Abstract

Black Americans disproportionately experience higher rates of health challenges and mortality compared to White Americans, yet the mechanisms underlying these disparities remain inadequately understood. Prominent theoretical models highlight stress and resulting allostatic load as putative mechanisms through which these Black-White racial disparities emerge; however, empirical data supporting such models with regard to mortality remains sparse. The current study examined the potential role of cumulative stress exposure across the life span and elevated levels of C-Reactive Protein, a biomarker of inflammation, in contributing to the longstanding increased mortality risk among Black relative to White Americans. Data were drawn from the Saint Louis Personality and Aging Network (SPAN) study, a longitudinal study that has followed a cohort of older adults from the St. Louis community (n = 1,577; 32.7% Black, 67.3% White; 55.1% female; mean age at baseline = 58.08 ± 2.95years). Cox hazard proportional mediational models showed that Black participants had significantly higher mortality risk than White participants (HR = 1.77, 95% CI [1.36, 2.31], p < 0.001), along with greater cumulative stress (b = 0.558, [0.487, 0.628], p < 0.001) and CRP levels (b = 0.184, 95% CI [0.132, 0.236], p < .001). Additionally, the serial model revealed that indirect effects through cumulative stress, CRP, and their serial pathway significantly mediated the relationship between race and mortality risk, collectively accounting for 35.85% of the disparity. These findings suggest that heightened stress exposure and inflammation are plausible mechanisms contributing to existing Black-White disparities in mortality risk, underscoring the importance of structural interventions aimed at reducing long-term stressors disproportionately experienced by Black Americans.

Committee Chair

Ryan Bogdan

Committee Members

Patrick Hill, Renee Thompson

Degree

Master of Arts (AM/MA)

Author's Department

Psychology

Author's School

Graduate School of Arts and Sciences

Document Type

Thesis

Date of Award

Spring 5-5-2025

Language

English (en)

Author's ORCID

https://orcid.org/0009-0009-3849-4441

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