in which
efforts to eliminate racial/ethnic
disparities in health are crucial,
has far more to gain than to lose
from making these principles explicit. The relevant ethical and
human rights principles support
prioritizing attention to those facing the greatest obstacles, and
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ample evidence has documented
the multiple and often crushing
obstacles faced by members of
disadvantaged racial/ethnic
groups in the United States, in
some cases for centuries. These
principles can protect initiatives
to address racial/ethnic as well as
other disparities in health from
a range of potential challenges
that constitute real threats.
Previous official approaches to
defining health disparities in the
United States have avoided being
explicit about values and principles, perhaps for fear of stirring
political opposition, because of
genuine differences in values or
because of the prevailing ethos
that enjoins researchers to avoid
the realm of values that might
compromise the integrity of their
science. Scientists, like all others,
should be guided by ethical and
human rights values. The first
decade of the 21st century has
ended with little if any evidence
of progress toward eliminating
health disparities by race or socioeconomic status.22 It is time to
be explicit that the heart of a
commitment to addressing health
disparities is a commitment to
achieving a more just society. j
About the Authors
Paula A. Braveman is with the University
of California, San Francisco. Shiriki
Kumanyika is with University of
Pennsylvania School of Medicine,
Philadelphia. Jonathan Fielding is with the
University of California, Los Angeles,
School of Public Health. Thomas LaVeist is
with Johns Hopkins Bloomberg School of
Public Health, Baltimore, MD. Luisa N.
Borrell is with Lehman College, City
University of New York, New York. Ron
Manderscheid is with the National
Association of County Behavioral Health
and Developmental Disability Directors,
Washington, DC. Adewale Troutman is
with the Louisville Metro Department of
Public Health and Wellness, Louisville, KY.
Correspondence should be sent to Paula A.
Braveman, MD, MPH, Director/Professor,
Center on Social Disparities in Health,
University of California, San Francisco,
3333 California St., Suite 365, San Francisco,
CA 94118 (e-mail: Braveman@fcm.ucsf.edu).
Reprints can be ordered at http://www.ajph.
org by clicking the ‘‘Reprints/Eprints’’ link.
This article was accepted November 1,
2010.
Contributors
All the authors participated conceptually
in developing the recommendations to
the Secretary’s Advisory Committee
(SAC) on Healthy People 2020, which
were the starting point for this article, and
all authors contributed ideas, reviewed
drafts, and made comments that shaped
this article in important ways. P. A.
Braveman conceived the initial idea for
the article, wrote initial drafts, and wrote
most revisions for coauthors’ review,
based on their comments. S. Kumanyika
also played a major role in writing the text
and a lead role in responding to external
reviewer comments. J. Fielding, T. LaVeist,
L. N. Borrell, R. Manderscheid, and
A. Troutman also contributed conceptually
and participated in substantive revisions
throughout the process.
Acknowledgments
We wish to thank Karen Simpkins, MLS,
and Colleen J. Barclay, MPH, for their
assistance with research. Written permission has been obtained from all persons
named here. The authors take full responsibility for the contents of this paper
as individuals. This article is not an official
report from the SAC or from the subcommittee to the SAC.
Note. The research presented here
neither has been published nor is being
considered for publication elsewhere,
and all research for this manuscript was
conducted in accord with prevailing
ethical principles. We have no affiliations with or involvement in any organization or entity with a direct financial
interest in the subject matter or materials
discussed in this manuscript. None of the
authors received compensation for this
work. The authors take full responsibility for the material.
Human Participant Protection
No institutional review board approval
was required.
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Braveman et al. | Peer Reviewed | Environmental Justice | S155
RESEARCH AND
POLICY BRIEF
FEBRUARY 2013
The Roots of the Widening Racial Wealth Gap:
Explaining the Black-White Economic Divide
Thomas Shapiro
Tatjana Meschede
Sam Osoro
G
rowing
concerns about wealth inequality and the
expanding racial wealth gap have in recent years become
central to the debate over whether our nation is on a sustainable economic path. This report provides critical
new information about what has fueled the racial wealth gap and points to policy approaches that will set our
country in a more equitable and prosperous direction.
All families need wealth to be economically secure and create
opportunities for the next generation. Wealth – what we own minus
what we owe—allows families to move forward by moving to better and
safer neighborhoods, investing in businesses, saving for retirement, and
supporting their children’s college aspirations. Having a financial cushion
also provides a measure of security when a job loss or other crisis strikes.
