Socioeconomic experience, race/ethnicity and adult health

Objective. This study examines the role of individual- and neighborhood-level socioeconomic characteristics over time in predicting adult health outcomes for individuals of different racial/ethnic backgrounds.; Data. The study population was drawn from the National Longitudinal Survey of Youth (NLSY79) with respondents' census tract residence matched with 2000 Decennial Census data. The NLSY79 cohort is a nationally representative sample of the non-institutionalized, civilian population aged 14--21 in 1979, surveyed annually and now biennially from 1979 to the present. Those who had answered the age 40 health module were included in this study (n = 3,154).; Methods. Sex and sex-race/ethnicity stratified multivariate linear regression models were used to examine the impact of education, occupational standing, income and neighborhood characteristics on five health outcomes (SF-12 Physical and Mental Health Summary Scores, depression, major morbidities and minor morbidities) measured at age 40. Census tract "neighborhoods" were characterized by racial/ethnic make-up, median family income, percent affluent, and percent of idle youth.; Results. In sex stratified models, individual-level socioeconomic factors alone fully accounted for observed racial/ethnic disparities in overall physical health and depression symptom levels, and provided a protective effect for major and minor morbidities among black and Mexican respondents, compared to white counterparts. Income appeared to have a positive, but lagged effect among black men and women, and no effect on Mexican men and women. Education exhibited a positive gradient effect for most sex-race categories and occupational standing had minimal to no effect on health outcomes. Neighborhood factors did not explain racial/ethnic health differentials beyond individual level socioeconomic experience, though tract-level socioeconomic resources had a protective effect on health, while the proportion of idle youth had a decidedly negative effect, particularly for women.; Conclusions. Results suggest that policies addressing socioeconomic inequities may reap significant health benefits, particularly with respect to addressing racial/ethnic health disparities. Programs aimed at improving education, income distribution and earnings should be considered in the health disparities discussion. Additional research on the pathways through which socioeconomic factors influence health are needed to better guide such program endeavors.