The Black-White Paradox Revisited: Understanding the Role of Counterbalancing Mechanisms during Adolescence

J Health Soc Behav. 2019 Jun;60(2):169-187. doi: 10.1177/0022146519845069. Epub 2019 May 9.

Abstract

The tendency for blacks to report similar or better mental health than whites has served as an enduring paradox in the mental health literature for the past three decades. However, a debate persists about the mechanisms that underlie this paradox. Drawing on the stress process framework, we consider the counterbalancing roles of self-esteem and traumatic stress exposure in understanding the "black-white paradox" among U.S. adolescents. Using nationally representative data, we observe that blacks have higher levels of self-esteem than whites but also encounter higher levels of traumatic stress exposure. Adjusting for self-esteem reveals a net higher rate of mood disorders and distress among blacks relative to whites, and differences in traumatic stress exposure mediate this association. In the full model, we show that self-esteem and stress exposure offset each other, resulting in a null association between race and mood disorders and a reduced association between race and distress.

Keywords: black-white paradox; distress; mental disorder; self-esteem; traumatic stressors.

MeSH terms

  • Adolescent
  • Black or African American / psychology*
  • Epidemiologic Studies
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Male
  • Mental Disorders
  • Mental Health*
  • Self Concept
  • United States
  • White People / psychology*
  • Wounds and Injuries / psychology