The Great Recession of 2007-2009 devastated the wealth of all families
except for those with the most. The unprecedented wealth destruction
during that period, accompanied by long-term high unemployment,
underscores the critical importance wealth plays in weathering emergencies
and helping families move along a path toward long-term financial security
and opportunity.
Extreme wealth inequality not only hurts family well-being, it hampers
economic growth in our communities and in the nation as a whole. In
the U.S. today, the richest 1 percent of households owns 37 percent of all
wealth. This toxic inequality has historical underpinnings but is perpetuated
by policies and tax preferences that continue to favor the affluent. Most
strikingly, it has resulted in an enormous wealth gap between white
households and households of color. In 2009, a representative survey of
American households revealed that the median wealth of white families was
$113,149 compared with $6,325 for Latino families and $5,677 for black
families.1
KEY FINDINGS
1. Tracing the same households over 25
years, the total wealth gap between
white and African-American families
nearly triples, increasing from $85,000
in 1984 to $236,500 in 2009.
2. The biggest drivers of the growing
racial wealth gap are:
• Years of homeownership
• Household income
• Unemployment, which is much
more prominent among AfricanAmerican families
• A college education
• Inheritance, financial supports
by families or friends, and
preexisting family wealth
3. Equal achievements, such as income
gains, yield unequal wealth rewards
for whites and African-Americans.
Looking at the same set of families over a 25-year period (1984-2009), our research offers key insight into how policy
and the real, lived-experience of families in schools, communities, and at work affect wealth accumulation. Tracing
the same households during that period, the total wealth gap between white and African-American families nearly
triples, increasing from $85,000 in 1984 to $236,500 in 20092 (see Figure 1). To discover the major drivers behind this
dramatic $152,000 increase, we tested a wide range of possible explanations, including family, labor market, and wealth
characteristics. This allowed us, for the first time, to identify the primary forces behind the racial wealth gap. Our
analysis found little evidence to support common perceptions about what underlies the ability to build wealth, including
the notion that personal attributes and behavioral choices are key pieces of the equation. Instead, the evidence points
to policy and the configuration of both opportunities and barriers in workplaces, schools, and communities that
reinforce deeply entrenched racial dynamics in how wealth is accumulated and that continue to permeate the most
K N O W L E D G E A D VA N C I N G S E C U R I T Y, O P P O RT U N I T Y, A N D E Q U I T Y
important spheres of everyday life. Data for this analysis derived from the Panel Study of Income Dynamics (PSID), a
nationally representative longitudinal study that began in 1968. We followed nearly 1,700 working-age households from
1984 through 2009. Tracking these families provided a unique opportunity to understand what happened to the wealth
gap over the course of a generation and the effect of policy and institutional decision-making on how average families
accumulated wealth. Unfortunately, there was not enough data that tracked wealth information in a sufficient number
of Latino, Asian American, or immigrant households to include in this report. As a result, the specific focus here is on
black-white differences. Yet, while each group shares different histories and experiences, we believe this examination
captures important dynamics that can be applied across communities of color.
The wealth trends depicted in Figure 1 beg the question of what caused such dramatic racial wealth inequities. With
a gap of close to a quarter of a million dollars, virtually every possible explanation will have some degree of accuracy,
no matter how miniscule a factor. The challenge is to identify the major evidence-based factors affecting the growing
racial wealth gap. To discover the major FIGURE 1. MEDIAN NET WORTH BY RACE, 1984-2009
drivers behind the $152,000 increase
in the racial wealth gap, we tested a
wide range of possible explanations
that included family, labor market,
demographic, and wealth characteristics,
and we have determined how different
factors affect the widening racial wealth
gap over a generation. The compelling
evidence-based story is that policy
shaping opportunities and rewards where
we live, where we learn, and where we
work propels the large majority of the
widening racial wealth gap.
The Foundations of Inequality
We started our analysis with an overriding question: Why has economic inequality become so entrenched in our
post-Civil Rights era of supposed legal equality? The first step was to identify the critical aspects of contemporary
society that are driving this inequality (Figure 2).3 Next, we sought to determine whether equal accomplishments are
producing equal wealth gains for whites and African-Americans (Figure 3)4. This approach allows for an evidencebased examination of whether the growing racial wealth gap is primarily the result of individual choices and cultural
characteristics or policies and institutional practices that create different opportunities for increasing wealth in white and
black families.
