Early-Life Racial Discrimination, Racial Centrality, and Adult Allostatic Load Among African American Older Adults

Abstract This study evaluated the life course processes through which early life racial discrimination (ELRD) and racial centrality (i.e., the importance of Black identity to one’s sense of self) interact to shape allostatic load (AL) among African American (AA) adults aged 50+ in the Nashville Stress and Health Study (N=260). Adolescent ELRD was associated with greater racial centrality in adulthood and conferred 35% greater risk of high adult AL; greater centrality was also linked to high adult AL. Centrality accounts for 24% of the association between ELRD and AL. ELRD and centrality interact to shape adult AL, such that racial centrality is protective against high AL for adults who experienced racial discrimination as children or adolescents. Findings highlight the multiple pathways through which race-related stressors and psychosocial resources interact to shape physiological dysregulation in later life and underscore the health significance of racial identity for older AAs.

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DOES EARLY-LIFE RACIAL DISCRIMINATION EXPLAIN A MENTAL HEALTH PARADOX AMONG BLACK ADULTS?

Innovation in Aging ◽

10.1093/geroni/igz038.689 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S192-S192

Author(s):

Courtney S Thomas Tobin ◽

Myles D Moody

Keyword(s):

Mental Health ◽

Racial Discrimination ◽

Early Life ◽

Health Study ◽

Black Adults ◽

The Life Course ◽

The Impact ◽

The Relationship ◽

Stress And Health ◽

Health Paradox

Abstract To evaluate the impact of early life racial discrimination (ELRD) on mental health among Black adults. Data were from the Nashville Stress and Health Study (n=618). OLS regression models examined the relationship between ELRD and adult psychological distress; logistic regression estimated the probability of past-year major depressive disorder (MDD). We also assessed whether ELRD moderated the relationship between adult discrimination and mental health. Childhood (b=1.07, SE=0.51, p=0.04) and adolescent ELRD (b=1.32, SE=0.42, p=0.002) were associated with adult distress. Individuals who experienced childhood ERLD had 88% lower odds of adult MDD than individuals with no ELRD. Significant interaction analyses showed that ELRD was generally protective against adult discrimination. While ELRD importantly shapes distress and MDD among Black adults, patterns vary by outcome. Results indicate that adult distress and MDD develop through cumulative adversity processes that are further influenced by sensitive periods in the life course.

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Discrimination, Stress, and Health Across the Life Course

Innovation in Aging ◽

10.1093/geroni/igab046.717 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 189-190

Author(s):

Roland Thorpe ◽

Carl V Hill

Keyword(s):

African American ◽

Health Disparities ◽

Life Course ◽

Racial Discrimination ◽

Stress Exposure ◽

Racial Centrality ◽

The Life Course ◽

Stress And Health ◽

Everyday Discrimination ◽

African American Health

Abstract There is a paucity of research that seeks to understand why race disparities in health across the life course remain elusive. Two such explanations that have been garnering attention is stress and discrimination. This symposium contains papers seeking to address the impact of discrimination or stress on African American health or health disparities across the life course. Brown and colleagues examine the differential effects of chronic stress exposure by means of latent class analysis on mental and physical health in the HRS. Analysis revealed four subgroups, each demonstrated a typological response pattern with the most pronounced health consequences for high stress exposure, appraisal and few or no coping mechanisms. This suggests an alternative approach to examining the stress-health link by using a combined person- and variable-centered approach. Thomas Tobin and colleagues evaluate the life course processes through which early life racial discrimination (ELRD) and racial centrality shape adult allostatic load (AL) among older Blacks in the Nashville Stress and Health Study. Findings indicate that racial centrality is protective against adult high AL for those who experienced racial discrimination as children or adolescents. Cobb and colleagues examine how multiple attributed reasons for everyday discrimination relates to all-cause mortality risk among older Blacks in HRS. The authors report the 3 or more attributed reasons for everyday discrimination is a particularly salient risk factor for mortality in later life. This collection of papers provides insights into how discrimination or stress impacts African American health or health disparities in middle to late life.

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Does Early Life Racial Discrimination Explain a Mental Health Paradox among Black Adults?

