Chronic Medical Conditions and Negative Affect; Racial Variation in Reciprocal Associations Over Time

Abstract

BackgroundThe Black–White health paradox can be defined as lower frequency of depression despite higher prevalence of economic and social adversities as well as chronic medical conditions (CMC) among American Blacks compared to American Whites. Based on this paradox, the CMC – depressive symptoms link is expected to be weaker among Blacks than Whites. We conducted a 10-year longitudinal study to compare Blacks and Whites for bidirectional associations between number of CMC and negative affect over time.MethodsWe used data from the MIDUS (Midlife in the United States), a nationally representative longitudinal study of American adults. A total number of 7,108 individuals with an age range of 25–75 years (N = 7,108) were followed for 10 years from 1995 to 2004. Age, gender, and socioeconomic status (education and income) were measured at baseline. Negative affect and CMC were measured at baseline (1995) and end of follow up (2004). Race was the moderator. Linear regression was used to test the moderating effect of race on the reciprocal associations between CMC and negative affect, net of covariates.ResultsIn the pooled sample, while baseline CMC was predictive of an increase in negative affect over time, baseline negative affect was also predictive of an increase in CMC. We found interactions between race and baseline CMC on change in depressive symptoms, as well as race with negative affect on CMC change, suggesting that the associations between CMC and negative affect are stronger for Whites in comparison to Blacks.ConclusionBlacks and Whites differ in reciprocal links between CMC and negative affect over time. This finding replicates recent studies on differential links between psychosocial factors and physical health based on race. Findings may help us better understand how Black-White health paradox develops across mid and later life.

History of Non-Fatal Physical Assault Is Associated with Premature Mortality for Whites but Not Blacks

“…Our finding regarding larger effects of history of non-fatal physical assault on risk of mortality in Whites compared to Blacks agrees with other research showing risk and protective factors have stronger effects for Whites than Blacks [20,55], a pattern which is frequently shown for physical and mental health outcomes ( [9,[11][12][13][14][15][16][17][18][19][56][57][58][59][60][61]; see References [20,55] for a review). Stronger effects of low education [17], unemployment [12], poor neighborhood quality [11], depression [16,18,19,62,63], hostility and anger [64], low sense of self efficacy [14], and low perception of control over life [65] were shown for Whites than Blacks.…”

“…Compared to their White counterparts who have not experienced the same level of adversities, one may hypothesize that Blacks may be more resilient to advertises such as non-fatal physical assault. This is in line with previous research showing weaker effects of social adversities for Blacks compared to Whites [9,[11][12][13][14][15][16][17][18][19].…”

“…A sum score was calculated, potentially ranging from 0 to 7. A detailed description of the measurement of chronic medical conditions is provided elsewhere [15,32]. We controlled for chronic medical conditions because some (i.e., heart disease, hypertension, diabetes, and cancer) increase risk of death.…”

Diabetes, hypertension, obesity, and long‐term risk of renal disease mortality: Racial and socioeconomic differences

“…According to our findings, SES differences in death from renal disease are not exclusively a result of SES gaps in exposures to medical risk factors (DM, HTN, and obesity). Instead, the same risk factors can have different roles across social groups, which is in line with the differential effect hypothesis. Thus, understanding the causal paths between social factors, medical risk factors, and health outcomes requires understanding the existing complex heterogeneity in the effects of the same risk factors on outcomes.…”

Sustained Obesity and Depressive Symptoms over 6 Years: Race by Gender Differences in the Health and Retirement Study

“…Similar differences have been found between Blacks and Whites (Johnson, 1989). In a series of studies, Assari has shown that depressive symptoms and negative affect better predict subsequent change in physical health outcomes such as chronic medical conditions and mortality for Whites than Blacks (Assari and Burgard, 2015; Assari et al, 2015b, 2016a,b; Assari and Lankarani, 2016b). …”