Among households with positive wealth growth5 during the 25-year study period, as shown in Figure 2, the number
of years of homeownership accounts for 27 percent of the difference in relative wealth growth between white and
African-American families, the largest portion of the growing wealth gap. The second largest share of the increase,
accounting for 20 percent, is average family income. Highly educated households correlate strongly with larger wealth
portfolios, but similar college degrees produce more wealth for whites, contributing 5 percent of the proportional
increase in the racial wealth gap. Inheritance and financial support from family combine for another 5 percent of the
increasing gap. How much wealth a family started out with in 1984 also predicts a portion (3 percent) of family wealth
25 years later.
Unemployment, the only significant factor that depleted wealth since it forced families to draw upon their nest eggs,
explains an additional 9 percent of the growing racial wealth gap. In addition to continuing discrimination, labor market
instability affected African-Americans more negatively than whites.
-2-
The evidence we present to examine
the racial wealth gap points to
institutional and policy dynamics in
important spheres of American life:
homeownership, work and increased
earnings, employment stability,
college education, and family financial
support and inheritance. Together,
these fundamental factors account for
nearly two-thirds (65 percent) of the
proportional increase in the wealth
gap. In the social sciences, this is a
very high level of explanatory power
and provides a firm foundation for
policy and reform aimed at closing the
gap.
FIGURE 2: WHAT’S DRIVING THE INCREASING RACIAL WEALTH GAP
The $152,000 Question: What Drove the Growing Gap?
Having identified the major drivers of the racial wealth gap, we now can dig deeper into each one—homeownership,
income, college education, inheritance, and unemployment—to determine how similar accomplishments grow wealth
differentially by race. Figure 3 provides a close look at how these factors, as well as marriage, which we will discuss later,
translate into differences in wealth accumulation for black and white families. We know that wealth increases through
accomplishments such as job promotions, pay increases, or the purchase of a home, as well as important life and family
events including receiving an inheritance and getting married. Figure 3 shows how similar accomplishments and life
events lead to unequal wealth gains for white and African-American families. The result is that while wealth grew
for African-Americans as they achieve life advances, that growth is at a considerably lower rate than it is for whites
experiencing the same accomplishments. This leads to an increase in the wealth gap.
Homeownership
The number of years families owned their homes was the largest predictor of the gap in wealth growth by race
(Figure 2). Residential segregation by government design has a long legacy in this country and underpins many of the
challenges African-American families face in buying homes and increasing equity. There are several reasons why home
equity rises so much more for whites than African-Americans:
• Because residential segregation artificially lowers demand, placing a forced ceiling on home equity for AfricanAmericans who own homes in non-white neighborhoods6;
• Because whites are far more able to give inheritances or family assistance for down payments due to historical
wealth accumulation, white families buy homes and start acquiring equity an average eight years earlier than black
families7;
• Because whites are far more able to give family financial assistance, larger up-front payments by white homeowners
lower interest rates and lending costs; and
• Due to historic differences in access to credit, typically lower incomes, and factors such as residential segregation,
the homeownership rate for white families is 28.4 percent higher than the homeownership rate for black families8.
Homes are the largest investment that most American families make and by far the biggest item in their wealth
portfolio. Homeownership is an even greater part of wealth composition for black families, amounting to 53 percent
of wealth for blacks and 39 percent for whites9. Yet, for many years, redlining, discriminatory mortgage-lending
practices, lack of access to credit, and lower incomes have blocked the homeownership path for African-Americans
while creating and reinforcing communities segregated by race. African-Americans, therefore, are more recent
homeowners and more likely to have high-risk mortgages, hence they are more vulnerable to foreclosure and volatile
-3-
housing prices.
Figure 1 shows households losing wealth between 2007 and 2009 (12 percent for white families, 21 percent for
African-American families), which reflects the destruction of housing wealth resulting from the foreclosure crisis
and imploded housing market. Overall, half the collective wealth of African-American families was stripped
away during the Great Recession due to the dominant role of home equity in their wealth portfolios and the
prevalence of predatory high-risk loans in communities of color. The Latino community lost an astounding 67
percent of its total wealth during the housing collapse10.
Unfortunately the end to this story has yet to be written. Since 2007, 10.9 million homes went into foreclosure.
