Accelerated Health Declines among African Americans in the USA

J Urban Health. 2016 Oct;93(5):808-819. doi: 10.1007/s11524-016-0075-4.

Abstract

The weathering hypothesis, an explanation for race disparities in the USA, asserts that the health of African Americans begin to deteriorate prematurely compared to whites as a consequence of long-term exposure to social and environmental risk factors. Using data from 2000-2009 National Health Interview Surveys (NHIS), we sought to describe differences in age-related health outcomes in 619,130 African Americans and whites. Outcome measures included hypertension, diabetes, stroke, and cardiovascular disease. Using a mixed models approach to age-period-cohort analysis, we calculated age- and race-specific prevalence rates that accounted for the complex sampling design of NHIS. African Americans exhibited higher prevalence rates of hypertension, diabetes, and stroke than whites across all age groups. Consistent with the weathering hypothesis, African Americans exhibited equivalent prevalence rates for these three conditions 10 years earlier than whites. This suggests that African Americans are acquiring age-related conditions prematurely compared to whites.

Keywords: African Americans; Allostatic load; Chronic conditions; Health disparities; Mixed models; Stress; Weathering hypothesis.

MeSH terms

  • Adult
  • Aged
  • Allostasis
  • Black or African American* / psychology
  • Chronic Disease
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Male
  • Middle Aged
  • Stress, Psychological
  • United States
  • White People / psychology