Project 3 - 2010

Project 3: Decomposing Racial/Ethnic Disparities in Health - Kajal Lahiri & Pinka Chatterji


A. SPECIFIC AIMS (unmodified from original)

1. To estimate and compare quality of health by racial/ethnic group; by state; by community size; and to examine trends over time in quality of health
2. To estimate within-group total and income-related health inequalities and their decomposition
3. To decompose between-group health inequalities into their determinants with special emphasis on the role of community size.


The project team continues to meet monthly as a large group, as well as weekly in smaller groups that are convened to discuss particular tasks and papers. We have complete drafts of the following three papers: (1) Beware of being unaware: racial/ethnic disparities in awareness of chronic disease (Specific Aims 1 and 2); (2) Child health inequality and its dynamics through adolescence (Specific Aim 3); and (3) Early health conditions and disparities in academic achievement. 

The first paper estimates racial/ethnic disparities in individuals’ awareness of chronic disease using biomarker data from the 2006 Health and Retirement Study.  We focus on racial/ethnic differences in disease awareness since these differences may be a critical factor underlying disparities in treatment and adequate control of disease. The findings suggest that African-Americans are more likely than non-Latino whites to have hypertension, but we find no statistically significant differences in awareness of hypertension between African-Americans and non-Latino whites. All minority groups are more likely than non-Latino whites to have diabetes but, among those with diabetes, African-Americans and Latinos are less likely to be aware of their condition compared to non-Latino whites.

The second paper applies innovative methods from econometrics to estimate racial/ethnic disparities in child health in U.S., and examine how disparities change as children enter adolescence. Data come from the Panel Study on Income Dynamics – Child Development Supplement.  The results indicate parental education and employment are important factors underlying income-related health inequality among children in the US. Especially for African-American children, effective policies to reduce disparities would include policies that target family structure and mother’s education and employment.  Living in a large metropolitan area (1 million+ population) in the US is associated with higher levels of child health after controlling for other factors.  Urban residence is an important factor in the decomposition of child health inequality both across and within racial/ethnic groups.

In the third paper, we use data from the Child Development (CDS) and the Transition into Adulthood (TA) Supplements of the Panel Study of Income Dynamics (PSID) to examine the role of health at birth and in early childhood as a contributor to racial disparities in academic achievement and educational attainment later in life. Our preliminary findings show that poor health at birth and in childhood indeed is more prevalent among African-American children compared to non-Latino white children.  However, the negative effects of poor health on academic outcomes appear to be concentrated among non-Latino white children, and the effects of poor health at birth on academic outcomes are small in magnitude.  As a result, early health is not an important contributor to racial differences in test scores or educational attainment.  Racial differences in educational attainment, in fact, are fully accounted for by racial differences in maternal SES at the time of the child’s birth.

All three papers were presented at the American Society of Health Economists (ASHE) biennial conference in July 2010.  The third paper was part of a session our group organized on this topic.  In addition, the second paper was accepted for and presented at a selective meeting on health and SES research hosted by the Panel Study on Income Dynamics in Ann Arbor, MI in September 2010.

Project staff had training opportunities, including taking on-line courses in STATA and attending a selective Summer Institute on Health and Aging held at RAND in July, 2010.


The completion of these analyses, particularly the analyses associated with Specific Aim 3, will provide unique data on the magnitude and persistence of health disparities along an urban-rural continuum. These results will identify health disparities that may be especially important to address in the smaller cities and towns comparable to the communities in which the Center is developing its intervention research.

In the next year, we will work to obtain community level data which can be merged to individual records in these large secondary data sets.  This will allow us to examine effects of community size and community attributes at a more disaggregated level.


Chatterji P, Joo H, Lahiri K. Beware of being unaware: Racial/ethnic disparities in awareness of chronic disease, National Bureau of Economic Research (NBER) working paper, 2010.

Lahiri K, Pulungan Z. Health inequality and its determinants in New York. Journal of Human Capital. Submitted for publication, 2010.


Chatterji P, Heesoo J, Lahiri K. Beware of Being Unaware: Disparities in the Awareness of Major Chronic Illnesses. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.

Chatterji P, Lahiri K, Song J. Child health disparity analysis and income gradient: evidence from PSID-CDS Data. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.

Chatterji P, Lahiri K. Early Health Conditions and Racial Disparities in Academic Achievement. American Society of Health Economists, 3rd Biennial Conference, Ithaca, NY, June 2010.

Chatterji P, Lahiri K, Song J. Child health disparity analysis and income gradient: evidence from PSID-CDS Data. Panel Study on Income Dynamics Conference: Research on Connections between Health and Socioeconomic Status Using PSID Data. Ann Arbor, MI, September 2010.