Health Psychology

© 2019 American Psychological Association 2019, Vol. 38, No. 8, 738 –747
0278-6133/19/$12.00 http://dx.doi.org/10.1037/hea0000776

Home Life and Health Among Native American, African American, and
Latino Adolescents
Robert H. Bradley
Arizona State University

Objective: Research provides limited detail on how aspects of home life influence basic health status for
ethnic/racial minority adolescents. This study examined 2 aspects of the home environment as they relate
to 2 markers of health status for Native American, African American, and Latino adolescents. The study
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.

addressed the hypothesis that family companionship and investment is associated with adolescent health
This document is copyrighted by the American Psychological Association or one of its allied publishers.

in all 3 groups. Method: Data collectors made visits to the homes of 53 Native American, 132 African
American, and 155 Latino families with an adolescent living in residence. They administered the HOME
Inventory along with components of the Child Health and Illness Profile and the American Community
Survey to parents and adolescents. Results: Significant correlations were observed between the
Companionship and Investment domain of LA-HOME and the 2 markers of health for all 3
racial/ethnic groups. Very few significant correlations were observed for the other LA-HOME
domain (Physical Environment). When health outcomes were regressed on the 2 home environment
factors and gender, Companionship and Investment was a significant predictor in 4 of the 6 models
run, with near significant differences in a 5th. Conclusions: In households where there was a high
level of connectedness between adolescents and other family members, adolescents showed more
endurance and had fewer health problems. Because adolescence is a period when children tend to
spend less time with other family members and are prone to engage in risky behavior, implementing
programs that promote parent-adolescent communication and productive time together would seem
helpful.

Keywords: adolescence, home environment, communication, physical environment, endurance

An overarching goal of Healthy People 2020 is to create envi-
ronments that promote good health for all (Centers for Disease
Control and Prevention, 2018). The goal was set in response to
research showing that members of certain subgroups (e.g., those
with low income, those from particular racial/ethnic minorities,
those living in rural areas) are at higher risk for poor health
(Castor, Smyser, Taualii, Park, Lawson, & Forquera, 2006; Cen-
ters for Disease Control, National Center for Health Statistics,
2017; Children’s Health Fund, 2006; Flores & Lin, 2013; Hodge &
Nandy, 2011; James et al., 2017), with evidence suggesting inter-
play among race/ethnicity, wealth, and geography (James et al.,
2017; Williams, Priest, & Anderson, 2016). Studies done of chil-
dren show that Native American, African American, and Latino
children are more likely to be overweight than is the case for
non-Hispanic Whites (Delva, O’Malley, & Johnston, 2006; Flores
& Lin, 2013). Oral health is also likely to be poorer among African
American and Latino children (Dye, Li, & Thornton-Evans, 2012;
Flores & Lin, 2013; Guarnizo-Herreño & Wehby, 2012), as is
overall reported health (Pastor, Reuben, & Duran, 2015). African
American, Native American, and Latino children are also more
likely to be diagnosed with asthma (Flores & Lin, 2013; National
This article was published Online First June 17, 2019.
Correspondence concerning this article should be addressed to Robert H.
Bradley, Center for Child and Family Success, Arizona State University,
721 S. Cady Mall, Tempe, AZ 85287. E-mail: robert.bradley@asu.edu
Center for Health Statistics, 2016; Price, Khubchandani, McKinney,
& Braun, 2013). Native American children are also likely to suffer
higher rates of injury (U.S. Department of Health and Human
Services, Indian Health Service, 2017), while African American
children were more likely to have lead poisoning (Children’s
Health Fund, 2006). On the other hand, research is not fully
consistent in showing particular health disparities and research
also shows that some health problems are higher in girls from
particular population subgroups, while others are more likely in
boys (Children’s Health Fund, 2006; National Center for Health
Statistics, 2016; Ogden, Carroll, Curtin, Lamb, & Flegal, 2010;
Price et al., 2013).
Because of world-wide disparities in health related to race/
ethnicity, income, and geography, the World Health Organization
Commission on the Social Determinants of Health made a strong
case for looking at proximal determinants, such as the family
environment, as a way of potentially addressing disparities that
arise among groups (Viner et al., 2012). Unfortunately, research on
associations between conditions present in the home and adoles-
cent health for most racial and ethnic groups in the United States
is limited. Most research concerns health indicators such as risky
behavior and mental health problems (Brody et al., 2014; Estrada-
Martínez, Caldwell, Schutz, Diez-Roux, & Pedraza, 2011; Hosk-
ins, 2014; Moretti & Peled, 2004; Resnick et al., 1997) or very
specific health markers such as obesity, injury, physical activity,
cardiovascular health, or oral health (Flores & Lin, 2013; Kwon &
Wickrama, 2014; Matthews et al., 2017; Newman, Harrison, Da-

