Neighborhood Poverty, College Attendance, and Diverging Profiles of Substance Use and Allostatic Load in Rural African American Youth

Chen, Eric; Miller, Gregory E.; Brody, Gene H.; Lei, Man‐Kit

doi:10.1177/2167702614546639

Cited by 78 publications

(90 citation statements)

References 66 publications

(97 reference statements)

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“…Previously, we reported a pattern of skin-deep resilience in low-SES African American youth, wherein self-control portends favorable psychosocial outcomes but worse cardiometabolic health status (18,19). Here, we extend these findings to a new cohort of adolescents making the transition into adulthood and highlight premature aging of PBMCs as a mechanism that could underlie this phenomenon.…”

Section: Discussionsupporting

confidence: 69%

“…How this process unfolds remains unclear. We considered the role of obesity, because youth who exhibit skindeep resilience have greater body mass (18,19), which in turn relates to faster epigenetic aging (29). However, mediation analyses did not yield support for this scenario nor one wherein these youth have more general life stress (SI Appendix, Table S7).…”

Section: Discussionmentioning

confidence: 99%

“…Collectively, these experiences seem likely to cause persistent activation of stress-response systems, in particular the sympathetic nervous system and hypothalamic-pituitaryadrenocortical axis. The hormonal products of these systems, glucocorticoids and catecholamines, are elevated in youth who exhibit skin-deep resilience (18,19). These hormones also can modify the chromatin architecture of leukocytes by altering the enzymatic activity of DNA methyltransferases, as well as histone deacetylases and acetyltransferases (38).…”

Section: Discussionmentioning

confidence: 99%

“…Research shows that for low-SES youth, particularly those of African American descent, achieving normatively favorable outcomes poses intense self-regulatory demands (20)(21)(22). Because such demands result in sustained activation of stress hormone systems (18,19,(23)(24)(25), we reasoned they would prematurely age bodily tissue through a process known as weathering (26). Here, we test this hypothesis in a new sample of rural African American youth, who were followed across the transition from adolescence to adulthood.…”

mentioning

confidence: 96%

“…However, this resilience was only "skin deep." Despite academic success and healthy lifestyles, these youth showed relatively poor cardiometabolic health at age 20 y, as reflected in obesity, blood pressure, and stress hormones (19).…”

mentioning

confidence: 99%

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Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth

Miller

Chen

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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216

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There are persistent socioeconomic disparities in many aspects of child development in America. Relative to their affluent peers, children of low socioeconomic status (SES) complete fewer years of education, have a higher prevalence of health problems, and are convicted of more criminal offenses. Based on research indicating that low self-control underlies some of these disparities, policymakers have begun incorporating character-skills training into school curricula and social services. However, emerging data suggest that for low-SES youth, self-control may act as a "double-edged sword," facilitating academic success and psychosocial adjustment, while at the same time undermining physical health. Here, we examine this hypothesis in a five-wave study of 292 African American teenagers from rural Georgia. From ages 17 to 20 y, we assessed SES and self-control annually, along with depressive symptoms, substance use, aggressive behavior, and internalizing problems. At age 22 y, we obtained DNA methylation profiles of subjects' peripheral blood mononuclear cells. These data were used to measure epigenetic aging, a methylationderived biomarker reflecting the disparity between biological and chronological aging. Among high-SES youth, better mid-adolescent self-control presaged favorable psychological and methylation outcomes. However, among low-SES youth, self-control had divergent associations with these outcomes. Self-control forecasted lower rates of depressive symptoms, substance use, aggressive behavior, and internalizing problems but faster epigenetic aging. These patterns suggest that for low-SES youth, resilience is a "skin-deep" phenomenon, wherein outward indicators of success can mask emerging problems with health. These findings have conceptual implications for models of resilience, and practical implications for interventions aimed at ameliorating social and racial disparities.health disparities | resilience | stress | poverty | aging

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Section: Discussionsupporting

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 96%

mentioning

confidence: 99%

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Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth

Miller

Chen

et al. 2015

Proc. Natl. Acad. Sci. U.S.A.

