Researchers use Add Health data to discover connections between chronic medical conditions and the importance of belonging

student in wheelchair receives a diploma from a university. disabled girl with a diploma from school and university.

Students with chronic medical conditions struggle with more than just their physical health. The hurdles formed from medical conditions impact their school attendance, concentration, and the expectations of their parents and teachers.   Around one-third of students suffering from chronic medical conditions experience symptoms so severe that it interferes with their schooling on a daily basis.  A sense of belonging is a basic human need, and a primary source of this belonging for adolescents come from their school community. Researcher Dr. Kathryn M. Kirkpatrick analyzed the restricted-use Add Health data to compare adolescents with chronic health conditions with their healthy peers to determine the impact of school belonging on their education. She found that the students with chronic medical conditions not only reported a lower sense of school belonging but were also less likely to graduate on time. Additionally, Dr. Kirkpatrick found that while school connectedness is important to all students, it has a stronger impact on those with medical conditions. 

Students with chronic medical conditions regularly report more feelings of loneliness and isolation with less school satisfaction, academic achievement, and motivation.  High-risk students may need more cultivated opportunities to engage with their instructors and peers to create a stronger sense of belonging. These findings contribute to both the fields of education and psychology, offering ways in which teachers can understand and promote a stronger feeling of perceived connectedness for all their students resulting in higher academic attainment for all.


Dr. Kathryn M. Kirkpatrick


Kirkpatrick, K. M. (2020). Adolescents with Chronic Medical Conditions and High School Completion: The Importance of Perceived School Belonging. Continuity in Education, 1(1), pp. 50–63. DOI:

Can Parental Communication Influence HIV Testing?

Adult Son And Senior Father Talking While Relaxing On Couch At Home

Add Health data collection began 25 years ago, yet new research is still being published using Wave I data which adds to the scientific knowledge of adolescent health. A recent study by Boyd, Quinn, and Aquino titled The Inescapable Effects of Parent Support on Black Males and HIV Testing sought to understand what factors influence HIV testing in adolescence.

The study applied the ecodevelopmental theory to understand whether family context, including parent support and parent relationships, impacted HIV testing for Black adolescent males. Waves I and III Add Health data allowed researchers to account for self-efficacy, peers’ knowledge and influence of sexual behaviors, the participants’ perception of risk of contracting the AIDS virus, and parental support.

The findings support the hypothesis that parental communication positively influences HIV-related behaviors including getting tested for HIV. Results also showed that if parents had positive attitudes about sex, adolescents were twice as likely to get tested for HIV. Other associated factors of HIV testing among Black males included self-efficacy, peer knowledge, and participant attitudes of sex. The authors suggest that future HIV-related interventions among Black adolescents should promote positive communication skills. You can read more about the findings and discussion here.


Donte T. Boyd, University of Houston

Camille R. Quinn, Ohio State University

Gabrielle A. Aquino, University of Houston


Boyd, Donte T., Quinn, Camille R., & Aquino, Gabrielle A. (2020). The Inescapable Effects of Parent Support on Black Males and HIV Testing. Journal of Racial and Ethnic Health Disparities.

Add Health data used to study eating disorder behaviors in adolescence and adulthood

hands wrapped in tailor measure tape covering face of young depressed and worried girl suffering anorexia or bulimia nutrition disorder

Add Health collected information on nutrition, eating habits and weight perception during the Wave I interview when respondents were in middle and high school. These questions were repeated during four waves of data collection, allowing researchers to explore pathways involving eating disorders. Four Add Health based studies published in 2019 focus on mechanisms of eating disorders that can inform programs and interventions.

Fergus, Copp, Tabler, & Nagata evaluated the association between eating disorders and sexual risk in young women – specifically sexually active, unmarried women. Results shows that young women with eating disorders have an increased number of new sexual partners and unprotected sex when compared to non-eating disordered peers. However, there was not an association with STI. These results may inform future screening and clinical management.

