Black-White Disparity in Young Adults' Disease Risk: An Investigation of Variation in the Vulnerability of Black Young Adults to Early and Later Adversity

J Adolesc Health. 2016 Aug;59(2):209-14. doi: 10.1016/j.jadohealth.2016.04.014. Epub 2016 Jun 11.


Purpose: Socioeconomic adversity in early years and young adulthood are risk factors for poor health in young adulthood. Population differences in exposure to stressful socioeconomic conditions partly explain the higher prevalence of disease among black young adults. Another plausible mechanism is that blacks are differentially vulnerable to socioeconomic adversity (differential vulnerability hypothesis), which has not been adequately investigated in previous research. The present study investigated variation in the vulnerability of black young adults leading to cardiometabolic (CM) disease risk.

Methods: We used a nationally representative sample of 8,824 adolescents who participated in the Add Health study. Early and later adversity was measured using a cumulative index of social and material adversity in adolescence and young adulthood. CM disease risk was assessed using nine biomarkers. Path analysis within a structural equation modeling framework was used.

Results: The findings indicated that both early and later socioeconomic adversity act as stressors with independent additive influences on young adults' CM disease risk, consistent with the differential exposure hypothesis. Moreover, the results showed that black youth are less vulnerable to early socioeconomic adversity than whites, but they are more vulnerable to later adversity.

Conclusions: The findings provide support for the unique and additive influences of early and later socioeconomic adversity on CM disease risk contributing to the black-white health disparity in young adulthood. The results also suggest that vulnerability to adversity varies depending on the life stage, which highlights the need for life-stage specific interventions to mitigate the existing black-white disparity in young adults' physical health.

Keywords: Adolescents; Black and white disparity in health; Cardiometabolic disease risk; Exposure and vulnerability; Young adults.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data*
  • Biomarkers / blood
  • Child
  • Disease Susceptibility / etiology
  • European Continental Ancestry Group / statistics & numerical data*
  • Female
  • Health Status Disparities*
  • Heart Diseases / etiology
  • Humans
  • Longitudinal Studies
  • Male
  • Poverty / psychology
  • Poverty / statistics & numerical data
  • Risk Factors
  • Socioeconomic Factors*
  • United States
  • Vulnerable Populations / statistics & numerical data*
  • Young Adult


  • Biomarkers