Article Open Access May 05, 2025

To Be Twice as Good to Get Half

1
Department of Internal Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
2
Department of Family Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
3
Department of Urban Public Health, Charles R. Drew University of Medicine and Science, Los Angeles, CA, United States
4
Marginalization-Related Diminished Returns (MDRs) Center, Los Angeles, CA, United States
5
College of Medicine, Charles R. Drew University of Medicine and Science, Los Angeles, USA
6
Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
7
School of Business, University of Maryland Global Campus (UMGC), Adelphi, MD, United States
Page(s): 67-83
Received
November 22, 2024
Revised
January 11, 2025
Accepted
February 09, 2025
Published
May 05, 2025
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright: Copyright © The Author(s), 2025. Published by Scientific Publications
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APA Style
Assari, S. , Pallera, J. A. , & Zare, H. (2025). To Be Twice as Good to Get Half. Current Research in Public Health, 5(1), 67-83. https://doi.org/10.31586/jbls.2025.1158
ACS Style
Assari, S. ; Pallera, J. A. ; Zare, H. To Be Twice as Good to Get Half. Current Research in Public Health 2025 5(1), 67-83. https://doi.org/10.31586/jbls.2025.1158
Chicago/Turabian Style
Assari, Shervin, John Ashley Pallera, and Hossein Zare. 2025. "To Be Twice as Good to Get Half". Current Research in Public Health 5, no. 1: 67-83. https://doi.org/10.31586/jbls.2025.1158
AMA Style
Assari S, Pallera JA, Zare H. To Be Twice as Good to Get Half. Current Research in Public Health. 2025; 5(1):67-83. https://doi.org/10.31586/jbls.2025.1158
@Article{crph1158,
AUTHOR = {Assari, Shervin and Pallera, John Ashley and Zare, Hossein},
TITLE = {To Be Twice as Good to Get Half},
JOURNAL = {Current Research in Public Health},
VOLUME = {5},
YEAR = {2025},
NUMBER = {1},
PAGES = {67-83},
URL = {https://www.scipublications.com/journal/index.php/JBLS/article/view/1158},
ISSN = {2831-5162},
DOI = {10.31586/jbls.2025.1158},
ABSTRACT = {“To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where “being twice as good” still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms—including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate—that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the “bootstraps” narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs’ phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, “I have to be twice as good to get half.”},
}
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%A Pallera, John Ashley
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AB  - “To Be Twice as Good to Get Half” is a common mindset among high aspiration and ambition Black individuals in the U.S., capturing the lived reality of Minorities’ Diminished Returns (MDRs). This paper explains that MDRs reflect how, even with high levels of ambition, self-efficacy, education, and income, Black individuals and other marginalized groups do not experience the same protective benefits for health and well-being as White populations. Systemic obstacles embedded within U.S. society weaken the expected returns on socioeconomic achievements for racialized individuals, creating a reality where “being twice as good” still results in lesser outcomes. High-SES Black individuals, for instance, continue to face significant risks for adverse outcomes, such as depression and chronic disease, due to structural inequities across domains like labor market discrimination, segregation, and accumulated disadvantage from childhood. Our analysis identifies key mechanisms—including interpersonal discrimination, lower-quality education, and structural racism in sectors like banking, policing, and real estate—that erode the protective effects of SES across racial lines. Mediating factors, such as chronic stress, allostatic load, and epigenetic changes over the life course, further compound these diminished returns, weakening the expected physical and mental health benefits. Drawing on extensive evidence from U.S. national and local datasets and corroborated by international studies, this paper underscores the necessity of policies that dismantle structural barriers rather than relying solely on SES improvements. Recommendations include implementing multi-sectoral policies, recognizing the unique challenges of middle-class non-White populations, and approaching policy with humility, acknowledging that achieving equity is a long-term endeavor. By challenging the “bootstraps” narrative, this paper advocates for structural interventions aimed at genuine health and economic equity for all racial and socioeconomic groups. While we provide an in-depth analysis of MDRs’ phenomena, mechanisms, mediators, and policy implications, the experience is often distilled as, “I have to be twice as good to get half.”
DO  - To Be Twice as Good to Get Half
TI  - 10.31586/jbls.2025.1158
ER  -