Hazzard, Bauer, Mukherjee, Miller, & Sonneville investigated the associations between types of childhood maltreatment and eating disorder symptoms in young adulthood. Researchers found that different eating disorder behaviors were associated with different categories of maltreatment. For example, participants labeled as “multi-type maltreatment” were more likely to report binge eating and fasting. Authors advocate for accurately developing childhood maltreatment profiles in order to identify high-risk groups for eating disorders.

Nagata, Braudt, Domingue, Bibbins-Domingo, Garber, Griffiths, & Murray used the polygenic score (PGS) for BMI to assess the genetic risk for BMI and weight control behaviors in young adults.  Their study found that actual BMI mediated the relationship between BMI genetic risk and weight loss behaviors. Though this study did not specifically focus on eating disorders, their work may provide some insight for clinical interventions to prevent unhealthy weight loss behaviors.

Arduini, Iorio, & Patacchini explored whether the development of eating disorders are influenced by peers’ body size. Their study showed that teenage girls with thinner female friends have misperceptions of their own weight. The authors comment how these results can influence eating disorder programs and anti-obesity messages.


Fergus, K., Copp, H., Tabler, J.l and Nagata, J. (2019) Eating disorders and disordered eating behaviors among  women: Association with sexual risk. International Journal of Eating Disorders, 52(11).

Hazzard, V., Bauer, K., Mukherjee, B., Miller, A., and Sonneville, K. (2019) Associations between childhood maltreatment latent classes and eating disorder symptoms in a nationally representative sample of young adults in the United States. Child Abuse and Neglect, 98.

Nagata, H., Braudt, D., Domingue, B., Bibbins-Domingo, K., Garber, A., Griffiths, S., and Murray, S. (2019) Genetic risk, body mass index, and weight control behaviors: unlocking the triad. International Journal of Eating Disorders, 52(7).

Arduini, T., Iorio, D., and Patacchini, E. (2019) Weight, reference points, and the onset of eating disorders. Journal of Health Economics, 65.

Suicide Ideation and Behaviors in Adolescents and Young Adults (Suicide Prevention Week)

Suicide is the second-leading cause of death in adolescents and young adults, ages 10 to 34 years old.  Add Health provides data resources for researchers determining commonalities in suicidal ideations and behaviors, along with possible suicide prevention methods.

While numerous studies are analyzing adolescent suicide ideation and behaviors, there is a lack of research investigating suicide-related outcomes during their transition into adulthood. In a study led by Dr. Jennifer Erausquin, the connections between race/ethnicity and suicide were evaluated using the longitudinal Add Health data. The study discovered that nonwhite racial/ethnic groups may be at higher risk for suicide than their white counterparts.  Their analysis of Add Health data from Waves I through IV indicates African Americans are less likely to attempt suicide than Whites, while Asians and Pacific Islanders were significantly more likely to experience both suicidal thoughts and attempts. In their trajectory research, they found that African Americans were at lower odds to be in the sustained higher risk trajectory while Asians and Pacific Islanders had 5 times the odds of being in the higher risk trajectory. The authors argue that not only do adolescents need targeted interventions to diminish suicidal thoughts, but certain ethnic and racial minority groups would benefit from customized interventions focusing on racism and encouraging a more positive racial identity.  They also note that Asian Americans deserve a special focus due to the increased risk of suicide within that group.

Add Health data was also used in the investigation of the role that parents and mental health service access play in the lives of suicidal adolescents.  Drs. Mary LeCloux, Peter Maramaldi, Kristie Thomas, and Elizabeth Wharff measured perceived parental support from a residential “mother” or “father” figure and its correlation with mental health service use, finding that higher levels of parental support were linked to lower levels of mental health service usage, depression, and suicide attempts. Evaluating Add Health data from Waves I and II, the authors found most respondents who reported suicide ideation in Wave I did not report accessing mental health services in Wave II. They also found that low levels of parental support begat higher levels of symptom severity.  Their research provides strong evidence for the need of additional family-based interventions in suicide prevention, both in neutralizing the stigma surrounding suicide and in recognizing key indicators of depression.