While the majority of the affected families are
FIGURE 3: HOW WEALTH IS ACCUMULATED*
white, borrowers of color are more than twice as
likely to lose their homes. These higher foreclosure
rates reflect a disturbing reality: borrowers of
color were consistently more likely to receive highinterest risky loan products, even after accounting
for income and credit scores11.
Foreclosures not only have a direct impact on
families, they also result in severe collateral
damage to surrounding neighborhoods. One
report estimates that this collateral destruction
led to nearly $2 trillion in lost property wealth
for communities across the country. More than
half of this loss is associated with communities
of color, reflecting concentrations of high-risk
loans, subsequent higher foreclosure rates, and
volatile housing prices12.
*This table shows how key life advances and events (an increase in income, inheritance,
family financial support, homeownership and marriage) translate into the ability to increase
wealth. Even with equal advances, wealth grows at far lower rates for black households, who
typically need to use financial gains for everyday needs rather than long-term savings and
assets.
**Regression estimates at the median change in wealth over the 25-year study period
conducted separately for white and black households
While homeownership has played a critical role in
the development of wealth for communities of
color in this country, the return on investment is far greater for white households, significantly contributing to the
expanding racial wealth gap shown in Figure 1. The paradox is that even as homeownership has been the main
avenue to building wealth for African-Americans, it has also increased the wealth disparity between whites and
blacks.
Income and Employment
Not surprisingly, increases in income are a major source of wealth accumulation for many US families. However,
income gains for whites and African-Americans have a very different impact on wealth. At the respective wealth
medians, every dollar increase in average income over the 25-year study period added $5.19 wealth13 for white
households (see Figure 3), while the same income gain only added 69 cents of wealth for African American
households.
The dramatic difference in wealth accumulation from similar income gains has its roots in long-standing patterns
of discrimination in hiring, training, promoting, and access to benefits that have made it much harder for AfricanAmericans to save and build assets. Due to discriminatory factors, black workers predominate in fields that are
least likely to have employer-based retirement plans and other benefits, such as administration and support and
food services. As a result, wealth in black families tends to be close to what is needed to cover emergency savings
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while wealth in white families is well beyond the emergency threshold and can be saved or invested more readily.
The statistics cited above compare change in wealth over the 25 years at the median wealth for typical white and
black households. Yet we already know that the average white family starts out with abundantly more wealth and
significantly higher incomes than the average black family. When whites and blacks start off on an equal playing
field with a similar wealth portfolio, their wealth returns from similar income gains narrow considerably.14 Black
families under this scenario see a return of $4.03 for each dollar increase in income – a considerable closing of
the wealth breach.
This analysis also captured the devastation of unemployment on wealth accumulation. Unemployment affects
all workers but due to the discriminatory factors listed above, black workers are hit harder, more often, and for
longer periods of time. With much lower beginning wealth levels and unequal returns on income, it is a greater
challenge for African-Americans to grow their family wealth holdings in the face of work instability.
Inheritance
Most Americans inherit very little or no money, but among the families followed for 25 years whites were five
times more likely to inherit than African-Americans (36 percent to 7 percent, respectively). Among those
receiving an inheritance, whites received about ten times more wealth than African-Americans. Our findings
show that inheritances converted to wealth more readily for white than black families: each inherited dollar
contributed to 91 cents of wealth for white families compared with 20 cents for African-American families.
Inheritance is more likely to add wealth to the considerably larger portfolio whites start out with since blacks, as
discussed above, typically need to reserve their wealth for emergency savings.
College Education
In the 21st century, obtaining a college degree is vital to economic success and translates into substantially greater
lifetime income and wealth. Education is supposed to be the great equalizer, but current research tells a different
story. The achievement and college completion gaps are growing, as family financial resources like income
and wealth appear to be large predictors of educational success. While current research identifies a narrowing
black-white achievement gap, race and class intersect to widen the educational opportunity deficit at a time when
workers without higher-level skills are increasingly likely to languish in the job market.