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216

148

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Family Disadvantage, Education, and Health Outcomes Among Black Youths Over a 20-Year Period

Chen,

Yu,

Ehrlich

et al. 2024

JAMA Netw Open

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ImportanceUpward mobility (via educational attainment) is highly valued, but longitudinal associations with mental and physical health among Black youths are less understood.ObjectiveTo examine associations of childhood family disadvantage and college graduation with adult mental and physical health in Black youths followed up into adulthood.Design, Setting, and ParticipantsThis longitudinal, prospective cohort study of Black youths from the state of Georgia who were studied for 20 years (ages 11 to 31 years) was conducted between 2001 and 2022. Participants for this study were drawn from the Strong African American Healthy Adults Program. Data analysis was conducted from April 2023 to January 2024.ExposuresFamily economic disadvantage (measured during the adolescent years) and college graduation (indicating upward mobility).Main Outcomes and MeasuresPrimary outcomes included mental health, substance use, and physical health. Mental health included a composite of internalizing and disruptive problems (anxiety, depression, anger, aggressive behaviors, and emotional reactivity). Substance use included a composite of smoking, drinking, and drug use. Physical health included metabolic syndrome (MetS) and proinflammatory phenotypes (immune cells mounting exaggerated cytokine responses to bacterial challenge and being insensitive to inhibitory signals from glucocorticoids). Mental and physical health measures were taken at age 31 and during the adolescent years. Linear and logistic regression analyses, as well as mediated moderation analyses, were conducted.ResultsThe study population consisted of 329 Black youths (212 women [64%]; 117 men [36%]; mean [SD] age at follow-up, 31 [1] years). Compared with those who did not graduate college, those who graduated from college had 0.14 SD fewer mental health problems (b = −1.377; 95% CI, −2.529 to −0.226; β = −0.137; P = .02) and 0.13 SD lower levels of substance use (b = −0.114; 95% CI, −0.210 to −0.018; β = −0.131; P = .02). Residualized change scores revealed that college graduates showed greater decreases from age 16 to 31 years in mental health problems (b = −1.267; 95% CI, −2.360 to −0.174; β = −0.133; P = .02) and substance use problems (b = −0.116; 95% CI, −0.211 to −0.021; β = −0.136; P = .02). For physical health, significant interactions between childhood family disadvantage and college completion emerged in association with MetS (OR, 1.495; 95% CI, 1.111-2.012; P = .008) and proinflammatory phenotype (b = 0.051; 95% CI, 0.003 to 0.099; β = 0.131; P = .04). Among youths growing up in disadvantaged households, college completion was associated with a 32.6% greater likelihood of MetS (OR, 3.947; 95% CI, 1.003-15.502; P = .049) and 0.59 SD more proinflammatory phenotype (mean difference, 0.249, 95% CI, 0.001 to 0.497; P = .049). Conversely, among those from economically advantaged backgrounds, college completion was correlated with lower MetS and less proinflammatory phenotype. Findings held after controlling for body mass index at age 19 years.Conclusions and RelevanceIn this longitudinal cohort study of Black youths, graduating from college was associated with an adult profile of better mental health but poorer physical health among those from economic disadvantage. These findings suggest that developing interventions that foster healthy outcomes across multiple life domains may be important for ensuring that striving for upward mobility is not accompanied by unintended cardiometabolic risk.

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Testing allostatic load factor structures among adolescents: A structural equation modeling approach

King

Garnier‐Villarreal

Simanek³

et al. 2019

American J Hum Biol

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Objectives: Allostatic load (AL) represents cumulative biological "wear and tear" that results from chronic stress exposure over time, ultimately increasing risk for chronic disease. A consensus is lacking regarding the best operationalization of AL, particularly for younger, less studied populations. The purpose of this study was to test multiple hypothesized factor structures for AL to determine the best measurement approach for adolescents. Methods: We analyzed biologic data for 1900 adolescents aged 12-18 from four waves (2003-2010) of the National Health and Nutrition Examination Survey. AL indicator variables included cardiovascular (systolic BP, creatinine), metabolic (HDL, LDL, triglycerides, insulin, fasting glucose, HA1C, body mass index [BMI], waist circumference), and immune (albumin, CRP, WBC, EBV) biomarkers. Structural equation modeling was used to test the fit of five hypothesized AL factor structures.Results: The data best supported a unidimensional factor structure, where the AL construct directly influenced each of the indicator variables. All but two of the indicators (HDL and albumin) had positive factor loadings, thus, as AL increases the values for those indicators also increase. The best indicators for AL were those measuring metabolic dysregulation, with BMI and waist circumference having the highest factor loadings (0.95 and 0.982, respectively). Conclusions: BMI and waist circumference may be some of the earliest clinical signs of elevated AL that manifest among adolescents. Future research should aim to include neuroendocrine biomarkers in their AL measures to have a more robust estimation of AL in younger populations.

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Neighborhood Poverty, College Attendance, and Diverging Profiles of Substance Use and Allostatic Load in Rural African American Youth

Cited by 78 publications

References 66 publications

Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth

Self-control forecasts better psychosocial outcomes but faster epigenetic aging in low-SES youth

Family Disadvantage, Education, and Health Outcomes Among Black Youths Over a 20-Year Period

Testing allostatic load factor structures among adolescents: A structural equation modeling approach

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