Journal of Aging and Health ◽

10.1177/0898264320988187 ◽

2021 ◽

pp. 089826432098818

Author(s):

Courtney S. Thomas Tobin ◽

Myles D. Moody

Keyword(s):

Mental Health ◽

Racial Discrimination ◽

Early Life ◽

Ordinary Least Squares ◽

Health Study ◽

Least Squares Regression ◽

Black Adults ◽

The Life Course ◽

The Impact ◽

The Relationship

Objectives: To evaluate the impact of early life racial discrimination (ELRD) on mental health among Black adults. Methods: Data were from the Nashville Stress and Health Study ( n = 618). Ordinary least squares regression models examined the relationship between ELRD and adult psychological distress; logistic regression estimated the probability of past-year major depressive disorder (MDD). We also assessed whether ELRD moderated the relationship between adult discrimination and mental health. Results: Childhood (b = 1.07, SE = .51, p = .04) and adolescent ELRD (b = 1.32, SE = .42, p = .002) were associated with adult distress. Individuals who experienced childhood ERLD had 88% lower odds of adult MDD than individuals with no ELRD. Significant interactions showed that childhood and adolescent ELRD was protective against adult discrimination. Discussion: While ELRD importantly shapes distress and MDD among Black adults, patterns vary by outcome. Results indicate that adult distress and MDD develop through cumulative adversity processes that are further influenced by sensitive periods in the life course.

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208 Life Course Socioeconomic Position and Allostatic Load Burden

Age and Ageing ◽

10.1093/ageing/afz103.126 ◽

2019 ◽

Vol 48 (Supplement_3) ◽

pp. iii17-iii65

Author(s):

Sinead McLoughlin ◽

Cathal McCrory

Keyword(s):

Life Course ◽

Social Mobility ◽

Allostatic Load ◽

Negative Binomial ◽

Negative Binomial Regression ◽

Later Life ◽

The Body ◽

Sensitive Period ◽

Physiological Dysregulation ◽

The Life Course

Abstract Background Allostatic load (AL) is a measure of cumulative physiological dysregulation that is posited to capture the ‘wear and tear’ on the body resulting from exposure to chronic stress. AL has been shown to predict disease, morbidity and mortality. Multiple studies have shown an inverse relationship between AL and SEP, but few have examined the life course social patterning of AL. Methods Using baseline data from The Irish Longitudinal Study on Ageing (TILDA), an AL index was calculated by summing the number of biomarkers for which respondents fell within high risk quartiles. 17 biomarkers were examined, representing cardiovascular, immune, metabolic and parasympathetic nervous systems. SEP and life course trajectories were determined using father’s occupation (at age 14) and current occupation, which were aggregated to create four categories of social mobility; stable high, downwardly mobile, upwardly mobile and stable low. Negative binomial regression models were fitted for each of the life course models of critical period, accumulation and social mobility, to examine the associations between SEP and AL (n=3,282). Results Higher SEP was associated with lower AL. A significant association between origin SEP and later life remained after controlling for destination SEP. The ‘stable high’ across the life course had the lowest AL burden, the ‘stable low’ had the highest burden, and the mobile groups ranked intermediate. Conclusion Findings suggest childhood to be a sensitive period for the embedding of early life disadvantage. The accumulation hypothesis suggests that those who spend more time disadvantaged fair worse in terms of health. This study supports this hypothesis, as those who were stable low / stable high were in the worst / best health respectively.

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Body size throughout the life-course and incident benign prostatic hyperplasia-related outcomes and nocturia

BMC Urology ◽

10.1186/s12894-021-00816-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Saira Khan ◽

K. Y. Wolin ◽

R. Pakpahan ◽

R. L. Grubb ◽

G. A. Colditz ◽

...

