Mechanisms of Racial Health Disparities: Evidence on Coping and Cortisol from MIDUS II

  • Julie Ober AllenEmail author
  • Daphne C. Watkins
  • Linda Chatters
  • Vicki Johnson-Lawrence



Blunted patterns of daily cortisol, an indicator of hypothalamic-pituitary-adrenal (HPA) axis stress response system dysregulation, are implicated in poor health outcomes and racial health disparities. It is unknown how coping—an important, but understudied, component of the stress-health disparities relationship—relates to these biological mechanisms of health.


This study investigated relationships, including racial differences, between 12 coping strategies and early-day cortisol changes (diurnal cortisol slopes from peak to before lunch) among 700 35–85-year-old Black and White male participants in the National Survey of Midlife Development in the United States (MIDUS) II. Cognitive-oriented (e.g., positive reinterpretation, denial, religious/spiritual) and behavioral (e.g., stress eating, substance use) coping strategies were examined.


Overall, Black and White men used similar coping strategies. Most coping strategies were not associated with men’s cortisol slopes. Religious/spiritual coping was associated with steeper (more robust) cortisol slopes among White (b = − 0.004, t = − 3.28, p = 0.001) but not Black men. Drug use was associated with steeper cortisol slopes among Black (b = − 0.095, t = − 2.87, p = 0.004) but not White men.


This exploratory study increases our understanding of relationships between coping and stress-related biological mechanisms underlying racial health disparities among men in later life. With some notable exceptions, men’s coping strategies were not associated with their diurnal cortisol slopes. This suggests that the coping strategies currently used by older Black and White men may not be important factors, as determinants or intervention targets, in disparities in diurnal cortisol slopes and associated health outcomes among men in this age group.


Health status disparities Coping skills Coping behaviors Men’s health Cortisol African Americans 


Funding Information

This research was supported by a fellowship from the University of Michigan Rackham School for Graduate Studies and a National Institute on Aging, NIH training grant to the Population Studies Center at the University of Michigan (T32-AG000221). Data used for this research were provided by the longitudinal study titled “Midlife in the United States” (MIDUS), managed by the Institute on Aging at the University of Wisconsin and supported by a grant from the National Institute on Aging, NIH (P01-AG020166).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Research Involving Human Participants and/or Animals

The present study was Internal Review Board exempt, because it involved secondary analysis of publicly available, deidentified data.

The MIDUS study, from which the data used in the present study were drawn, performed all study procedures involving human participants in accordance with the ethical standards of the University of Wisconsin Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the MIDUS study.


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Copyright information

© W. Montague Cobb-NMA Health Institute 2019

Authors and Affiliations

  1. 1.Population Studies Center, Institute for Social ResearchUniversity of MichiganAnn ArborUSA
  2. 2.School of Social WorkUniversity of MichiganAnn ArborUSA
  3. 3.Schools of Social Work and Public HealthUniversity of MichiganAnn ArborUSA
  4. 4.Division of Public Health, College of Human MedicineMichigan State UniversityFlintUSA

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