Abstract
Interracial relationships are becoming increasingly common in the United States, yet the physical health status of individuals in interracial relationships is not well understood. Using 18 years of pooled data from the National Health Interview Study (2001–2018) (N = 264, 891), we compared the odds of having multiple chronic conditions (MCC) among adults in interracial and same-race unions. We anticipate that individuals in interracial relationships may be at higher risk of MCC than individuals in same-race relationships due to increased exposure to stressors associated with crossing racial boundaries. Findings indicate that the implications of interracial relationships on MCC depended on the racial composition of the couple. We found that White-Black couples had higher odds of MCC than both White-White and Black-Black couples, but Asian-Black and Hispanic-Black couples did not differ from their same-race couple counterparts, indicating a pronounced and unique health disadvantage for White adults paired with Black adults. We also found that Asian-White and Hispanic-White couples had higher odds of MCC relative to their same-race counterparts. In addition, minority-minority couples generally did not differ from their same-race minority couple counterparts in terms of MCC. The results of the study provide new insights into how the racial composition of interracial unions impacts health and how a closer proximity to Whiteness may be a health risk for some minority groups.
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References
Livingston G, Brown A. Intermarriage in the U.S. 50 years after loving v. Virginia. Pew Research Center; 2017.
Williams DR. Miles to go before we sleep: racial inequities in health. J Health Soc Behav. 2012;53(3):279–95. https://doi.org/10.1177/0022146512455804.
Williams DR, Mohammed SA. Racism and health I: pathways and scientific evidence. Am Behav Sci. 2013;57(8):1152–73. https://doi.org/10.1177/0002764213487340.
Bratter JL, Eschbach K. ‘What about the couple?’ Interracial marriage and psychological distress. Soc Sci Res. 2006;35(4):1025–47. https://doi.org/10.1016/j.ssresearch.2005.09.001.
Calderon PSP, Wong JD, Hodgdon BT. A scoping review of the physical health and psychological well-being of individuals in interracial romantic relationships. Fam Relat. 2022;71(5):2011–29. https://doi.org/10.1111/fare.12765.
Lopez A, Sheehan C, Yahirun J. Interracial unions and sleep duration among heterosexual American adults. SSM - Popul Health. 2022;19:101188. https://doi.org/10.1016/j.ssmph.2022.101188.
Turner RJ. Understanding health disparities: the relevance of the stress process model. Soc Ment Health. 2013;3(3):170–86. https://doi.org/10.1177/2156869313488121.
Ward BW, Black LI. State and regional prevalence of diagnosed multiple chronic conditions among adults aged ≥18 years — United States, 2014. MMWR Morb Mortal Wkly Rep. 2016;65(29):735–8. https://doi.org/10.15585/mmwr.mm6529a3.
Bor J, Cohen GH, Galea S. Population health in an era of rising income inequality: USA, 1980–2015. The Lancet. 2017;389(10077):1475–90. https://doi.org/10.1016/S0140-6736(17)30571-8.
Wang L, Si L, Cocker F, Palmer AJ, Sanderson K. A systematic review of cost-of-illness studies of multimorbidity. Appl Health Econ Health Policy. 2018;16(1):15–29. https://doi.org/10.1007/s40258-017-0346-6.
Choi KH, Goldberg RE. Fertility behavior of interracial couples. J Marriage Fam. 2018;80(4):871–87. https://doi.org/10.1111/jomf.12483.
Pittman PS, Kamp Dush C, Pratt KJ, Wong JD. Interracial couples at risk: discrimination, well-being, and health. J Fam Issues. 2024;45(2):303–325. https://doi.org/10.1177/0192513X221150994.
Bratter J, Campbell ME, Saint Onge JM. Living race together: the role of partner’s race in racial/ethnic differences in smoking. Ethn Health. 2020;25(1):141–59. https://doi.org/10.1080/13557858.2017.1398316.
Caraballo C, Herrin J, Mahajan S, et al. Temporal trends in racial and ethnic disparities in multimorbidity prevalence in the United States, 1999–2018. Am J Med. 2022;135(9):1083-1092.e14. https://doi.org/10.1016/j.amjmed.2022.04.010.
Louie P, Upenieks L. Vicarious discrimination, psychosocial resources, and mental health among Black Americans. Soc Psychol Q. 2022;85(2):187–209. https://doi.org/10.1177/01902725221079279.
Vasquez JM. Race cognizance and colorblindness: effects of Latino/Non-Hispanic White intermarriage 1. Bois Rev Soc Sci Res Race. 2014;11(2):273–93. https://doi.org/10.1017/S1742058X14000174.
Geronimus AT. The weathering hypothesis and the health of African-American women and infants: evidence and speculations. Ethn Dis. 1992;2(3):207–21.
Bratter JL, Whitehead EM. Ties that bind? Comparing kin support availability for mothers of mixed-race and monoracial infants. J Marriage Fam. 2018;80(4):951–62. https://doi.org/10.1111/jomf.12485.
