Longitudinal Examination of an Ethnic Paradox of Stress and Mental Health in Older Black and Latinx Adults

ABSTRACT

Objectives

To explain the ethnic paradox of mental health in aging, we evaluated whether Black and Latinx older adults experience (1) fewer depressive symptoms (DepSx), but more physical problems, and (2) greater psychological resilience as a result of life stressors than White older adults.

Methods

DepSx, physical health, and recent stress were obtained biennially from 25,893 older adults (77% White, 15% Black, 9% Latinx) in the U.S. Health and Retirement Study, across 16 years. Psychological resilience, lifetime stress, and discrimination experiences were available for 13,655 individuals. We conducted mixed-effects and linear regression analyses.

Results

For Blacks and Latinxs, experiencing more-than-usual stress events was associated with less increase in DepSx compared to Whites, although on average Blacks and Latinxs experience more DepSx. Black adults showed worse physical health than White adults and weaker effects of stress on psychological resilience despite experiencing more stress of all types. Findings were mixed for Latinxs.

Conclusions

Studying effects of time-varying stress on changes in health and multiple stressors on psychological resilience by race/ethnicity elucidates mechanisms for later-age health disparities.

Clinical Implications

Cross-sectional evaluations of stress and psychological health in a clinical setting may provide incomplete appraisals of health risks for Black and Latinx older Americans.

KEYWORDS:

• Health disparities
• depressive symptoms
• stressful life events
• older adults
• psychological resilience
• race/ethnicity
• physical functioning

Data availability statement

The data that support the findings of this study are available from the University of Michigan at https://hrs.isr.umich.edu. Collection of these data were supported by the National Institute on Aging (NIA U01AG009740) and the Social Security Administration.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Clinical implications

• Evaluating relationships between recent stress events and psychological health within a given timepoint in a clinical setting may be misleading in appraising the overall risk and what is placing Black and Latinx older adults at increased risk for poorer psychological health.

• Taking a lifespan perspective of health and influences of experiential histories can provide clinicians with a better picture of what contributes to changing health outcomes across adulthood, such as cumulative stress that places Black Americans at greater levels of depressive symptoms and physical morbidity.

• Resilience is strongly related to multiple clinical measures of mental health. Shifting research towards identifying underlying mechanisms of successful aging for the diversity of individuals in the growing aging population enables clinicians and researchers to understand, support, and promote the protective factors specific experiences of Black Americans, Latinxs, and others who experience social and structural disadvantage.

Additional information

Funding

This work was supported by the National Institute on Aging, of the National Institutes of Health, under grant F32AG048681 (PI: T.E. Arpawong); P30AG017265 (PI: E. Crimmins). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.