Light Privilege? Skin Tone Stratification in Health among African Americans.

Skin tone is a significant marker used by others to evaluate and rank the social position of minorities. While skin color represents a particularly salient dimension of race, its consequences for health remains unclear. This study uses four waves of panel data from the Coronary Artery Risk Development in Young Adults (CARDIA) Study and random intercept multilevel models to address three research questions critical to understanding the skin color-health relationship among African American adults (N=1,680): what is the relationship between skin color and two global measures of health (cumulative biological risk and self-rated health)? To what extent are these relationships gendered? Do socioeconomic resources, stressors, and discrimination help explain the skin color-health relationship? Findings indicate that dark-skinned women have more physiological deterioration and self-report worse health than lighter-skinned women. These associations are not evident among men, and socioeconomic factors, stressors, and discrimination do not explain the light-dark disparity in physiological deterioration among women. Differences in self-ratings of health among women are partially explained by education and income. Results of this study highlight heterogeneity in determinants of health among African Americans, and provide a more nuanced understanding of health inequality by identifying particularly disadvantaged members of racial groups that are often assumed to have monolithic experiences.