Race/Ethnicity, Socioeconomic Characteristics, Coethnic Social Ties, and Health: Evidence From the National Jewish Population Survey

摘要

Objectives. We explored whether a White ethnic group with a history of structural disadvantage, Jewish Americans, shows evidence of continuing health impact independent of socioeconomic position (SEP), whether coethnic social ties appear health protective, and whether the strength of any protection varies by SEP. Methods. In a series of ordered logistic regressions, we analyzed data from the National Jewish Population Survey, 2000–2001, regressing self-rated health on race/ethnicity, education, and income for US Blacks, Jews, and other Whites and, for Jews alone, indicators of coethnic social ties. Results. controlling for SEP indicators, the self-rated health of Jews converged with that of Blacks and was significantly worse than that of other Whites. Access to coethnic social ties was associated with better self-rated health among Jews, with the strongest estimated association among those of lower SEP. Conclusions. The finding that a White ethnic group with a favorable socioeconomic profile reported significantly worse health than did other Whites, after controlling for SEP, calls for better understanding of the complex interplay of cultural, psychosocial, and socioeconomic resources in shaping population health. A longstanding literature supports the importance of social ties to health. 1 , 2 Less is known about the importance of coethnic social ties to the health of racial/ethnic groups. 3 Social ties can influence health as a buffer against the harmful effects of psychosocial stressors. Coethnic social ties may play a particularly beneficial role in mitigating the harmful effects of race/ethnicity-related stressors that contribute to excess disease prevalence among diverse groups, independent of socioeconomic position (SEP). 4 – 26 Coethnic social ties may help members of marginalized groups develop or maintain a positive identity in the face of negative stereotypes. 3 , 8 , 9 , 27 As James first speculated, strong ethnic social networks may protect the health of stigmatized racial/ethnic group members by providing identity safety and an affirming alternative cultural framework to the dominant, marginalizing one. 3 Empirical evidence of this possibility is sparse, but suggestive. Dressler et al. 28 found that the extent to which individuals in a southern rural African American community were able to live in accordance with culturally constructed local community norms—or enjoyed cultural consonance in lifestyle—was a stronger, independent predictor of hypertension and smoking than were conventional socioeconomic measures. A qualitative study by Viruell-Fuentes 27 of women of Mexican origin in Detroit suggests the importance of coethnic social ties in countering the impact of the social psychological process of “othering.” For US residents of Mexican origin, othering occurs through encounters with non-Hispanic Whites. Infrequent othering encounters may contribute to the well-documented good health of recent immigrants, 29 – 37 whose everyday lives may not take them beyond the Spanish-speaking community. However, as immigrants with longer US residence and US-born children of immigrants have more frequent interactions with non-Hispanic Whites, they come face to face with US racial/ethnic dynamics. Through recognition of their stereotypic and subordinate place in the US racial hierarchy, othering encounters may threaten their health by, for example, activating physiological stress processes. 10 , 38 , 39 Indeed, empirical evidence suggests that in middle age, US-born Mexican Americans and Mexican immigrants who are long-term US residents are at greater risk of suffering a high allostatic load—or stress-mediated wear and tear on important body systems—than are recent Mexican immigrants, despite having higher SEP and after controlling for measured differences in smoking, diet, physical activity, and medical care utilization. 29 Further qualitative analysis of Viruell-Fuentes' Detroit interviews revealed that US-born participants highlighted the personal salience of constructing a positive identity and sense of belonging given the racialized, stigmatizing experiences they confronted in the broader social world. 40 Social ties to Mexican friends and family played a critical role in the development of this shared positive Mexican identity. Members of other racial/ethnic groups who experience othering may experience similar benefits of coethnic social ties. The cultural affirmation they provide may be health protective. James asked whether a marginalized racial/ethnic group's access to cultural affirmation may “become progressively more important to preserving the health of its members as the group's (economic) strengths … diminish.” 3 (p135) Pearson 41 posited that cultural affirmation is always important to health whether or not it offsets material disadvanta