A new groundbreaking study found that in the US, black boys, even those raised in the highest income households in the toniest neighborhoods, earn less later in life than white boys who grow up in similar circumstances. In other words, race matters, and race may matter even more at higher income levels.

Class does not protect black Americans from racism. Regardless of class status, black people have higher incarceration rates, lower incomes, less wealth, and worse health outcomes. Many politicians and academics continue to insist that education is the key to upward mobility, yet racial disparities persist even when black people attain high levels of education. Of course education is important in its own right, but it is not a panacea to address long-established racist structural barriers.

The evidence from the study makes clear that being upper class does not protect black children from a future of precariousness. Indeed, to overcome racial barriers many black children from poor to well-to-do families have heard the adage from a parent or other relative that they need to “work twice as hard to get by”.

Black men with a college degree are nearly three times more likely to die from a stroke than white men without a high school diploma

As an individual strategy this seems like sound advice, but from a social perspective, shouldn’t we also be concerned about the costs of “working twice as hard to get by”? Are there health consequences associated with above normal effort, grit, or perseverance for racially stigmatized highly educated black people in the context of a racially stratified America?

The World Health Organization says that “the conditions in which individuals are born, grow, live, work, and age” are the primary determinants of health. Why, then, do racial disparities in health persist or even grow with higher educational attainment in the US?

For instance, for black mothers the maternal mortality and infant mortality rates are nearly double the white rates at all levels of education. Indeed, black women with a college degree have higher maternal and infant mortality rates than white women who dropped out of high school.

Alarming and persistent health disparities extend to black men as well. For instance, black men with a college degree are nearly three times more likely to die from a stroke than white men without a high school diploma.

More generally, black men and women between the ages of 25 and 64 have about a 50% higher mortality rate than their white counterparts. Even more disheartening, these disparities increase with education – for both men and women, black people with a college degree have nearly a 70% higher mortality rate than comparably educated whites.

The new study makes a clear and convincing case concerning the fragility of the black upper class maintaining their position across generations due to structural racism. Personal responsibility, hard work, perseverance and – especially – education are supposedly all that one needs to achieve a better life in the US.

The sad irony is that the added stress and physical strain caused by the grit, perseverance and hard work needed to overcome structural racism very well may worsen one’s health. Race matters; it matters throughout class and with the rising mortality rates demonstrated here, it’s even a matter of life and death.