Biopsychosocial Risk Profiles among African American and Non-Hispanic White Adults: Findings from The Health and Retirement Study.

BACKGROUND: Compared to Whites, African Americans have elevated risk for earlier onset fatal and non-fatal chronic conditions and accelerated aging. Despite these persistent race disparities, the causes remain poorly understood. The purpose of this study was to define a biopsychosocial risk typology that might explain accelerated aging in African Americans.

METHODS: Analyses were based on the African American and White subsample of the Health and Retirement Study (N=8,269). Latent class analysis was used to identify risk types. Chronic health conditions, salivary telomere length (STL), emotional support from family, negative interaction with family, early life adversities, and discrimination were used as class indicators. Latent class multinomial logistic regression was used to identify racial and demographic differences in risk type membership.

RESULTS: Three distinct risk types were identified: high risk, health risk, and psychosocial risk. African Americans were more likely than Whites to be assigned to the high risk type characterized by chronic health conditions, shorter STL, strained social relationships and high psychosocial stress. African Americans were less likely than Whites to be assigned to the health risk type characterized by chronic health conditions, shorter STL, optimal social relationships and low psychosocial stress.

CONCLUSIONS: The biopsychosocial risk typology accounted for population heterogeneity, identified high-risk profiles and modifiable factors within risk types that can inform current clinical interventions. The risk types also revealed different patterns of risk and resilience factors and shed light on the interplay between telomere length, stress exposure, chronic disease and accelerated aging in African Americans.