The contribution of three dimensions of allostatic load to racial/ethnic disparities in poor/fair self-rated health

Abstract

ObjectiveThis study evaluates whether different dimensions of physiological dysregulation, modeled individually rather than additively mediate racial/ethnic disparities in self-reported health.MethodsUsing data from the National Health and Nutrition Examination Survey (2005–2010) and the Karlson, Hold, and Breen (KHB) mediation model, this paper explores what operationalization of biomarker data most strongly mediate racial/ethnic disparities in poor/fair self-rated health (SRH) among adults in the United States, net of demographic, socioeconomic, behavioral, and medication controls.ResultsNon-Hispanic blacks and Hispanics had significantly higher odds of reporting poor/fair self-rated health in comparison to non-Hispanic whites. Operationalizations of allostatic load that disaggregate three major dimensions of physiological dysregulation mediate racial/ethnic disparities strongly between non-Hispanic blacks and non-Hispanic whites, but not between Hispanics and non-Hispanic whites. Disaggregating these dimensions explains racial/ethnic disparities in poor/fair SRH better than the continuous score. Analyses on sex-specific disparities indicate differences in how individual dimensions of allostatic load contribute to racial/ethnic disparities in poor/fair SRH differently. All individual dimensions are strong determinants of poor/fair SRH for males. In contrast, for females, the only dimension that is significantly associated with poor/fair SRH is inflammation. For the analytic sample, additive biomarker scores fit the data as well or better than other approaches, suggesting that this approach is most appropriate for explaining individual differences. However, in sex-specific analyses, the interactive approach models fit the data best for men and women.ConclusionsFuture researchers seeking to explain racial/ethnic disparities in full or sex-stratified samples should consider disaggregating allostatic load by dimension.

Foreign-Born Hispanic Women's Health Patterns in Allostatic Load Converge to U.S.-Born Hispanic Women at a Slower Tempo Compared With Men

“…Table 1 also presents clinical incidence of each biomarker for men and women, which was determined based on exceeding clinically determined thresholds, consistent with previous literature (Howard & Sparks, 2016a). Among the 10 biomarkers considered in our study consistent with previous studies (e.g., Juster, McEwen, & Lupien, 2010;Santos-Lozada & Daw, 2018), only four exceeded an incidence of 20% (i.e., HDL cholesterol (mg/dL), triglycerides (mg/dL), BMI (kg/m 2 ), and C-reactive protein (mg/dL)). Three exceeded an incidence of 10%: systolic blood pressure (mmHg), total cholesterol (mg/dL), and glycosylated hemoglobin (%).…”

Racial and ethnic differences in the associations between social integration, C-reactive protein and depressive symptoms

“…Black and Hispanic populations have higher levels of CRP compared to the White population ( Nazmi & Victora, 2007 ; Santos-Lozada & Daw, 2018 ), which may explain disparities in depressive symptoms. However, the association between CRP and depressive symptoms varies by race/ethnicity, and the results are mixed ( Case & Stewart, 2014 ; Deverts et al, 2010 ; Stewart, 2016 ).…”

Accumulating burden: Exposure to interpersonal discrimination based on multiple attributes and allostatic load

“…Although using the 75th/25th percentile of the sample distribution is the established gold standard of measuring allostatic load ( McLoughlin et al, 2020 ), there are alternative ways researchers have constructed measures of allostatic load. To determine if the results are robust to other established measurements of allostatic load, all analyses were estimated using clinically defined high risk threshold measures for each biomarker (e.g., McLoughlin et al, 2020 ; Santos-Lozada & Daw, 2018 ). Results from these analyses were substantively identical to results using the 75th/25th percentile measurement (results available upon request).…”