Multiple risks and comorbidity in an African‐American population

Social problems tend to cluster, developing in similar areas, seemingly produced in similar families, and menacing similar individuals. This fact gives rise to questions about whether the same or different conditions predict violence, depression and alcoholism, whether co‐occurrences of morbidity are attributable to similar risk conditions creating alternative ‘outcomes’ or to the co‐occurrence of risk conditions, whether males and females are equally exposed to risk conditions, and whether adverse (and protective) conditions affect males and females similarly. To answer these questions, we used information about 456 males and 497 females who were part of a panel first studied when they entered elementary school, in 1966, and subsequently interviewed at the age of 32. Six risk factors were considered. Aggressiveness, intelligence, school attendance and frequency of spanking were measured when the panel was in first grade; age at leaving home and exposure to discrimination were measured retrospectively. Risk factors available when children were in first grade were reasonably effective predictors of morbidity 26 years later. The risk factors predicting violence differed from those predicting depression and alcoholism. In addition, some risk factors that increased the likelihood of depression in females increased the likelihood of alcoholism in males. Males were more likely to be exposed to multiple risks, but also males and females appear to have somewhat different responses to similar risk conditions. These results are discussed. Copyright © 1997 Whurr Publishers Ltd.