Dr. William Feigelman led a research team who studied the relationship between easy access to firearms and premature death through his analysis of Add Health data from Waves I, II, and III.  It was found that males who reported easy access to firearms had a higher rate of suicide, homicide, and accidental death, although they did not experience higher levels of suicidal thoughts in comparison to those without easy access.  This subgroup of males with easy access to firearms also shared other commonalities, including residence in the South and Midwest regions of the country, were more likely to fight and engage in risk-taking behaviors such as drug use, were white and less likely to be impoverished, came from a two-parent household, and had a stronger relationship with those parents.  Add Health data also provided evidence of increased risk-taking behaviors such as substance use and motorcycle riding within this subgroup.  Easy access to firearms during Waves I and II, when respondents were adolescents, indicates that weapons are not safely stored, perhaps due to the stronger relationship with parents. By Wave III, these same adolescents were more likely to be gun owners themselves, perpetuating the cycle of easy access and premature death. The authors acknowledge the difficulty in reducing firearm access, taking into account the perceived necessity of gun ownership within many U.S. households.  Researchers advocate for parents to be better educated on the dangers of firearms and securing them properly as an additional prevention method.

Because of the rich datasets provided by Add Health, researchers can research preventative measures to lower both suicidal ideations and behaviors. Add Health is a longitudinal study of more than 20,000 adolescents evaluating their social, economic, psychological, and physical health with contextual data regarding their family, neighborhood, community, and relationships. Beginning in the mid-1990s with in-home and in-school interviews of youth grades 7 to 12 from all backgrounds, the study continues tracking these respondents as they transition into adulthood.

Suicide prevention week is September 8th to 14th.  If you or someone you know is struggling with suicidal thoughts or distress of any kind, please contact the suicide help line at 1-800-273-8255. 


  • Erausquin, J. T., McCoy, T. P., Bartlett, R., & Park, E. (2019). Trajectories of suicide ideation and attempts from early adolescence to mid-adulthood: Associations with Race/Ethnicity. Journal of Youth and Adolescence, 1-10. doi:10.1007/s10964-019-01074-3
  • LeCloux, M., Maramaldi, P., Thomas, K., & Wharff, E. (2016). Family support and mental health service use among suicidal adolescents. Journal of Child and Family Studies, 25(8), 2597-2606. doi:10.1007/s10826-016-0417-6
  • Feigelman, W. , Rosen, Z. and Cerel, J. (2019), Unraveling the Complex Web of Associations Between Easy Access to Firearms and Premature Mortalities. Suicide Life Threat Behav. doi:10.1111/sltb.12580

Interracial Romance and Friendship in Adolescence and Adulthood

Within the context of America’s continuing racial divisions, sociologists from Yale University and Bowling Green State University analyzed Add Health data in order to determine what key contributing factors increase the likelihood of adulthood interracial relationship formation. Despite approval of interracial marriages rising in recent years, there continues to be a strong racial divide in the formation of friendships and romantic relationships, particularly between whites and blacks.  In Interracial Friendships and Romantic Relationships from Adolescence to Adulthood, sociologists, Grace Kao, Kara Joyner, and Kelly Stamper Balistreri, examine the lack of diversity within our school systems and its impact on future racial divides. The authors provide compelling evidence that changes within schools can decrease the racial gap. When adolescents are provided with opportunities to cross racial barriers, allowing interracial friendships to be formed, they are more likely to incur romantic attachments to members of opposing races as adults.

