Document Type : Original Article
Center for Research on Ethnicity, Culture, and Health (CRECH), School of Public Health, University of Michigan, Ann Arbor, MI 48104, USA/Department of Psychiatry, University of Michigan, 4250 Plymouth Rd., Ann Arbor, MI 48109-2700, USA
Background and aims: As suggested by the Minorities’ Diminished Return Theory, the association
between socioeconomic status and health is weaker for racial and ethnic minorities compared to
Whites. The current study compared Blacks and Whites in terms of the association between marital
status and physical health.
Methods: The State of the State Survey (SOSS) included 881 adults (92 Blacks and 782 Whites)
generalizable to the state of Michigan, the United States. The marital status and self-rated physical health
(SRPH), which was measured using a single item, were considered as independent and dependent
variables, respectively. In addition, age, gender, education, and employment were covariates and race/
ethnicity was regarded as the moderating factor. Finally, logistic regression was used for data analysis.
Results: Based on the results, being married was associated with better SRPH, which is the net
considered by all confounders. A significant interaction was found between race and marital status on
SRPH, suggesting a larger association for Blacks compared to Whites. In race stratified models, marital
status was related to better SRPH for Whites and Blacks, but the magnitude of this link was larger for
Blacks compared to Whites.
Conclusion: Overall, marital status was differently linked to SRPM for Whites and Blacks. Accordingly,
policymakers should be cautious while not assuming that diverse racial and ethnic groups with similar
economic resources have similar health status.
2. Ross CE, Mirowsky J. Does employment affect health? J Health Soc Behav. 1995;36(3):230-43.
3. Phelan JC, Link BG, Diez-Roux A, Kawachi I, Levin B. “Fundamental causes” of social inequalities in mortality: a test of the theory. J Health Soc Behav. 2004;45(3):265-85. doi: 10.1177/002214650404500303.
4. Link BG, Phelan J. Social conditions as fundamental causes of disease. J Health Soc Behav. 1995;Spec No:80-94.
5. Mirowsky J, Ross CE. Education, health, and the default American lifestyle. J Health Soc Behav. 2015;56(3):297-306. doi: 10.1177/0022146515594814.
6. Assari S, Lankarani MM. Demographic and Socioeconomic Determinants of Physical and Mental Self-rated Health Across 10 Ethnic Groups in the United States. Int J Epidemiol Res. 2017;3(12):185-93. doi: 10.15171/ijer.2017.02.
7. Assari S. Health disparities due to diminished return among black Americans: Public policy solutions. Soc Issues Policy Rev. 2018;12(1):112-45. doi: 10.1111/sipr.12042.
8. Assari S. Unequal gain of equal resources across racial groups. Int J Health Policy Manag. 2017;7(1):1-9. doi: 10.15171/ ijhpm.2017.90.
9. Assari S, Caldwell CH. Family Income at Birth and Risk of Attention Deficit Hyperactivity Disorder at Age 15: Racial Differences. Children (Basel). 2019;6(1). doi: 10.3390/ children6010010.
10. Assari S, Farokhnia M, Mistry R. Education attainment and alcohol binge drinking: diminished returns of Hispanics in Los Angeles. Behav Sci (Basel). 2019;9(1). doi: 10.3390/ bs9010009.
11. Assari S. Family Socioeconomic Position at Birth and School Bonding at Age 15; Blacks’ Diminished Returns. Behav Sci (Basel). 2019;9(3). doi: 10.3390/bs9030026.
12. Assari S. The benefits of higher income in protecting against chronic medical conditions are smaller for African Americans than whites. Healthcare (Basel). 2018;6(1). doi: 10.3390/ healthcare6010002.
13. Assari S, Caldwell CH, Mincy R. Family socioeconomic status at birth and youth impulsivity at age 15; Blacks’ diminished return. Children (Basel). 2018;5(5). doi: 10.3390/children5050058.
14. Assari S, Hani N. Household income and children’s unmet dental care need; Blacks’ diminished return. Dent J (Basel). 2018;6(2). doi: 10.3390/dj6020017.
15. Assari S, Mistry R. Educational Attainment and smoking status in a national sample of american adults; evidence for the blacks’ diminished return. Int J Environ Res Public Health. 2018;15(4). doi: 10.3390/ijerph15040763.
16. Assari S, Thomas A, Caldwell CH, Mincy RB. Blacks’ diminished health return of family structure and socioeconomic status; 15 years of follow-up of a national urban sample of youth. J Urban Health. 2018;95(1):21-35. doi: 10.1007/s11524-017- 0217-3.
17. Assari S, Caldwell CH, Zimmerman MA. Family structure and subsequent anxiety symptoms; Minorities’ Diminished Return. Brain Sci. 2018;8(6). doi: 10.3390/brainsci8060097.
18. Marmot M. Social determinants of health inequalities. Lancet. 2005;365(9464):1099-104. doi: 10.1016/s0140- 6736(05)71146-6.
19. Marmot M. Economic and social determinants of disease. Bull World Health Organ. 2001;79(10):988-9.
20. Assari S. Parental education better helps white than black families escape poverty: National survey of children’s health. Economies. 2018;6(2):30. doi: 10.3390/economies6020030.
21. Assari S. General self-efficacy and mortality in the USA; racial differences. J Racial Ethn Health Disparities. 2017;4(4):746- 57. doi: 10.1007/s40615-016-0278-0.