Journal of Urban Health

, Volume 93, Issue 5, pp 808–819 | Cite as

Accelerated Health Declines among African Americans in the USA

  • Roland J. ThorpeJr
  • Ruth G. Fesahazion
  • Lauren Parker
  • Tanganiyka Wilder
  • Ronica N. Rooks
  • Janice V. Bowie
  • Caryn N. Bell
  • Sarah L. Szanton
  • Thomas A. LaVeist


The weathering hypothesis, an explanation for race disparities in the USA, asserts that the health of African Americans begin to deteriorate prematurely compared to whites as a consequence of long-term exposure to social and environmental risk factors. Using data from 2000–2009 National Health Interview Surveys (NHIS), we sought to describe differences in age-related health outcomes in 619,130 African Americans and whites. Outcome measures included hypertension, diabetes, stroke, and cardiovascular disease. Using a mixed models approach to age-period-cohort analysis, we calculated age- and race-specific prevalence rates that accounted for the complex sampling design of NHIS. African Americans exhibited higher prevalence rates of hypertension, diabetes, and stroke than whites across all age groups. Consistent with the weathering hypothesis, African Americans exhibited equivalent prevalence rates for these three conditions 10 years earlier than whites. This suggests that African Americans are acquiring age-related conditions prematurely compared to whites.


Weathering hypothesis Health disparities Chronic conditions Mixed models African Americans Stress Allostatic load 


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Copyright information

© The New York Academy of Medicine 2016

Authors and Affiliations

  • Roland J. ThorpeJr
    • 1
    • 2
    • 3
  • Ruth G. Fesahazion
    • 1
  • Lauren Parker
    • 2
  • Tanganiyka Wilder
    • 4
  • Ronica N. Rooks
    • 5
  • Janice V. Bowie
    • 1
    • 2
  • Caryn N. Bell
    • 6
  • Sarah L. Szanton
    • 1
    • 7
  • Thomas A. LaVeist
    • 1
    • 8
  1. 1.Hopkins Center for Health Disparities SolutionsJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Department of Health, Behavior, and SocietyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  3. 3.Center for Biobehavioral Health Disparities ResearchDuke UniversityDurhamUSA
  4. 4.Department of Biological SciencesFlorida A&M UniversityTallahasseeUSA
  5. 5.Department of Health and Behavioral SciencesUniversity of Colorado DenverDenverUSA
  6. 6.Department of African American StudiesUniversity of Maryland College ParkCollege ParkUSA
  7. 7.Johns Hopkins School of NursingJohns Hopkins UniversityBaltimoreUSA
  8. 8.Department of Health Policy and Management, Milken Institute School of Public HealthGeorge Washington UniversityWashington, DCUSA

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