Evidence map›Paper›PMID 41104070›Full record

ArticleJournal of biomedical and life sciences2025

"To Be Twice as Good to Get Half": Minorities' Diminished Returns.

Shervin Assari, John Ashley Pallera, Hossein Zare

Abstract read
In one paragraph

Article in Journal of biomedical and life sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Shervin AssariDepartment of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States.
John Ashley PalleraCollege of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA.
Hossein ZareDepartment of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.

Funding

Why Place MattersU54MD000214 · NIMHD · JOHNS HOPKINS UNIVERSITY · PI THORPE, ROLAND J. · 2017 to 2022
$8.8M
The Next Generation Substance Abuse Research Training at Charles R. Drew University (CDU) and UCLA (NGSART-CU)R25DA050723 · NIDA · CHARLES R. DREW UNIVERSITY OF MED & SCI · PI FRIEDMAN, THEODORE C · 2020 to 2024
$1.4M
NIDA NIH HHS R25 DA050723NIMHD NIH HHS U54 MD000214
6 · The paper itself

Abstract

"To Be Twice as Good to Get Half" is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities' Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where "being twice as good" still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms-including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate-that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the "bootstraps" narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs' phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, "I have to be twice as good to get half."

Indexed as

Chronic StressHealth DisparitiesMinorities’ Diminished ReturnsPolicy InterventionsSocioeconomic StatusStructural RacismSystemic Barriers

Identifiers

PMID41104070
PMCPMC12526249

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.