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


Wickrama, Kandauda A. S.; Bae, Dayoung; & O'Neal, Catherine Walker (2016). Black-White Disparity in Young Adults' Disease Risk: An Investigation of Variation in the Vulnerability of Black Young Adults to Early and Later Adversity. Journal of Adolescent Health. vol. 59 (2) pp. 209-214


AbstractPurpose 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.



Black and white disparity in health Adolescents Young adults Cardiometabolic disease risk Exposure and vulnerability

Reference Type

Journal Article

Journal Title

Journal of Adolescent Health


Wickrama, Kandauda A. S.
Bae, Dayoung
O'Neal, Catherine Walker

Year Published


Volume Number


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June 11, 2016





Reference ID