Hohmann-Marriott BE, Amato P. Relationship quality in interethnic marriages and cohabitations. Soc Forces. 2008;87(2):825–55. https://doi.org/10.1353/sof.0.0151.
Irby-Shasanmi A, Erving CL. Do discrimination and negative interactions with family explain the relationship between interracial relationship status and mental disorder? Socius Sociol Res Dyn World. 2022;8:237802312211248. https://doi.org/10.1177/23780231221124852.
LeBlanc AJ, Frost DM, Wight RG. Minority stress and stress proliferation among same-sex and other marginalized couples. J Marriage Fam. 2015;77(1):40–59. https://doi.org/10.1111/jomf.12160.
Skinner AL, Hudac CM. “Yuck, you disgust me!” Affective bias against interracial couples. J Exp Soc Psychol. 2017;68:68–77. https://doi.org/10.1016/j.jesp.2016.05.008.
Irby-Shasanmi A, Erving CL. Do discrimination and negative interactions with family explain the relationship between interracial relationship status and mental disorder? Socius. 2022;8:23780231221124852. https://doi.org/10.1177/23780231221124852.
Wong JS, Penner AM. Better together? Interracial relationships and depressive symptoms. Socius. 2018;4:2378023118814610. https://doi.org/10.1177/2378023118814610.
Yu YL, Zhang Z. Interracial marriage and self-reported health of Whites and Blacks in the United States. Popul Res Policy Rev. 2017;36(6):851–70. https://doi.org/10.1007/s11113-017-9438-0.
Childs EC. Navigating interracial borders: black-white couples and their social worlds. Rutgers University Press; 2005.
Herman MR, Campbell ME. I wouldn’t, but you can: attitudes toward interracial relationships. Soc Sci Res. 2012;41(2):343–58. https://doi.org/10.1016/j.ssresearch.2011.11.007.
Kroeger RA, Williams K. Consequences of Black exceptionalism? Interracial unions with Blacks, Depressive symptoms, and relationship satisfaction. Sociol Q. 2011;52(3):400–20. https://doi.org/10.1111/j.1533-8525.2011.01212.x.
Lee J, Bean FD. Reinventing the color line immigration and America’s new racial/ethnic divide. Soc Forces. 2007;86(2):561–86. https://doi.org/10.1093/sf/86.2.561.
Yancey G. Crossracial differences in the racial preferences of potential dating partners: a test of the alienation of African Americans and social dominance orientation. Sociol Q. 2009;50(1):121–43.
Barr AB, Simons RL. A dyadic analysis of relationships and health: does couple-level context condition partner effects? J Fam Psychol. 2014;28(4):448–59. https://doi.org/10.1037/a0037310.
Miller B, Kail BL. Exploring the effects of spousal race on the self-rated health of intermarried adults. Sociol Perspect. 2016;59(3):604–18. https://doi.org/10.1177/0731121416641702.
Buxton OM, Marcelli E. Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States. Soc Sci Med. 2010;71(5):1027–36.
Gans HJ. The possibility of a new racial hierarchy in the twenty-first-century United States. In: Lamont M, editor. The cultural territories of race: Black and White boundaries. University of Chicago Press; 1999. p. 371–90.
Louie P, Upenieks L, Erving CL, Thomas Tobin CS. Do racial differences in coping resources explain the Black-White paradox in mental health? A test of multiple mechanisms. J Health Soc Behav. 2022;63(1):55–70. https://doi.org/10.1177/00221465211041031.
Louie P, Wheaton B. Prevalence and patterning of mental disorders through adolescence in 3 cohorts of Black and White Americans. Am J Epidemiol. 2018;187(11):2332–8. https://doi.org/10.1093/aje/kwy144.
Thomas Tobin CS, Erving CL, Barve A. Race and SES differences in psychosocial resources: implications for social stress theory. Soc Psychol Q. 2021;84(1):1–25. https://doi.org/10.1177/0190272520961379.
Louie P, Wheaton B. The Black-White paradox revisited: understanding the role of counterbalancing mechanisms during adolescence. J Health Soc Behav. 2019;60(2):169–87. https://doi.org/10.1177/0022146519845069.
Anderson RE, Anyiwo N, Gumudavelly D, et al. Racial socialization provision in African American and Black Caribbean families. J Child Fam Stud. 2023;32(1):1–16. https://doi.org/10.1007/s10826-022-02415-w.
DeAngelis RT. Moving on up? Neighborhood status and racism-related distress among Black Americans. Soc Forces. 2022;100(4):1503–32. https://doi.org/10.1093/sf/soab075.
Gabriel R. A middle ground? Residential mobility and attainment of mixed-race couples. Demography. 2015;53(1):165–88. https://doi.org/10.1007/s13524-015-0445-7.
Dow DM. The deadly challenges of raising African American boys. Gend Soc. 2016;30:161–88. https://doi.org/10.1177/0891243216629928.
Leventhal T, Brooks-Gunn J. Moving to opportunity: an experimental study of neighborhood effects on mental health. Am J Public Health. 2003;93(9):1576–82. https://doi.org/10.2105/AJPH.93.9.1576.
