Race, Lifetime SES, and Allostatic Load Among Older Adults.

Abstract

Prior research demonstrates that Black Americans receive fewer health benefits at high levels of socioeconomic status (SES) relative to Whites. Yet, few studies have considered the role of lifetime SES (ie, changes in SES from childhood to adulthood) in shaping these patterns among older adults. This study investigates the extent to which racial disparities in allostatic load (AL), an indicator of accelerated physiological aging, vary across levels of lifetime SES among Black and White adults aged 50 and older. With data from the Nashville Stress and Health Study, modified Poisson regression models were used to assess racial differences in the odds of high AL (4+ high-risk biomarkers) among Black and White older adults (N = 518) within each level of lifetime SES (ie, stable low SES, upward mobility, downward mobility, and stable high SES). Stable high SES was associated with greater odds of high AL; there was not a significant association between other lifetime SES trajectories and AL. However, the magnitude of racial disparities varied across levels of lifetime SES, with a significant Black-White difference in AL observed only among upwardly mobile (odds ratio [OR] = 1.76, 95% confidence interval [CI] = 1.24-2.51) and high SES groups (OR = 2.22, 95% CI = 1.37-3.58). Our study demonstrates that racial disparities in AL among older adults depend on individuals' lifetime SES trajectories and that older Black Americans receive fewer health benefits for achieving higher SES. These findings underscore the need to evaluate socioeconomic resources across the life course to clarify the extent of racial disparities among aging populations.