The Black-White paradox in health: flourishing in the face of social inequality and discrimination

J Pers. 2009 Dec;77(6):1677-706. doi: 10.1111/j.1467-6494.2009.00597.x. Epub 2009 Sep 30.


This paper reviews published research and presents new analyses from the 1995 nationally representative sample from the Midlife in the United States (MIDUS) study to investigate whether there is support for the paradox of race and health in the United States. Findings reveal that Blacks have lower rates of several common mental disorders, but Blacks also have higher rates of flourishing than Whites. Blacks are mentally resilient in the face of greater social inequality and exposure to discrimination as well as high rates of physical morbidity--all of which are distinctive risk factors for mental distress and mental illness in the general population. Findings also show that controlling for perceived discrimination increases the Black advantage in 12 of the 13 signs of flourishing, suggesting that Blacks would have even better mental health were it not for discrimination. This paper concludes by considering what mechanisms--both adaptive and maladaptive--might explain this particular example of resilience in the Black population.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Black or African American / statistics & numerical data*
  • Chronic Disease / ethnology
  • Cultural Characteristics
  • Health Behavior / ethnology
  • Health Status
  • Humans
  • Life Style / ethnology
  • Mental Disorders / ethnology*
  • Mental Health / statistics & numerical data*
  • Prejudice*
  • Quality of Life
  • Residence Characteristics
  • Resilience, Psychological*
  • Social Class
  • Social Environment
  • Socioeconomic Factors
  • United States
  • White People / statistics & numerical data*