Effects of an intervention on Black family incomes on self-rated health and obesity in Black and White adolescents and young adults

Abstract

Structural racism contributes to health disparities between US non-Hispanic Black and non-Hispanic White populations by differentially distributing resources used to maintain health. Policies that equitably redistribute resources may mitigate racialized health disparities. Using National Longitudinal Study of Adolescent to Adult Health data and time-to-event parametric g-formula methods, we investigate a hypothetical intervention to reduce Black-White family income inequities on racialized differences in self-rated health (n = 11 312) and obesity (n = 10 547). We first intervene to increase individual Black family incomes by $11 000, creating Black-White equity in median incomes in 1995. Then, we measure social multiplier effects by additionally increasing county-level Black median household incomes by $11 000. By wave 4, individual, direct effects models comparing Black intervention to Black control groups show no risk differences (RD) in self-rated health (RD = -0.009; 95% CI, -0.026 to 0.008) or obesity (RD = 0.003; 95% CI, -0.017 to 0.023). Social multiplier effects models suggestively reduce Black-White inequalities in obesity by increasing obesity in White intervention versus White control groups (RD = 0.050; 95% CI, -0.011 to 0.110) but exacerbate Black-White disparities in self-rated health by reducing self-rated health in Black intervention versus White control groups (RD = 0.184; 95% CI, 0.018 to 0.351). In this cohort, income transfers may not reduce racialized disparities in obesity and self-rated health.