Racial Differences in Social Relationships with Family and Allostatic Load

Background and Purpose: The allostatic load (AL) refers to the cumulative biological wear and tear on the body’s regulatory systems as a result of pathophysiologic response to stressful life events. A growing body of evidence points to the association between social relationships and physiological processes such as AL, but less is clear about the racial differences in the associations. As such, the present study aims to: 1) examine whether social support from family and negative interactions with family are associated with AL; 2) examine racial and ethnic differences in AL; and 3) test whether race moderates the associations in aim 1.

Methods: The study utilized data from the Health and Retirement Study (HRS). The HRS utilized a multi-stage area probability sample design, and was conducted biannually among a nationally representative sample of adults aged 51 and older in the United States. Participants with complete psychosocial and biomarker data were selected for the current study (N = 12,016). A composite score of AL was created based on three regulatory systems (i.e., cardiovascular, metabolic, and immune systems) by counting the number of high-risk biomarkers and physiological parameters, with final scores ranging from 0 to 8. Social support from family and negative interactions with family was assessed using a three-item and a four-item scale, respectively. Related socio-demographic and health covariates were included. Weighted multivariable linear regression models were conducted to test the study aims. Interaction terms were created to test the moderating effects of race. Respondent-level sampling weights and design factors were adjusted to generate weighted estimates.

Results: The study participants had an average age of 68.3 and were predominantly female (57%). About 20% of study sample were Black and 15% were Hispanic. The study participants reported an average of 12.5 years of education. Multivariable analysis showed that a higher level of negative interactions with family was associated with a higher AL score (b = 0.07, p = 0.022). On the other hand, a higher level of social support from family was associated with a lower AL score (b = -0.04, p = 0.023). In addition, being Black was associated with a higher AL score compared to White (b = 0.19, p < 0.001). A significant interaction was found between negative interaction with family and being Black (b = -0.16, p = 0.017). Specifically, negative interactions with family was associated with higher AL score among White adults, but this association was non-significant among Black adults.

Conclusions and Implications: Negative interactions with family may be stressful experiences that increase the risk of physiological dysregulation. Conversely, social support from family may protect against the physiological wear and tear in reactions and adaptations to stressful environment. Older Black adults are at risk of a higher AL score than White adults, suggesting Black-White differences in the lifetime stress exposure and burden. However, Black adults may have strong resilience in the face of negative interactions with family. Additional research is needed to further understand the underlying biopsychosocial factors driving the racial disparities in allostatic load.