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Health Psychol. 2016 Apr;35(4):322-32. doi: 10.1037/hea0000251.

Mediators of the relationship between race and allostatic load in African and White Americans.

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Department of Psychology, University of Calgary.
Department of Psychiatry, University of California, San Diego.



Allostatic load (AL) is a cumulative index of physiological dysregulation, which has been shown to predict cardiovascular events and all-cause mortality. On average, African Americans (AA) have higher AL than their White American (WA) counterparts. This study investigated whether differences in discrimination, negative affect-related variables (e.g., experience and expression of anger, depression), and health practices (e.g., exercise, alcohol use, smoking, subjective sleep quality) mediate racial differences in AL.


Participants included healthy, AA (n = 76) and WA (n = 100), middle-aged (Mage = 35.2 years) men (n = 98) and women (n = 78). Questionnaires assessed demographics, psychosocial variables, and health practices. Biological data were collected as part of an overnight hospital stay-AL score was composed of 11 biomarkers. The covariates age, gender, and socioeconomic status were held constant in each analysis.


Findings showed significant racial differences in AL, such that AA had higher AL than their WA counterparts. Results of serial mediation indicated a pathway whereby racial group was associated with discrimination, which was then associated with increased experience of anger and decreased subjective sleep quality, which were associated with AL (e.g., race → discrimination → experience of anger → subjective sleep quality → AL); in combination, these variables fully mediated the relationship between race and AL (p < .05).


These results suggest that discrimination plays an important role in explaining racial differences in an important indictor of early disease through its relationship with negative affect-related factors and health practices. (PsycINFO Database Record

[Indexed for MEDLINE]

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