Change in Cardiometabolic Risk Among Blacks, Whites, and Hispanics: Findings From the Health and Retirement Study

Mitchell, Uchechi A.; Ailshire, Jennifer; Crimmins, Eileen M.

doi:10.1093/gerona/gly026

Cited by 23 publications

(23 citation statements)

References 38 publications

(41 reference statements)

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“…Covariates. We controlled for participant and couple characteristics, including age, education, self-rated health, race/ ethnicity, marital strain, partnership status, marital duration, presence of coresident children, and subsample year (2008/ 2012 vs. 2010/2014) as these may all be associated with loneliness and physiological health (Das, 2019;Mitchell et al, 2019;O'Luanaigh et al, 2012;Stokes, 2017b;Tampubolon & Maharani, 2018). Age was measured as a continuous variable, in years.…”

Section: Predictors Of Interestmentioning

confidence: 99%

Dyadic Loneliness and Changes to HbA1c Among Older US Couples: The Role of Marital Support as Stress Buffer

Stokes

Barooah

2021

J Aging Health

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Objectives: Both experiencing loneliness and having a lonely partner can be psychosocial stressors, with implications for health. Yet, marital support may buffer against the cardiometabolic effects of loneliness. This study examines (1) whether own and/or partner’s loneliness predict changes in HbA1c over 4 years and (2) whether marital support moderates these effects. Methods: Actor–partner interdependence models analyzed data from 1,854 older couples who provided psychosocial and biomarker data at two timepoints (2008/2012 or 2010/2014) of the Health and Retirement Study. Results: Neither partner’s loneliness predicted changes in HbA1c overall. However, significant interactions indicated that both own baseline loneliness and partner’s baseline loneliness predicted significant increases to HbA1c over 4 years among those who reported below-average marital support. Discussion: Both the experience of loneliness and loneliness of a dyadic partner may have longitudinal consequences for cardiometabolic health. However, these effects are contingent upon perceived quality of the marriage, specifically marital support.

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Section: Predictors Of Interestmentioning

confidence: 99%

Dyadic Loneliness and Changes to HbA1c Among Older US Couples: The Role of Marital Support as Stress Buffer

Stokes

Barooah

2021

J Aging Health

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“…This absence of a significant difference in risk is an unexpected finding because prior research has shown that Blacks have a greater average number of cardiovascular risk factors than Whites regardless of sex. 20,23,32,33 One possible explanation is that past efforts at reducing disparities in cardiovascular risk factors and improving the cardiovascular health of Black men have been successful. However, it is unlikely that disparities in cardiovascular risk would have been eliminated prior to the 1990s.…”

Section: Change In Cardiovascular Risk: 1990 -2010 -Mitchell Et Almentioning

confidence: 99%

Black-White Differences in 20-year Trends in Cardiovascular Risk in the United States, 1990-2010

et al. 2019

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Objective: Improvements in the Black- White difference in life expectancy have been attributed to improved diagnosis and treatment of cardiovascular diseases and declines in cardiovascular disease mortality. However, it is unclear whether race differences in total cardiovascular risk and the prevalence of cardiovascular risk factors have improved in the United States since the 1990s.Design: Serial cross-sectional design.Setting: Data from the 1988-1994, 1999- 2002, and 2009-2012 National Health and Nutrition Examination Survey (NHANES).Methods: We estimated total cardiovascular risk levels, the prevalence of high-risk cardiovascular risk factors and the use of antihypertensive and lipid-lowering drugs among US Black and White men and women to determine whether differential changes occurred from 1990-2010.Results: Total cardiovascular risk declined for all races from 1990-2010. The Black- White difference was only significant in 2000 and sex-specific analyses showed that trends seen in the total population were driven by changes among women. Black and White men did not differ in risk at any time during this period. Conversely, Black women had significantly higher risk than White women in 1990 and 2000; this difference was eliminated by 2010. Improved diagnosis and treatment of high blood pressure and high cholesterol reduced risk in the total population; improved blood pressure and lipid profiles among Black women and increasing obesity prevalence among White women specifically contributed to the narrowing of the Black-White difference in risk among women.Conclusion: Cardiovascular risk and racial disparities in risk declined among US Whites and Blacks due to greater use and effectiveness of lipid-lowering and antihypertensive medications.Ethn Dis. 2019;29(4):587-598; doi:10.18865/ed.29.4.587

