Dataset Information

Racial Differences in Early Parental Death, Midlife Life Problems, and Relationship Strain With Adult Children.

ABSTRACT:

Objectives

Black Americans typically experience the death of a parent earlier in the life course than do non-Hispanic Whites, and early parental death is known to hinder subsequent relationship outcomes. Whether early parental death may contribute to racial differences in midlife family relationships and the role midlife adults' current life problems play remain unexplored.

Method

Using multilevel modeling, we examined how timing of parental death is associated with relationship strain with adult children and whether the association differs by midlife adults' life problems in Black (n = 166) and non-Hispanic White (n = 467) families from the Family Exchanges Study.

Results

Losing a parent in childhood was associated with more relationship strain with adult children for Black midlife adults, but not for their non-Hispanic White counterparts. Among the bereaved, earlier timing of parental death was associated with more relationship strain with adult children only for Black midlife adults. In both bereaved and nonbereaved sample, participants' recent physical-emotional problems exacerbated the link between timing of parental death and relationship strain with adult children for Black midlife adults.

Discussion

Experiencing the death of a parent in the early life course can be an added structural disadvantage that imposes unique challenges for Black Americans in midlife. Policies and programs aimed at supporting bereaved children may benefit relationships with their own children later in life, and addressing physical-emotional problems in midlife may be a viable intervention point for those midlife adults who experienced the death of a parent in the early life course.

SUBMITTER: Kim YK

PROVIDER: S-EPMC8436672 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundBlacks have a higher incidence of out-of-hospital sudden cardiac death (SCD) in comparison with whites. However, the racial differences in the cumulative risk of SCD and the reasons for these differences have not been assessed in large-scale community-based cohorts. The objective of this study is to compare the lifetime cumulative risk of SCD among blacks and whites, and to evaluate the risk factors that may explain racial differences in SCD risk in the general population.MethodsThis is a cohort study of 3832 blacks and 11 237 whites participating in the Atherosclerosis Risk in Communities Study (ARIC). Race was self-reported. SCD was defined as a sudden pulseless condition from a cardiac cause in a previously stable individual, and SCD cases were adjudicated by an expert committee. Cumulative incidence was computed using competing risk models. Potential mediators included demographic and socioeconomic factors, cardiovascular risk factors, presence of coronary heart disease, and electrocardiographic parameters as time-varying factors.ResultsThe mean (SD) age was 53.6 (5.8) years for blacks and 54.4 (5.7) years for whites. During 27.4 years of follow-up, 215 blacks and 332 whites experienced SCD. The lifetime cumulative incidence of SCD at age 85 years was 9.6, 6.6, 6.5, and 2.3% for black men, black women, white men, and white women, respectively. The sex-adjusted hazard ratio for SCD comparing blacks with whites was 2.12 (95% CI, 1.79-2.51). The association was attenuated but still statistically significant in fully adjusted models (hazard ratio, 1.38; 95% CI, 1.11-1.71). In mediation analysis, known factors explained 65.3% (95% CI 37.9-92.8%) of the excess risk of SCD in blacks in comparison with whites. The single most important factor explaining this difference was income (50.5%), followed by education (19.1%), hypertension (22.1%), and diabetes mellitus (19.6%). Racial differences were evident in both genders but stronger in women than in men.ConclusionsBlacks had a much higher risk for SCD in comparison with whites, particularly among women. Income, education, and traditional risk factors explained ≈65% of the race difference in SCD. The high burden of SCD and the racial-gender disparities observed in our study represent a major public health and clinical problem.