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What are MDRs?

Marginalization-related Diminished Returns (MDRs) refer to weaker than expected effects of socioeconomic status indicators for Black than White people. To give examples, high parental education better reduces risk of depression for White than Black youth and adults.

Are MDRs specific to Black people?

MDRs reflect structural racism because (1) they are seen for all racialiaizedm marginalized, and minoritizid social groups, (2) they are seen in the absence of poverty, (3) they are shown to be related to residential place, segregation, stress, labor market discrimination, and poor education quality in majority minority areas.

Are MDRs caused by genes?

MDRs are due to social not biological mechanisms. A study published in Brain Sciences for example showed that residential segregation has a role. For Black families, high SES means more exposure to White people, which increases their discriminatory experiences. Another study showed the same pattern for high SES Black youth who were attending schools with more White students, again increasing their experience of discrimination. 

When do MDRs emerge?

The MDRs are shown for newborns, children, youth, adults, and older adults. Thus, despite they accumulate over the life-course, they start early in life. As such, early interventions are needed to address MDRs. Thus, prevention of MDRs should start before birth.

Are MDRs shown by other researchers?

Reserach by Assari has documented MDRs . Other scholars who have shown similar MDRs include Zajacova, FerraroBrody, Thorpe, and many others.

Why MDRs reflect structural racism?

Reserach shows that MDRs are not specific to Black people. Similar MDRs are shown for  LGBT, LatinoAsian American, Native Americanmarginalized White, and immigrant people. However, they seem to be worse for Black people, which is due to the legacy and slavery of Jim Crow laws and racism.

Do MDRs have any policy implications? 

There are multiple policy implications for MDRs: (1) To address health inequality, we need fair public policy rather than health policy, (2) Addressing health disparities requires beyond poverty elimination. We need to also reduce racism and discrimination, and (3)  As income is less vulnurable to MDRs than education, wealth and income redistribution policies are real opportunities for elimination of health inequalities. 

What is the risk if policymakers overlook the MDRs? 

 Some well-intended policies may widen the existing inequalities because they may have larger uptakes and effects in White than Black communities. Thus, there is always a need to evaluate policies for their effects overall and also on inequalities.

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