Black-white differences in health and mortality: A review and conceptual model

An important segment of social science research focuses on differences in health and mortality between the African American and non-Hispanic white populations in the United States. This article begins by documenting some of the current health and mortality differences. I then review and critique the three major theoretical approaches that are most often used to explain such differences: racial genetic, cultural/behavioral, and socioeconomic. Finally, I present an alternative conceptual framework for the study of black-white differences in health and mortality. This reorientation of the importance of race for health and mortality moves beyond narrow genetic, cultural/behavioral, or socioeconomic representations to include, most importantly, multiple forms of racism as crucial sociological determinants of health and mortality differentials. Key sers of intervening, or proximate, variables are also identified to specify the process by which the health and mortality differentials are created. While no single future study may encompass all of the factors highlighted in the proposed framework, data collection and research efforts in;his area can be guided by a model that organizes into a relatively parsimonious framework the seemingly endless number of factors involved in the creation of such differences.