SES is one of the strongest known predictors of variations in health; and racial differences in SES reflect, in part, the impact of economic discrimination produced by large-scale societal structures. Residential de facto segregation has been a primary mechanism by which racial inequality has been created and reinforced. Racial segregation has limited access to educational and employment opportunities, which has led to truncated socioeconomic mobility for Blacks and Native Americans or Alaska Natives (Jaynes and Williams, 1987; Massey and Denton, 1993). Moreover, racism skews the value of SES indicators, making them nonequivalent across racial groups. This makes it difficult to truly adjust racial differences in health for SES (Kaufman et al., 1997). For example, there are racial differences in the quality of education, income returns for a given level of education or occupational status, wealth or assets associated with a given level of income, purchasing power of income, stability of employment, and health risks associated with occupational status (Williams and Collins, 1995; Kaufman et al., 1997).

Evidence suggests that some White employers use racial group membership and residence in undesirable neighborhoods as criteria for refusing to hire some urban residents (Kirschenman and Neckerman, 1991). Thus, beliefs based on stereotypes are combined with Blacks’ geographic concentration to systematically reduce their employment opportunities. Empirical evidence suggests corporate executives use beliefs about minority group inferiority and data on minority group concentration to move firms away from areas that are likely to have a high proportion of minority group workers. A Wall Street Journal analysis of the Equal Employment Opportunity Commission reports of more than 35,000 U.S. companies revealed that during the economic downturn of 1990–1991, Blacks were the only group that experienced a net job loss—59,500 jobs—compared to net job gains of 71,100 for Whites, 60,000 for Hispanics, and 55,100 for Asians (Sharpe, 1993). Blacks lost a disproportionately high share of the jobs that were cut and gained a disproportionately low share of the jobs that were added.

Corporate America indicated that these job losses were the result of restructuring, relocating, and downsizing. Sears moved distribution centers from the central city to the suburbs to facilitate more convenient routing of its truck fleet. Coca Cola reduced its workforce to maintain profits, but 42 percent of those laid off were Black, even though Blacks were only 18 percent of its workforce. General Electric stopped production in two plants—39 percent of employees in one were Black, in the other, 80 percent. Clearly there are a number of structural forces driving the movement of high-pay, low-skill jobs from the urban areas where