What role does wealth play in the racial health gap in the United States? Examining differences among African Americans, Latinos, and non-Hispanic Whites.

Wealth resources has received little attention when studying how socioeconomic status shapes health outcomes. In the United States (USA), there is a growing body of evidence acknowledging a widening racial/ethnic wealth gap. However, little is known about wealth's role in shaping health inequity. Hence, our study examined the role wealth plays in the racial health gap across and within three racial/ethnic groups (African Americans - AA; Latinos -L; non-Hispanic Whites - NHW). We used nine waves of the nationally representative Survey of Consumer Finances (1995-2019). Trends over time were estimated with survey-weighted descriptive statistics. A series of linear probability regression models predicted fair/poor health based on overall and within-group wealth position, along with sociodemographic variables. Regression models revealed that both overall and within-racial-group wealth position matter when examining health outcomes. In fully adjusted models, racial health gaps practically disappeared for overall wealth position. While overall wealth position moderates the race-health path similarly for AA and NHW, the probability of fair/poof health for high-wealth Latinos is the same as medium-wealth AA and NHW. When considering within-group wealth position, AA and L have similar levels of fair/poor health (and significantly higher than NHW). Moreover, within-NHW wealth position matters for health at each level of wealth, while within-AA and within-L improvements are only evident at the high-wealth level. Our study provides evidence that wealth shapes health inequities differently when considering the overall wealth and within-racial group wealth. Policies to reduce wealth-health gaps should consider low and middle-wealth AA, L, and NHW.