During the mid-1990s, Add Health began following more than 20,000 adolescents, completing both in-school and in-home interviews with these respondents.  Respondents have now been followed over five waves of data collection spanning more than 20 years, providing a wealth of data for longitudinal research.  The early in-school and in-home interviews resulted in a collection of peer network data describing youth respondents’ friendships and relationships which the authors reviewed to better understand the complexity of race among youths. By evaluating contributing factors such as race, gender, and socioeconomic status, Kao et al. discovered interracial contact at a younger age is crucial to the creation of interracial friendships and romantic relationships, both as adolescents and as adults. Their study found that young people that attended a diverse school had a greater likelihood of forming friendships and romantic relationships with those of a different race than their counterparts attending a school lacking in racial diversity. The authors argue that this lack of diversity within schools has a lasting impact on young adults’ social attachments and perpetuates the racial divides in America.

Thanks in part to the data provided by Add Health, Interracial Friendships and Romantic Relationships from Adolescence to Adulthood delivers a strong argument for school diversity and the encouragement of interracial contact at a young age.


Kao, Grace; Joyner, Kara; & Balistreri, Kelly. (Forthcoming). Interracial Romance and Friendship in Adolescence and Adulthood. New York: Russell Sage Foundation.


  • Grace Kao is IBM Professor of Sociology at Yale University
  • Kara Joyner is Professor of Sociology at Bowling Green State University
  • Kelly Stamper Balistreri is Associate Professor of Sociology at Bowling Green State University

Publisher Information  

Published by the Russell Sage Foundation, a social science foundation dedicated to the development of educated responses and improvement of living conditions through an in-depth comprehension of enduring issues within society.  The Company We Keep is a volume in the American Sociological Association’s Rose Series in Sociology. The series is currently published for the ASA by the Russell Sage Foundation.

Mothers’ social norms influence youth outcomes

In a Journal of Child and Family Studies article, researchers proposed that social norms and social connections across parents, friends, and schools on substance use and depression would have a greater association when both parties were of the same sex. For example, the social norms of mothers may have a stronger influence on substance use outcomes for their daughters as compared to their sons. This research expands previous efforts to understand adolescent health by looking at sex-specific constructs.

To test this hypothesis, the authors utilized multiple data sources which are made possible through the unique study design of Add Health. In-Home Interviews during Wave I and II provided youth respondent variables on substance use, depression symptoms, and parental and school connectedness. During Wave I, youth respondents were asked to identify their friends, allowing the creation of peer network data used to construct friend social norm variables. Parent variables of substance use and depression symptoms came from the parent questionnaire, also completed at Wave I. Finally, In-School Questionnaires were administered to more than 90,000 students across the sampled schools, allowing the current study to use a larger sample size to better represent school social norms.

Results from the study suggest that social connections between fathers and sons serve as a protective factor for mental health, whereas social norms of mothers, measured by unhappiness, had greater association with daughters’ depression. Additionally, mothers’ alcohol use, but not fathers’ alcohol use, were linked with increased drinking for both daughters and sons. Similar to this finding, a pattern emerged from the data suggesting that social norms from mothers and female schoolmates have a greater influence on youth behaviors.  The authors emphasize that future research should continue to understand how differentiating social norms by sex impacts adolescent health.

You can read the study and the rest of the findings here.


Caitlin McPerran Lombardi – University of Connecticut

Rebekah Levine Coley, Alicia Doyle, Lynch, & James R. Mahlik – Boston College

Jacqueline Sims – Boston University

“Deaths of Despair” may be a problem across generations and demographics

A study using Add Health data suggests that “deaths of despair” are rising among Americans entering midlife across many demographics, contrasting with previous research which argues the recent increase in these types of deaths are due to non-Hispanic white Americans.

Add Health Wave V data collection was conducted from 2016-2018 to collect social, environmental, behavioral, and biological data from cohort members. With respondents now in their 30s to early 40s, the nationally representative data from Wave V provided the opportunity for researchers to examine despair in adults entering midlife. Author Lauren Gaydosh explained in a Vanderbilt University article, “What we wanted to do in this paper was to examine whether the factors that may be predictive of those causes of death—substance use, suicidal ideation and depression—are isolated to that particular population subgroup, or whether it’s a more generalized phenomenon.”