College readiness is greatly dependent on quality K – 12 education. As a result of neighborhood segregation,
lower-income students—especially students of color—are too often isolated and concentrated in lower-quality
schools. Neighborhoods have grown more segregated, leaving lower-income students—especially students of
color—isolated and concentrated in lower-quality schools, and less academically prepared both to enter and
complete college. Further, costs at public universities have risen 60 percent in the past two decades, with many
low-income and students of color forced to hold down jobs rather than attend college full time and graduating
in deep debt. Average student debt for the class of 2011 was $26,600. Student debt is an issue that affects most
graduates, but black graduates are far more vulnerable: 80 percent of black students graduate with debt compared
with 64 percent of white students.15 More blacks than whites do not finish their undergraduate studies because
financial considerations force them to leave school and earn a steady income to support themselves and their
families.16
The context of broad class and race educational inequity helps us better understand why a college education
produces more wealth for white than black households, accounting for a 5 percent share of the widening racial
wealth gap (see Figure 2). In the past 30 years, the gap between students from low- and high-income families
who earn bachelor’s degrees has grown from 31 percent to 45 percent.17 Although both groups are completing
college at higher rates today, affluent students (predominantly white) improved much more, widening their already
sizable lead. In 1972, upper-income Americans spent five times as much per child on college as low-income
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families. By 2007, the difference in spending between the two groups had grown to nine to one; upper-income
families more than doubled how much they spent on each child, while spending by low-income families grew by
just 20 percent.18
Social and Cultural Factors
As part of this analysis we set out to test notions about the role social and cultural factors play in widening or
closing the racial wealth gap. To determine how these factors might affect wealth, we zeroed in on the role of
marriage in perpetuating the racial wealth gap. We found that getting married over the 25-year study period
significantly increased the wealth holdings for white families by $75,635 but had no statistically significant impact
on African-Americans. Single whites were much more likely to possess positive net worth, most likely due to
benefits from substantial family financial assistance, higher paying jobs, and homeownership. Hence, marriages
that combine modest wealth profiles seem to move whites past emergency-level savings to opportunities to invest
and build wealth.
By contrast, marriage among African-Americans typically combines two comparatively low-level wealth portfolios
and, unlike white households, does not significantly elevate the family’s wealth. While the number of household
wage earners bringing in resources does correlate to higher wealth, the impact of marriage is not statistically
significant for blacks and the reality is that most do not marry out of the racial wealth gap.
Closing the Racial Wealth Gap
Public policy can play a critical role in creating a more equitable society and helping all Americans build wealth.
College loans, preferential homeownership, and retirement tax policies helped build opportunities and wealth
for America’s middle class. Medicare and Social Security have protected that wealth. While the bold vision of
policymakers, advocates, and others interested in social and racial justice is needed to develop a precise policy
agenda, we believe the following broad public policy and institutional changes are critical to closing the gap:
• Homeownership – The data in this report clearly target homeownership as the biggest driver of the racial
wealth gap. We need to ensure that mortgage and lending policies and fair housing policies are enforced and
strengthened so that the legacy of residential segregation no longer confers greater wealth opportunities to
white homeowners than it does to black homeowners. As our nation moves towards a majority people of
color population, increasingly diverse neighborhoods must deliver equitable opportunities for growing home
equity.
• Income – This report identifies the importance of stable, family-supporting jobs and increasing incomes as
a prime avenue for building wealth. To address the gap caused by income disparity, proven tools should be
fully implemented at the national, state, and local levels, including raising the minimum wage, enforcing equal
pay provisions, and strengthening employer-based retirement plans and other benefits.
• Education – It is clear that differential educational opportunities and rewards are further widening the
racial wealth gap. We need to invest in affordable high-quality childcare and early childhood development
so every child is healthy and prepared for school. We need to support policies that help more students from
low-and moderate-income families and families of color attend college and graduate. And we need to value
education as a public good and invest in policies that do not leave students strapped with huge debt or a
reason to drop out.
• Inheritance – Due to the unearned advantages it transmits across generations, inheritance widens inequality
and is a key driver of the racial wealth gap. If we truly value merit and not unearned preferences, then we
need to diminish the advantages passed along to a small number of families. Preferential tax treatment
for large estates costs taxpayers and provides huge benefits to less than 1 percent of the population while
diverting vital resources from schools, housing, infrastructure, and jobs. Preferential tax treatment for
dividends and interests are weighted toward wealthy investors as is the home mortgage deduction and tax
shielding benefits from retirement savings.
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It is time for a portfolio shift in public investment to grow wealth for all, not just a tiny minority. Without that
shift the wealth gap between white and black households has little prospect of significantly narrowing. A healthy,
fair, and equitable society cannot continue to follow such an economically unsustainable trajectory.
