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Examining The Causes Behind Black Health Disparities

Young Nurse

By Elika Oakley


Elika Oakley is a recent graduate from the University of Redlands. She has two Bachelors of Arts in Health, Medicine, and Society & Public Policy. Elika strives to dismantle health disparities and stigmatization by providing information and strategies

to address the root cause of health complications. She believes that health is a basic human right and everyone should have equitable access to quality healthcare. Aside from being an advocate for health equity, she is an avid baker, an above average roller skater, and a Bay Area native.

Examining the Causes Behind Black Health Disparities

Social determinants of health are important to help understand the underlying causes of the health disparities that African Americans experience. Social, economic, and political resources and structures, also known as social determinants, are responsible for a larger portion of health disparities because they impact one’s ability to buffer disease. It is also important to understand that there is not one social determinant that can describe health disparities for African Americans. Health disparities are caused by a collection of social determinants that interact with each other. In this article, we will examine how education, employment, and poverty play a role in health disparities for Black patients.

Fundamental Causes: Education, Employment, Poverty

Although the death gap between whites and Black Americans has narrowed since 1999, health disparities continue to be the leading catalyst of death for Black individuals over their lifespan.  Particularly, Black Americans had higher rates in the leading causes of death (Cunningham et al., 2017). This can be linked to “fundamental causes”, such as low educational attainment, unemployment, and poverty. In a study done by Cunningham et al. (2017), researchers found that when compared to their white counterparts, Black Americans of all age groups were more likely to have less than 12 years of education, to be unemployed, and live below the poverty line. These factors have compounding effects on each other making it even harder for Black Americans to achieve good health in these circumstances.


Education is a vital tool because it allows individuals to advance their knowledge and gain new opportunities. There are many connections to how education affects health. In a study analyzed by Braveman and Gottlieb (2014), researchers showed that women with lower educational attainment rates live shorter, and the lower a pregnant mother’s education level is the lower chance an infant has of surviving. When people are more educated, they have greater access to resources to help navigate the health care system and health complications.


Employment also plays a huge role in health because it generates income and provides benefits, such as health insurance. Income is necessary to help pay for health care, prescriptions, and medical bills. Employment benefits, such as health insurance, are necessary to help lower the out-of-pocket price so that people can afford the care they need. Unfortunately, Black Americans are more likely to be unemployed compared to their white counterparts, which hinders their access to the resources that are necessary to afford medical care––income and health insurance. Even when Black Americans are employed, many of them still struggle to get access to adequate salaries and health insurance. There is a “disproportionate percentage of African Americans who

work in jobs that do not provide health insurance” (Copeland, 2005). This impacts their ability to access and afford medical care.


Living at or below the poverty line has damaging effects on Black Americans; health at all stages of life. In a study by Fiscella & Williams (2004), the researchers show that children living in poverty have higher sudden infant death, child abuse, asthma, developmental delays, and overall poor health. The study continues to show that adolescents who live in poverty experience higher

rates of pregnancies, sexually transmitted diseases, depression, obesity, and suicide. By adulthood, Black Americans in poverty experience premature chronic morbidity and have higher rates of death across the spectrum of causes (Fiscella & Williams, 2004).


These fundamental causes lead to poor health outcomes for Black Americans because they limited their human capital and ability to get access to health-promoting resources. In combination, the lack of education, employment, and living in poverty can lead to higher stress levels and allostatic load. This contributes to high rates of hypertension, cardiovascular disease, and cumulative physiological effects––on top of the negative health outcomes that already come with each fundamental cause individually.

Educational attainment, employment, and poverty are not the only social barriers that are causing health disparities for Black patients. There are several other factors that play a role, and determining the exact social determinants of health is complex. Although the causal pathways of every Black Americans’ health disparity may not be known, it is still important to try to reduce

these disparities because health is a basic human right.

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