Losing Loved Ones Too Soon and Too Much: Measuring Racial Disparities in Lifetime Loss Burden

Though racial disparities in shortened life expectancy have been well-established, racial disparities in the burden of grief after such premature deaths are severely understudied. This is, in part, due to a lack of measurement tools for characterizing lifetime exposure to loss. We propose three novel indices as the first to simultaneously measure premature and cumulative lifetime loss—two typically unmeasured dimensions of loss. Using a nationally representative longitudinal U.S. sample of 27,986 participants from the Health and Retirement Study (HRS, 1992 to 2020) who experienced at least one lifetime loss, we assessed racial disparities in exposure to earlier and repeated loss of family members over the lifespan. Hierarchical linear models accounting for participants nested within households showed that Black participants and Native American participants had higher premature and cumulative lifetime loss burden than White participants across all three indices. These effects consistently remained after sensitivity analyses controlling for sociodemographic variables such as parental education, household size, and birth cohort. Secondly, we provided initial construct validity evidence of our three indices by demonstrating their distinguishability from other measures of lifetime stressors and current, chronic stressors, presenting a case for attending to lifetime exposure to grief as a unique stressor. Together, our work leverages prospective, longitudinal methodologies to identify racial disparities in exposure to premature and cumulative death. The proposed novel measurement approach has future applications for understanding how loss exposure—both “too soon” and “too much”—predicts poor health.