Endnotes:
Rakesh, Kochhar, Richard Fry and Paul Taylor, Wealth Gaps Rise to Record Highs Between Whites, Blacks, Hispanics. Pew Research Center,
July 2011. Data is from the Survey on Income and Program Participation.
2
Figure 1 presents median wealth values for each year depicted in the graph. All dollar values are in 2009 dollars.
3
Figure 2 presents the major factors yielded through Oaxaca decomposition analyses. The dependent variable, change in wealth over the
25 year study period, was transformed into its natural logarithm due to its skewed distribution. As such, these analyses were conducted
only for households with positive wealth gain over 25 years. The variables in the analysis include change of marital status from married
to single and vice versa, number of children, age, college degree, retired, unemployment (duration), average income over 25 years,
inheritances and monetary supports, change from renting to owning and vice versa, homeownership (duration), and baseline wealth in
1984.
4
Figure 3 summarizes findings for median regression analyses conducted separately for white and African-American households.
Median regressions are the appropriate approach for highly skewed dependent variables, in this case change in wealth over 25 years. The
variables in the median regression models include change of marital status from married to single and vice versa, number of children,
age, college degree, retired, unemployment (duration), average income over 25 years, inheritances and monetary supports, change from
renting to owning and vice versa, and homeownership (duration).
5
These analyses could be only conducted for households with positive wealth due to the need to transform the dependent variable into
its natural logarithm. In this sample, 87% of white and 70% of African-American households had positive wealth growth during the
study period.
6
Shapiro, Thomas, The Hidden Cost of Being African American, Oxford University Press, 2004.
7
Joint Center for Housing Studies analysis of American Housing Survey, 2009, tabulations of 2009 AHS.
8
Joint Center for Housing Studies, State of the Nation’s Housing 2012.
9
IASP tabulations of Survey on Income and Program Participation, SIPP 2008, Wave 7.
10
Rakesh, Kochhar, Richard Fry, and Paul Taylor, Wealth Gaps Rise to Record Highs Between Whites, Blacks, Hispanics. Pew Research Center,
July 2011.
11
Gruenstein Bocian, Debbie, Peter Smith, and Wei Li, Collateral Damage: The Spillover Costs of Foreclosures. Center For Responsible
Lending, October 24, 2012.
12
Gruenstein Bocian, Debbie, Peter Smith, and Wei Li, ibid.
13
White and African-American wealth holdings are measured as the change of their wealth portfolios over the 25 year study period,
comparing baseline wealth to wealth in 2009. The median 25 year change in wealth for white families in this group is $211,400 and
$18,942 for African-Americans.
14
In real terms this means comparing whites at the 50th percentile to African-Americans at the 76th percentile.
15
The Project on Student Debt, Student Debt and the Class of 2011, October 2012.
16
The Project on Student Debt, ibid.
17
Martha J. Bailey and Susan M. Dynarski, “Inequality in Postsecondary Education” in Whither Opportunity? Edited by Greg J. Duncan
and Richard J. Murnane, 2011.
18
Kornrich, Sobino and Frank Furstenberg, Investing in Children: Changes in Parental Spending on Children, 1972 to 2007 Demography
2012 Sep 18.
1
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RELATED IASP PUBLICATIONS:
The Racial Wealth Gap Increases Fourfold, May 2010, byThomas Shapiro, Tatjana Meschede, and Laura Sullivan
The Crisis of Economic Insecurity for African-American and Latino Seniors, September 2011, by Tatjana
Meschede, Laura Sullivan, and Thomas Shapiro
Severe Financial Insecurity Among African-American and Latino Seniors, May 2010, by Tatjana Meschede, Thomas
Shapiro, Laura Sullivan and Jennifer Wheary
SPECIAL ACKNOWLEDGEMENT:
A special thanks to the Ford Foundation for their continued partnership and dedication to world-wide social change
and to Amy Saltzman, Anand Subramanian, Anne Price, Solana Rice, and Milly Hawk Daniel for their insightful
contributions to this research brief.
IN STITU T E O N A S S E T S & S O C I A L P O LI C Y
C O N TA C T
Brandeis University
415 South Street, MS-035
Waltham , MA 02454-9110
(781) 736-8685
www.iasp.brandeis.edu
Tatjana Meschede
Research Director
meschede@brandeis.edu
(781) 736-8685
@IASP_HELLER