Long-standing racial differences in US life expectancy suggest that black Americans would be exposed to significantly more family member deaths than white Americans from childhood through adulthood, which, given the health risks posed by grief and bereavement, would add to the disadvantages that they face. We analyze nationally representative US data from the National Longitudinal Study of Youth (n = 7,617) and the Health and Retirement Study (n = 34,757) to estimate racial differences in exposure to the death of family members at different ages, beginning in childhood. Results indicate that blacks are significantly more likely than whites to have experienced the death of a mother, a father, and a sibling from childhood through midlife. From young adulthood through later life, blacks are also more likely than whites to have experienced the death of a child and of a spouse. These results reveal an underappreciated layer of racial inequality in the United States, one that could contribute to the intergenerational transmission of health disadvantage. By calling attention to this heightened vulnerability of black Americans, our findings underscore the need to address the potential impact of more frequent and earlier exposure to family member deaths in the process of cumulative disadvantage. Significance Due to historical racial inequalities in the United States, including poverty, inadequate health care, and criminal victimization, black Americans die at much higher rates than white Americans. How the consequences of these elevated rates reverberate across family networks warrants attention. If blacks die at higher rates and earlier in the life course than whites, then blacks lose more loved ones from childhood through adulthood. Through the damaging effects of grief and other mechanisms, such losses are likely to undermine multiple life course outcomes. By analyzing nationally representative datasets to compare black and white Americans on the likelihood of losing family members over the life course, this study documents an intergenerational process with corrosive effects on black families and communities.

U.S. trends in population health suggest alarming disparities among young adults, who are less healthy across most measureable domains than their counterparts in other high-income countries; these international comparisons are particularly troubling for women. To deepen our understanding of gender disparities in health and underlying behavioral contributions, we document gender-specific clusters of health behavior among U.S. young adults using nationally representative data from the National Longitudinal Study of Adolescent to Adult Health. We find high levels of poor health behavior, but especially among men; 40 percent of men clustered into a group characterized by unhealthy behavior (e.g., poor diet, no exercise, substance use), compared to only 22 percent of women. Additionally, women tend to age out of unhealthy behaviors in young adulthood more than men. Further, we uncover gender differences in the extent to which sociodemographic position and adolescent contexts inform health behavior clustering. For example, college education was more protective for men, whereas marital status was equally protective across gender. Parental drinking mattered for health behavior clustering among men, whereas peer drinking mattered for clustering among women. We discuss these results in the context of declining female advantage in U.S. health and changing young adult social and health contexts.

Romantic involvement and mental health are dynamically linked, but this interplay can vary across the life course in ways that speak to the social and psychological underpinnings of healthy development. To explore this variation, this study examined how romantic involvement was associated with trajectories of depressive symptomatology across the transition between adolescence and young adulthood. Growth mixture modeling of data from the National Longitudinal Study of Adolescent to Adult Health identified trajectories of depressive symptomatology as teens grew into their late 20s and early 30s (N = 8,712). Multinomial logistic techniques regressed these trajectories on adolescent and young adult romantic experiences. Adolescent dating was associated with increased depressive symptoms early on, particularly for girls, but this risk faded over time. For both boys and girls, trajectories of decreasing symptoms were associated with young adult unions but also the coupling of adolescent dating with young adult singlehood.

Objective: Given the substantial demands of cancer caregiving, practical and psychometrically sound tools to evaluate distress among cancer caregivers are needed. CancerSupportSource^TM‐Caregiver is a distress screening, referral, and support program designed to identify the unmet needs of cancer caregivers and link caregivers to desired resources and support. This study refined and finalized the CancerSupportSource‐Caregiver screening measure and examined its psychometric properties.Methods: Using an analytic sample of 400 caregivers to people with cancer, we first performed item reduction by assessing exploratory factor analysis, external/internal item quality, and judging theoretical and practical implications of items. Confirmatory factor analysis along with reliability and validity analyses were then conducted to corroborate dimensionality and psychometric properties of the final measure. Nonparametric receiver operating characteristic curve analyses determined scoring thresholds for depression and anxiety risk subscales.Results: Scale refinement resulted in an 18‐item measure plus one screening item assessing tobacco and substance use. Items represented five domains of caregiver concerns: emotional well‐being, patient well‐being, caregiving tasks, finances, and healthy lifestyle. Our analyses showed strong internal consistency and test‐retest reliability, a replicable factor structure, and adequate convergent, discriminant, and known groups validity. Sensitivity of 2‐item depression and 2‐item anxiety risk subscales were 0.95 and 0.87, respectively.Conclusions: CancerSupportSource‐Caregiver is a reliable and valid multidimensional measure of caregiver distress that also screens for risk for clinically significant depression and anxiety. It can be implemented within a distress screening, referral, and follow‐up program to rapidly assess caregivers' unmet needs and enhance caregiver well‐being across the care continuum.