Implications of White Diversity for U.S. Black-White Health Disparities

Stratification research in the U.S. has historically relied on non-Hispanic whites as a reference group to measure inequities between the majority white population and racial and ethnic minorities (Malat et al. 2018). The practice is common in comparisons between whites and other broad racial/ethnic groups (e.g., blacks, Hispanics compared to whites) and in more recent work that disaggregates heterogeneity within broad groups (e.g., native- and foreign- born blacks compared to whites) (Kauh et al. 2020). Such a strategy ignores several important demographic shifts that make the practice of using whites as a reference group increasingly problematic. First, whites are projected to be in the minority by 2040 (Vespa et al. 2020), which begs the question of appropriate reference category in studies of inequality, particularly if policies are driven by numerically larger minority groups. Second, the ethnic composition of whites has changed dramatically since the 1965 Immigration and Nationality Act and is far less homogeneous than typically assumed (Iceland 2014; Lopez and Radford 2017). In the 1960s, whites of western European descent made up 85-88% of the total white population; today, that proportion is down to less than one-half (Grieco 2010). In contrast, whites of eastern European and Middle Eastern/North African descent have been on the rise, as has the proportion of Whites who identify as “American” or “North American” (for a review, see Read et al. 2021). These compositional changes suggest that using the aggregate white category may obscure within-group inequalities and contribute to inaccurate estimates of gaps in inequality between whites and other racial and ethnic populations.

To date, however, research continues to rely on a definition of whites that was created in an era of greater homogeneity among whites. In 1977, the White House Office of Management and Budget released federal standards for collecting data on race and ethnicity to provide consistency across federal agencies tasked with enforcing civil rights laws. The standards included five broad categories that were revised slightly in 1997 to yield the following racial groups: White; Black or African American; Asian or Native Hawaiian or other Pacific Islander; American Indian or Alaska Native; and two options for Hispanic or Latino ethnicity (yes/no).

Importantly, the OMB defines whites as “...persons having origins in any of the original peoples of Europe, North Africa, or the Middle East” (OMB, 1997). When the standards were created, over 80% of whites were of western European origin. The majority had arrived under welcoming immigration policies in a context that privileged whites over all other racial and ethnic groups. Fast forward to 2023 and the picture looks much different in terms of the ethnic composition of whites. Political and civil unrest in many parts of the Middle East and eastern Europe—couple with U.S. involvement in the regions—has resulted in more diverse waves of white migration to the U.S. Today, whites of western European descent make up a dwindling proportion of the white population, yet the aggregate category remains the basis for most studies that include whites in the analysis. Studies that disaggregate whites have indeed shown that there are disadvantaged white subgroups that are obscured when grouped together.

The proposed study aims to extend the emergent literature on diversity among whites to focus on interracial inequality. Given changes in the ethnic composition of whites over time, I ask whether and how this impacts knowledge on black-white health disparities. This is a timely and important question that addresses directly current debates on federal revisions to racial and ethnic categories. My work has informed these debates by demonstrating that the aggregate white category masks the needs of vulnerable populations classified as white, such as Arabs and eastern Europeans from the Former Soviet Union. What remains unknown is whether the aggregate white category also effects knowledge on racial and ethnic health disparities, more broadly. The current project will fill that gap.

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