Results from the study show that despair is generalizable across cohort demographics and is not isolated among low educated, non-Hispanic whites. You can read more about the results and Dr. Gaydosh in this article.

The study, published in the American Journal of Public Health, is also available online.

Study Authors:

Lauren Gaydosh – Vanderbilt University

Kathleen Mullan Harris, Robert A. Hummer, Taylor W. Hargrove, Carolyn T. Halpern, Jon M. Hussey, Eric A. Whitsel, & Nancy Dole – University of North Carolina at Chapel Hill

Add Health CDC mRFEI dataset used to study whether food insecurity is related to obesity

Add Health boasts a nationally representative sample with hundreds of variables related to social, economic, psychological, and physical well-being and a wealth of merged contextual data.  Several of the Add Health contextual datasets were made possible via ancillary studies.  The ancillary study process is in place for investigators seeking to add supplemental data to Add Health. These ancillary studies can:

  • Collect new, original questionnaire data on Add Health respondents
  • Merge secondary data sources onto Add Health respondent or school records and requires personal identifiers (e.g., geocodes) to perform the linkages
  • Collect new biospecimens from Add Health respondents
  • Use archived biospecimens collected by the Add health study

Through one of these ancillary studies (Testa, 2018), the Center for Disease Control and Prevention’s (CDC) Modified Retail Food Environment Index (mRFEI) data were linked to Add Health respondents’ Wave IV residential location. The mRFEI, which measures the percentage of health food retailers by census tract, adds a measure of food insecurity that was previously unavailable in Add Health datasets.

In a study recently published by the Journal of Community Health, the ancillary study investigators used the mRFEI data to analyze the relationship between food insecurity, food deserts, and obesity. The results showed that food insecurity is associated with an increased risk of obesity in women, and living in a food desert is positively associated with measures of obesity for both genders.

Other datasets available thanks to dedicated Add Health ancillary investigators and the Add Health team include:

  • Wave III Academic Transcript Social Studies and Civic Coursework (ATRCVC) data (Patterson, 2018)
  • Ambient Air Pollutants Data (Richmond-Briyant & Meng, 2018)
  • Wave I, II, III Political Context Data (Fowler, Settle, & Monbureau, 2010)
  • Wave III Sex Ration Data (Falcon & Rosenfeld, 2015)
  • Wave III Alcohol Outlet Density Data (Waller, 2011 )
  • Wave I & III Obesity and Neighborhood Environment (ONE) files (Gordon-Larsen, 2009)

Want to learn more about Add Health ancillary studies? Check out our introductory page and read the guide for ancillary studies that you can find here. The proposal application forms are currently unavailable as the Add Health team readies the Wave V data for dissemination.  Add Health investigators and staff will resume receipt/review of applications later in 2019 after the Wave V survey and biological data have been disseminated.

News article featuring mRFEI study:

UTSA researchers: Those with inadequate access to food likely to suffer from obesity


Testa, A., & Jackson, D. B. (2018). Food insecurity, food deserts, and waist-to-height ratio: Variation by sex and race/ethnicity. Journal of Community Health, 1-7. doi: 10.1007/s10900-018-00601-w

Selected Ancillary Study Datasets:

  • Falcon, M.F. & Rosenfeld, M.J. (2015) WAVE III County-level Sex Ratio Data [Codebook] The National Longitudinal Study of Adolescent to Adult Health
  • Fowler, J., Settle, J., & Monbureau, T. (2010). Wave I, II, III Political Context Data [Codebook]
  • Patterson, K.M. (2018). Wave III Academic Transcript Social Studies and Civic Coursework (ATRCVC) data [Codebook] The National Longitudinal Study of Adolescent to Adult Health
  • Richmond-Briyant, J & Meng, Q. (2018) Wave IV Ambient Air Pollutants: Individual Pollutant, Daily Particulate Matter, and Toxic Gas Estimates [Codebook] The National Longitudinal Study of Adolescent to Adult Health
  • Testa, A (2018). Wave IV Modified Retail Food Environment Index (mRFEI) Data [Code book] The National Longitudinal Study of Adolescent to Adult Health
  • Waller, M.W. (2011). Wave III Alcohol Outlet Density Data [Codebook] The National Longitudinal Study of Adolescent to Adult Health