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“…Several studies have documented broad psychological distress or depression among older adults who face financial hardship ( 60 , 61 ). Older adults who have difficulty paying bills have been shown to delay or forego taking medications due to cost, which can have a devastating impact on mental health symptoms ( 62 , 63 ) in addition to their physical health ( 50 ). These findings suggest that experiencing financial or housing insecurity in older adulthood poses a threat to the mental health of older adults.…”

Section: Discussionmentioning

confidence: 99%

“…First, measuring symptomology limits bias due to differential access to health care across respondents that can be introduced by only measuring diagnoses. Self-reports of diagnosed disorders that are often found in nationally representative samples may underestimate and misrepresent health for older black adults who have been historically excluded from the health care system and often distrust and have less access to health care that provides diagnoses ( 50 ). Second, symptomology measures generally have more variation than simple yes/no measures of diagnosis ( 51 ).…”

Section: Background and Objectivesmentioning

confidence: 99%

Measuring More Than Exposure: Does Stress Appraisal Matter for Black–White Differences in Anxiety and Depressive Symptoms Among Older Adults?

Brown

Abrams²,

Mitchell

et al. 2020

Innovation in Aging

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Background and Objectives Prior research and theory suggest that exposure to objectively stressful events contributes to mental health disparities. Yet, Blacks report higher cumulative stress exposure than whites but lower levels of common psychiatric disorders. In order to understand why Blacks bear disproportionate stress exposure but similar or better mental health relative to whites, we need to consider race differences in not only stress exposure, but also stress appraisal—how upsetting stress exposures are perceived to be Research Design and Methods We examine whether race differences in the number of reported chronic stressors across five domains (health, financial, residential, relationship, caregiving) and their appraised stressfulness explain Black-white differences in anxiety and depressive symptoms. Data come from 6,019 adults ages 52+ from the 2006 Health and Retirement Study Results Older Blacks in this sample experience greater exposure to chronic stressors but appraise stressors as less upsetting relative to whites. In fully adjusted models stress exposure is related to higher levels of anxiety and depressive symptoms and perceiving stress as upsetting is associated with higher symptomology for whites and Blacks. We also find that Blacks report greater anxiety symptoms but fewer depressive symptoms with more stress exposure relative to whites. Stress appraisal partially explains race differences in the association between stress exposure and anxiety symptoms and fully explains race differences in the association between exposure and depressive symptoms Discussion and Implications The relationship between race, chronic stress exposure, and mental health is mediated by stress appraisal. Stress appraisal provides insight on important pathways contributing to Black-white mental health disparities in older adulthood

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Change in Cardiometabolic Risk Among Blacks, Whites, and Hispanics: Findings From the Health and Retirement Study

Abstract: We show that the cardiometabolic health of older blacks worsens as they age both absolutely and relative to that of whites and Hispanics because of poor blood pressure control and diabetes prevention.

Cited by 23 publications

References 38 publications

Dyadic Loneliness and Changes to HbA1c Among Older US Couples: The Role of Marital Support as Stress Buffer

Dyadic Loneliness and Changes to HbA1c Among Older US Couples: The Role of Marital Support as Stress Buffer

Black-White Differences in 20-year Trends in Cardiovascular Risk in the United States, 1990-2010

Measuring More Than Exposure: Does Stress Appraisal Matter for Black–White Differences in Anxiety and Depressive Symptoms Among Older Adults?

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