title: Does Inflammation Mediate Relationships Between Racial Identity and Onset of Menopause Among US Adults?
abstract: We assess how well differences in ethnoracial background may predict timing of menopause among females in the USA and whether or not inflammatory biomarker levels appear to mediate these overall associations. We use data from the National Social Life, Health, and Aging Project (NSHAP) to model apparent net effects from race on menopausal onset, as well as possible mediating influences from the inflammatory biomarker C-reactive protein (CRP). Using continuous time event history analysis, we assess and frame overall relationships between race and menopausal age. We use structural equation modeling to assess potential mediating effects from CRP and to estimate direct and indirect components of these apparent effects. Our findings suggest that on average, black females experience menopause earlier than their peers of other racial backgrounds, and have higher inflammatory biomarker levels. Both black race and higher CRP have negative and significant direct associations with menopausal age. CRP appears to partially mediate the overall association between black race and earlier menopause. This apparent mediation persists with statistical controls for income, education, and body mass index. Our study concludes with recommendations for future research on racial identity, inflammation, and menopausal onset. We focus our recommendations on intersectional forms of inequality that may affect black females in later life.
authors.affiliation: Department of Geriatrics, College of Medicine, Florida State University, 1115 W Call Street, Suite 4235, Tallahassee, FL, 32306-4300, USA. xnowakowski@fsu.edu.
authors.forename: Alexandra C H
authors.initials: ACH
authors.lastname: Nowakowski
authors.affiliation: Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, 1115 W Call Street, Suite 3200, Tallahassee, FL, 32306-4300, USA.
authors.forename: Katelyn Y
authors.initials: KY
authors.lastname: Graves
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007249:Inflammation / Q000208:ethnology* / Q000378:metabolism; D008593:Menopause / Q000208:ethnology*; D008875:Middle Aged; D014481:United States
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Event history analysis; Inflammation; Menopause; NSHAP