Research study uses Add Health data to compare relationship quality in same-sex and different-sex relationships

Posted February 14, 2019

As the prevalence of research focused on romantic relationships between same-sex partners increases, there are gaps in the literature describing these relationships in a nationally representative context and understanding their effects on the transition to adulthood. A recent study by Joyner, Manning, and Prince begins to address these gaps by examining relationship quality and how it may differ between same-sex and different-sex couples.

The study tested two competing hypotheses. The first hypothesized a lower quality relationship among same-sex couples due to external stress facing sexual minorities. The second hypothesis postulates a higher quality relationship for same-sex couples due to greater concordance of views on emotional intimacy and autonomy within genders. Add Health data allowed researchers to use both subjective and objective relationship qualities including commitment, satisfaction, emotional intimacy, sexual activity, and exclusivity to test both hypotheses. The researchers also included both dating couples and cohabiting couples in their analyses, compared to other many other studies which only focused on cohabiting couples.

The findings show that both same-sex and different-sex young adult couples have the same level of relationship commitment, satisfaction, and emotional intimacy, while young men in same-sex relationships indicate lower levels of sexual exclusivity than female same-sex and different-sex couples. Although these results are supported by previous studies, the reasons why same-sex couples fare as well as their different-sex counterparts have varied across studies. You can read more about the findings and discussion here.

Joyner, K., Manning, W., & Prince, B. (2018). The qualities of same-sex and different-sex couples in young adulthood. Journal of Marriage and Family. doi:10.1111/jomf.12535

Nature Genetics publishes two genetic studies using Add Health data

Posted January 25, 2019

Add Health genetic data is used in two recent studies which exemplify the growing field of sociogenomics.

The first study by Karlsson Linnér et al. focuses on genetic variants (differences in genes across individuals) that are associated with risky behaviors and risk tolerance, or willingness to take risks. Through genome wide association studies (GWAS), the authors not only found 124 gene variants associated with risk tolerance, but also failed to find evidence that supported biological pathways that previous research linked to risk tolerance.

These GWAS results allow the creation of polygenic scores of general risk tolerance. “I expect it to be useful in social science studies,” Jonathan Beauchamp, corresponding author, told University of Toronto news staff. “For instance, the score can be used to study how genetic factors interact with environmental variables to affect risk tolerance and risky behaviors.”

The second study by Liu et al. found 566 genetic variants associated with tobacco and alcohol use. Specifically, these genetic variants were related to five characteristics: the age when a respondent began smoking, the number of cigarettes smoked per day, smoking regularly, if the respondent ever quit smoking, and number of alcoholic drinks per week. Scott Vrieze, a researcher on the project, said “We hope the results drive research on how these genes affect addiction and, ultimately, inform treatment development.”

Both articles were featured in University newspapers:


Karlsson Linnér, R., Biroli, P., Kong, E., Meddens, S. F. W., Wedow, R., Fontana, M. A., . . . Social Science Genetic Association, C. (2019). Genome-wide association analyses of risk tolerance and risky behaviors in over 1 million individuals identify hundreds of loci and shared genetic influences. Nature Genetics. doi: 10.1038/s41588-018-0309-3

Liu, M., Jiang, Y., Wedow, R., Li, Y., Brazel, D. M., Chen, F., . . . Psychiatry, H. A.-I. (2019). Association studies of up to 1.2 million individuals yield new insights into the genetic etiology of tobacco and alcohol use. Nature Genetics. doi: 10.1038/s41588-018-0307-5