Liu H, Reczek C. Cohabitation and U.S. adult mortality: an examination by gender and race. J Marriage Fam. 2012;74(4):794–811. https://doi.org/10.1111/j.1741-3737.2012.00983.x.
Henderson AK, Brantley MJ. Parent’s just don’t understand: parental support, religion and depressive symptoms among same-race and interracial relationships. Religions. 2019;10(3):162. https://doi.org/10.3390/rel10030162.
Musick K, Bumpass L. Reexamining the case for marriage: union formation and changes in well-being. J Marriage Fam. 2012;74(1):1–18. https://doi.org/10.1111/j.1741-3737.2011.00873.x.
Perelli-Harris B, Styrc M. Mental well-being differences in cohabitation and marriage: the role of childhood selection. J Marriage Fam. 2018;80(1):239–55. https://doi.org/10.1111/jomf.12431.
Choi KH, Goldberg RE. The social significance of interracial cohabitation: inferences based on fertility behavior. Demography. 2020;57(5):1727–51. https://doi.org/10.1007/s13524-020-00904-5.
Musick K. Planned and unplanned childbearing among unmarried women. J Marriage Fam. 2002;64(4):915–29. https://doi.org/10.1111/j.1741-3737.2002.00915.x.
Brown SL. The effect of union type on psychological well-being: depression among cohabitors versus marrieds. J Health Soc Behav. 2000;41(3):241. https://doi.org/10.2307/2676319.
Lamb KA, Lee GR, DeMaris A. Union formation and depression: selection and relationship effects. J Marriage Fam. 2003;65(4):953–62. https://doi.org/10.1111/j.1741-3737.2003.00953.x.
Blewett LA, Rivera Drew J, Griffin R, King ML, Williams KC. IPUMS health surveys: National Health Interview Survey, Version 6.3. Minneapolis, MN: IPUMS 2018.
Erving CL, Frazier C. The association between multiple chronic conditions and depressive symptoms: intersectional distinctions by race, nativity, and gender. J Health Soc Behav. 2021;62(4):599–617. https://doi.org/10.1177/00221465211040174.
Jason KJ, Carr DC, Washington TR, Hilliard TS, Mingo CA. Multiple chronic conditions, resilience, and workforce transitions in later life: a socio-ecological model. The Gerontologist. 2015;25:101. https://doi.org/10.1093/geront/gnv101.
Ward BW, Schiller JS. Prevalence of multiple chronic conditions among us adults: estimates from the National Health Interview Survey, 2010. Prev Chronic Dis. 2013;10:120203. https://doi.org/10.5888/pcd10.120203.
Rothstein R. The color of law: a forgotten history of how our government segregated America. Liveright Publishing; 2017.
Yancey G. Experiencing racism: differences in the experiences of whites married to Blacks and Non-Black racial minorities. J Comp Fam Stud. 2007;38(2):197–213. https://doi.org/10.3138/jcfs.38.2.197.
Davis FJ. Who is Black? One nation’s definition. 10th anniversary ed. Pennsylvania State University Press; 2001.
Gullickson A. Black/White interracial marriage trends, 1850–2000. J Fam Hist. 2006;31(3):289–312. https://doi.org/10.1177/0363199006288393.
Kreager DA. Guarded borders: adolescent interracial romance and peer trouble at school. Soc Forces. 2008;87(2):887–910. https://doi.org/10.1353/sof.0.0128.
Lewis R, Yancey G. Biracial marriages in the United States: an analysis of variation in family member support. Sociol Spectr. 1995;15(4):443–62. https://doi.org/10.1080/02732173.1995.9982111.
Pryor E. Love sees no color: the pervasiveness of color-blindism within Black-White intimate interracial relationships. Mich Sociol Rev. 2018;32:91–130.
Yancey GA. Who is white? latinos, asians, and the new black/nonblack divide. Lynne Rienner; 2004.
Field CJ, Kimuna SR, Straus MA. Attitudes toward interracial relationships among college students: race, class, gender, and perceptions of parental views. J Black Stud. 2013;44(7):741–76. https://doi.org/10.1177/0021934713507580.
Behler R, Donnelly R, Umberson D. Psychological distress transmission in same-sex and different-sex marriages. J Health Soc Behav. 2019;60(1):18–35. https://doi.org/10.1177/0022146518813097.
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Patricia Louie, conceptualization, methodology, formal analysis, writing original draft, supervision. Hana R.H. Brown, writing review and editing. Ryon J. Cobb, writing review and editing. Connor Sheehan, writing review and editing and methodology.
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Louie, P., Brown, H.R.H., Cobb, R.J. et al. Are Interracial Couples at Higher Risk of Multiple Chronic Conditions? Evidence from a Nationally Representative Sample. J. Racial and Ethnic Health Disparities (2024). https://doi.org/10.1007/s40615-024-01952-y
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DOI: https://doi.org/10.1007/s40615-024-01952-y