Coping While Black: Chronic Illness, Mastery, and the Black-White Health Paradox

  • Eundria A. Hill-JosephEmail author


Prior research indicates that there is a black-white paradox in the relationship between physical health and mental health among American adults. However, none have considered black-white differences in psychosocial coping and depressive symptoms during the transitional stages from health to chronic illness. Using a nationally representative sample of chronically ill adults from the American Changing Lives study, this study builds on literature on chronic illness and the black-white paradox to examine if (1) growth in depressive symptoms across 16 years differs for black and white adults as they transition from healthy to chronically ill and (2) if the protective coping resource, mastery, provides an equal benefit to black and white chronically ill adults during that transition. Findings indicate that among chronically ill adults, not only do black-white disparities exist in how much mastery each group possesses, but that mastery’s utility as a protective resource against depressive symptoms differs by race, with black ill adults experiencing a poorer return on their mastery than white adults. Moreover, findings that black adults maintain the same level of depressive symptoms as white adults despite this mastery disadvantage provide additional support for Minorities’ Diminishing Returns Theory and some support for an emerging theory of collective resilience with regard to black American mental health.


Chronic illness Depressive symptoms Racial disparities Mastery Collective resilience 



This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. The author declares no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Compliance with Ethical Standards

Ethical Approval

The Ethics Review Board at Biola University (the site at which the data analysis was conducted) does not require ethics approval for the use of publicly available secondary data, the type of data used in the submitted paper.

Conflict of Interest

The author declares no conflict of interest.


All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) with the Helsinki Declaration of 1975, as revised in 2000.

Animal Studies

No animal studies were conducted in completion of this study.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.Department of SociologyBiola UniversityLa MiradaUSA

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