Longitudinal Trends in Race/Ethnic Disparities in Leading Health Indicators From Adolescence to Young Adulthood

Abstract

OBJECTIVE: To use ethnically diverse, national data to examine longitudinal trends in race/ethnic disparities in 20 leading health indicators from Healthy People 2010 across multiple domains from adolescence to young adulthood. Much of what is known about health disparities is based on cross-sectional measures collected at a single time point. DESIGN, SETTING, AND PARTICIPANTS: Nationally representative data for more than 14 000 adolescents enrolled in wave I (1994-1995) or wave II (1996) of the National Longitudinal Study of Adolescent Health (Add Health) and followed up into adulthood (wave III; 2001-2002). We fit longitudinal regression models to assess and contrast the trend in health indicators among racial/ethnic groups of adolescents as they transition into adulthood. MAIN OUTCOME MEASURES: Diet, inactivity, obesity, tobacco use, substance use, binge drinking, violence, sexually transmitted diseases, mental health, and health care access. RESULTS: Diet, inactivity, obesity, health care access, substance use, and reproductive health worsened with age. Perceived health, mental health, and exposure to violence improved with age. On most health indicators, white and Asian subjects were at lowest and Native American subjects at highest risk. Although white subjects had more favorable health in adolescence, they experienced greatest declines by young adulthood. No single race/ethnic group consistently leads or falters in health across all indicators. CONCLUSIONS: Longitudinal data indicate that, for 15 of 20 indicators, health risk increased and access to health care decreased from the teen and adult years for most US race/ethnic groups. Relative rankings on a diverse range of health indicators (and patterns of change over time) vary by sex and race/ethnicity, causing disparities to fluctuate over time.