Keyword(s):

Body Size ◽

Benign Prostatic Hyperplasia ◽

Life Course ◽

Early Life ◽

Prostate Volume ◽

Late Life ◽

Later Life ◽

Normal Weight ◽

Prostatic Hyperplasia ◽

The Life Course

Abstract Background Existing evidence suggests that there is an association between body size and prevalent Benign Prostatic Hyperplasia (BPH)-related outcomes and nocturia. However, there is limited evidence on the association between body size throughout the life-course and incident BPH-related outcomes. Methods Our study population consisted of men without histories of prostate cancer, BPH-related outcomes, or nocturia in the intervention arm of the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) (n = 4710). Associations for body size in early- (age 20), mid- (age 50) and late-life (age ≥ 55, mean age 60.7 years) and weight change with incident BPH-related outcomes (including self-reported nocturia and physician diagnosis of BPH, digital rectal examination-estimated prostate volume ≥ 30 cc, and prostate-specific antigen [PSA] concentration > 1.4 ng/mL) were examined using Poisson regression with robust variance estimation. Results Men who were obese in late-life were 25% more likely to report nocturia (Relative Risk (RR): 1.25, 95% Confidence Interval (CI): 1.11–1.40; p-trendfor continuous BMI < 0.0001) and men who were either overweight or obese in late-life were more likely to report a prostate volume ≥ 30 cc (RRoverweight: 1.13, 95% CI 1.07–1.21; RRobese: 1.10, 95% CI 1.02–1.19; p-trendfor continuous BMI = 0.017) as compared to normal weight men. Obesity at ages 20 and 50 was similarly associated with both nocturia and prostate volume ≥ 30 cc. Considering trajectories of body size, men who were normal weight at age 20 and became overweight or obese by later-life had increased risks of nocturia (RRnormal to overweight: 1.09, 95% CI 0.98–1.22; RRnormal to obese: 1.28, 95% CI 1.10–1.47) and a prostate volume ≥ 30 cc (RRnormal to overweight: 1.12, 95% CI 1.05–1.20). Too few men were obese early in life to examine the independent effect of early-life body size. Later-life body size modified the association between physical activity and nocturia. Conclusions We found that later-life body size, independent of early-life body size, was associated with adverse BPH outcomes, suggesting that interventions to reduce body size even late in life can potentially reduce the burden of BPH-related outcomes and nocturia.

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Early-life circumstances and the risk of function-limiting long-term conditions in later life

Longitudinal and Life Course Studies ◽

10.1332/175795919x15762565000695 ◽

2020 ◽

Vol 11 (2) ◽

pp. 157-180

Author(s):

Matthew H. Iveson ◽

Chris Dibben ◽

Ian J. Deary

Keyword(s):

Life Course ◽

Cognitive Ability ◽

Early Life ◽

Economic Status ◽

Functional Limitation ◽

Later Life ◽

Socio Economic Status ◽

Childhood Cognitive Ability ◽

The Life Course

Older adults are particularly prone to function-limiting health issues that adversely affect their well-being. Previous work has identified factors from across the life course –childhood socio-economic status, childhood cognitive ability and education – that predict later-life functional outcomes. However, the independence of these contributions is unclear as later-in-the-life-course predictors are themselves affected by earlier ones. The present study capitalised on the recent linkage of the Scottish Mental Survey 1947 with the Scottish Longitudinal Study, using path analyses to examine the direct and indirect associations between life-course predictors and the risk of functional limitation at ages 55 (N = 2,374), 65 (N = 1,971) and 75 (N = 1,534). The odds of reporting a function-limiting long-term condition increased across later life. At age 55, reporting a functional limitation was significantly less likely in those with higher childhood socio-economic status, higher childhood cognitive ability and higher educational attainment; these associations were only partly mediated by other predictors. At age 65, adult socio-economic status emerged as a mediator of several associations, although direct associations with childhood socio-economic status and childhood cognitive ability were still observed. At age 75, only childhood socio-economic status and adult socio-economic status directly predicted the risk of a functional limitation, particularly those associated with disease or illness. A consistent pattern and direction of associations was observed with self-rated health more generally. These results demonstrate that early-life and adult circumstances are associated with functional limitations later in life, but that these associations are partly a product of complex mediation between life-course factors.

