The Longitudinal Association between Exposure to Violence and Patterns of Health Risk Behaviors among African American Youth

Hsieh, H. F., Mistry, R., Lee, D. B., Scott, B. A., Eisman, A. B., Heinze, J. E., & Zimmerman, M. A. (2021). The longitudinal association between exposure to violence and patterns of health risk behaviors among African American youth. American journal of health promotion35(6), 794-802.


Purpose: We investigate whether exposure to violence (ETV) during adolescence and emerging adulthood predicts engagement in chronic disease-related health risk behaviors years later among African Americans.

Design: A longitudinal study following youth from mid-adolescence (mean age = 14.8 years) to young adulthood (mean age = 32.0 years).

Setting: Flint, Michigan.

Sample: Four hundred forty-two African American (96.2%) and mixed African American and White (3.8%) participants.

Measures: Outcomes were diet, smoking, drinking, and physical inactivity. Covariates were ETV, sex, mother’s educational attainment, and substance use by siblings, peers, and parents.

Analysis: Latent profile analysis was conducted to identify distinct patterns of adult health risk behaviors and assess the association of youth ETV and identified patterns.

Results: Four latent profiles were identified: high substance use (n = 46; 10.41%), high overall risk (n = 71; 16.06%), low overall risk (n = 140; 31.67%) and inactive (n = 185, 41.86%). Relative to the low overall risk profile, ETV was associated with being in the high overall risk profile (b = 0.37, p = 0.04), but not other profiles. Female gender and higher maternal education were associated with being in the inactive profile compared to the low overall risk profile. Peer alcohol and tobacco use were associated with being in the high substance use profile.

Conclusion: ETV during adolescence and emerging adulthood increased the risk of engagement in multiple health risk behaviors later in life.

Keywords: adolescence; emerging adulthood; health disparity; latent class analysis; risk behaviors; violence; young adulthood.