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Direct and Vicarious Racial Discrimination at Three Life Stages and Preterm Labor: Results from the African American Women’s Heart & Health Study

Maternal and Child Health Journal ◽

10.1007/s10995-020-03003-4 ◽

2020 ◽

Vol 24 (11) ◽

pp. 1387-1395 ◽

Cited By ~ 1

Author(s):

Katie P. Daniels ◽

Zulema Valdez ◽

David H. Chae ◽

Amani M. Allen

Keyword(s):

African American ◽

Racial Discrimination ◽

Preterm Labor ◽

Health Study ◽

Life Stages ◽

Heart Health

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A Longitudinal Study of Allostatic Load in Later Life: The Role of Sex, Birth Cohorts, and Risk Accumulation

Research on Aging ◽

10.1177/0164027518813839 ◽

2018 ◽

Vol 41 (5) ◽

pp. 419-442 ◽

Cited By ~ 1

Author(s):

Ioana van Deurzen ◽

Bram Vanhoutte

Keyword(s):

Longitudinal Study ◽

Life Course ◽

Allostatic Load ◽

Later Life ◽

The Body ◽

Life Course Perspective ◽

Birth Cohorts ◽

Wear And Tear ◽

The Life Course

Are challenging life courses associated with more wear and tear on the biological level? This study investigates this question from a life-course perspective by examining the influence of life-course risk accumulation on allostatic load (AL), considering the role of sex and birth cohorts. Using biomarker data collected over three waves (2004, 2008, and 2012) of the English Longitudinal Study of Ageing ( N = 3,824) in a growth curve framework, AL trajectories over a period of 8 years are investigated. Our results illustrate that AL increases substantially in later life. Men have higher AL than women, but increases are similar for both sexes. Older cohorts have both higher levels and a steeper increase of AL over time. Higher risk accumulation over the life course goes hand in hand with higher AL levels and steeper trajectories, contributing to the body of evidence on cumulative (dis)advantage processes in later life.

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Abstract P189: Greater Purpose In Life Is Associated With Lower Allostatic Load Among Hispanics/ Latinos: The Hispanic Community Health Study/study Of Latinos (hchs/sol) Sociocultural Ancillary Study (scas)

Circulation ◽

10.1161/circ.143.suppl_1.p189 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Mayra L Estrella ◽

Melissa Lamar ◽

Ramon A Durazo-Arvizu ◽

Josiemer Mattei ◽

Lisa A Sanchez-Johnsen ◽

...

Keyword(s):

Psychosocial Factors ◽

Allostatic Load ◽

Family Cohesion ◽

Psychosocial Factor ◽

Purpose In Life ◽

Sociodemographic Factors ◽

Ethnic Discrimination ◽

Health Study ◽

Linear Regression Models ◽

Physiological Dysregulation

Introduction: Allostatic load (AL), a multi-system measure of physiological dysregulation that represents cumulative wear-and-tear due to chronic stressors, is related to higher risk of cardiovascular disease (CVD). Evidence on the association of psychosocial factors with AL is mixed despite accruing research that suggests that psychosocial factors are related to CVD, in part, through AL. We examined the associations of psychosocial factors with AL among Hispanics/Latinos. Hypothesis: Psychosocial intrapersonal ( ethnic identity , optimism, and purpose in life) and interpersonal ( family cohesion , social network embeddedness , and social support ) resources will each be inversely associated with AL while stressors ( perceived ethnic discrimination , familism, and loneliness ) will each be positively associated. Methods: Data from the HCHS/SOL SCAS were used (n=4,914; ages 18-74). AL was assessed using 16 biomarkers representing cardiometabolic, glucose, cardiopulmonary, parasympathetic, and inflammatory systems. The AL score (0-16) was computed as the number of biomarkers for which a participant had a high-risk quartile; higher scores represent greater physiological dysregulation. Psychosocial factors were self-reported. Survey-weighted linear regression models adjusted for sociodemographic factors examined associations of each psychosocial factor with AL. We also examined whether sex modified these associations. Results: Mean AL score was 4.0 (SD=3.2). In fully-adjusted models (Table), the purpose in life score was inversely associated with AL. No other significant associations were observed, although regression estimates were generally in the hypothesized direction. Sex did not modify the association of psychosocial factors with AL. Conclusions: Greater sense of purpose in life, an intrapersonal psychosocial resource, is associated with lower physiological dysregulation in Hispanics/Latinos. Findings highlight the need to examine prospective associations of purpose in life with AL.

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