738
 HOME LIFE AND ADOLESCENT HEALTH
shiff, & Davies, 2008). There is scant information on relations
between particular aspects of the home environment and gen-
eral health status for minority adolescents. Looking more ho-
listically at overall health status would seem important for
several reasons. First, there is quite complex interplay between
genes and environments with respect to human health (Hunter,
2005). Relatedly, there are cultural and geographic variations in
how particular aspects of the environment are implicated in
health problems (National Research Council and Institute of
Medicine, 2004; Williams et al., 2016). Finally, the connection
between particular aspects of the social and physical environ-
ment and particular health outcomes may reflect multiple dif-
ferent mechanisms/pathways (e.g., access to particular oppor-
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tunities, experiences of different hazards, and implementation
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of different lifestyle choices; Berkman, Glass, Brissette, &
Seeman, 2000; Hernandez & Blazer, 2006; Thoits, 2011). Ac-
cordingly, to determine how to address health disparities, it can
be useful to consider health status more broadly as well as to
consider particular health conditions.
Healthy People 2020 lists physical determinants of health,
such as housing quality, and social determinants of health, such
as supportive relationships among family members, as being of
potential importance for adolescent health (Centers for Disease
Control and Prevention, 2018). Members of some racial and
ethnic groups are more likely to live in low quality, crowded
housing and reside in neighborhoods that have high crime rates
or lack amenities that promote good health (Adler & Newman,
2002; Evans, 2006; Hood, 2005; Shaw, 2004; Villanueva et al.,
2016). Such conditions often give rise to family conflict and
stress, with evidence indicating decreases in attachment secu-
rity during adolescence in high-risk families (Weinfield,
Sroufe, & Egeland, 2000). Such conditions could have negative
consequences for adolescent health (Evans, 2006; Shaw, 2004;
Villanueva et al., 2016). Although research shows a general
association between the physical environment and children’s
health, the relation does not appear to be linear or consistent.
Research on household conditions indicates that youth living in
poor quality homes are more likely to sustain injuries; but
poor-quality housing shows less consistent relations with most
other markers of physical health (Ferguson, Cassells, Mac-
Allister, & Evans, 2013). The world-wide literature on living
conditions suggests that the association between physical con-
ditions associated with home life are likely to be a negatively
accelerating function, with negative impacts occurring most
often in conditions that expose children to key pathogens and
major hazards, conditions more often present in lower and
middle-income countries (Bradley, 2015). In the United States,
exposure to high levels of pathogens such as lead or hazards
like deteriorated housing or neighborhood violence are more
likely to occur in specific geographic niches, places where only
a small proportion of any given racial/ethnic group live (Akkus
& Ozdenerol, 2014; Clark, Millet, & Marshall, 2017; Saegert &
Evans, 2003; Wattingney, Irvin-Barnwell, Pavuk, & Ragin-
Wilson, 2015).
At present, research does not speak with high authority on how
social aspects of the home environments may contribute to phys-
ical health in adolescents who come from ethnic/racial minority
groups that face significant discrimination and high levels of
adversity such as Native Americans, African Americans, and La-
739
tinos (Brody et al., 2014; Hoskins, 2014; Moretti & Peled, 2004;
Resnick et al., 1997; Viner et al., 2012). In the Healthy People
2020 report, social factors were discussed as contributing to health,
and the advisory committee responsible for the report recom-
mended that more research was needed to specify how particular
social factors were implicated in the health of various constituent
groups in the U.S. population (Centers for Disease Control and
Prevention, 2018). Given that there are often marked changes in
health behaviors during adolescence with those changes having
implications for long-term well-being (Ames, Leadbeater, & Mac-
Donald, 2018), it is important to more fully delineate the social
factors connected with health in minority adolescents. What is
clear is that many Native American, African American and Latino
families have social assets that help strengthen resilience and
promote well-being in family members (Cabrera & the SRCD
Ethnic and Racial Issues Committee, 2013). Positive connections
between family members has been identified as a potentially
protective factor for adolescents who live in conditions of risk
(Fergus & Zimmerman, 2005; Lee, Wickrama, & Simons, 2013).
Connectedness seems to protect adolescents from engaging in
maladaptive behavior while facilitating both positive mood and
engagement in productive behavior, with some evidence that it
promotes health among adolescents (Fergus & Zimmerman, 2005).
When families spend time together and when parents and adoles-
cents communicate with one another regarding problems and ex-
pectations, it appears to facilitate adolescent self-efficacy, which
can promote life satisfaction and health (Conger, Williams, Little,
Masyn, & Shebloski, 2009).
The broad findings about social connections and health in
adolescents are consistent with theories pertaining to adolescent
development. Although attachment theory was initially promul-
gated to address the behavior and development of young chil-
dren, Moretti and Peled (2004) argued that adolescent attach-
ment to parents functions in ways similar to those observed for
young children; specifically, securely attached adolescents are
more comfortable in their environments, better able to form new
social relationships and they are more confident in making
decisions connected with daily life. According to Pietromonaco,
Uchino, and Dunkel Schetter (2013), individuals with good
attachment relationships are likely to manifest greater self-
regulatory capacities. Accordingly, securely attached adoles-
cents are likely to feel less stress and to make lifestyle choices
that foster good health. A second area of theory that would seem
particularly germane to the association between social connec-
tions with parents and adolescent health is Self-Determination
Theory (SDT; Deci & Ryan, 2008). At the core of SDT is the
idea of autonomous motivation and its connection to an indi-
vidual’s sense of self and personal decision making. According
to SDT, individuals have three basic needs: (a) competence, (b)
relatedness, and (c) autonomy. Critically, research shows that
these needs are operative across cultures. When each of these
needs is met, a person tends to be more mindful in dealing with
daily activities; moreover, they tend to manifest greater energy
and vitality. Arguments pertaining to the need for relatedness in
SDT are in some respects analogous to the idea that the desire
for interpersonal attachments (i.e., belongingness needs) are
fundamental to human motivation (Baumeister & Leary, 1995).
For adolescents, the needs for relatedness and for autonomy are
more likely to be met when adolescents have continued good
 740 BRADLEY
connections with parents and have communications with par-
ents where there is mutual respect for one anothers’ autonomy
and efforts to promote the adolescent’s competence (Joussemet,
Landry, & Koestner, 2008).
Adolescents typically spend less time with other family mem-
bers than is the case for younger children, and there is a tendency
for parent– child relationships to weaken during adolescence (Gut-
man, Peck, Malanchuk, Sameroff, & Eccles, 2017). Research by
Stanik, Riina, and McHale (2013) specifically speaks to this issue
as it pertains to African American adolescents. Moreover, African
American adolescents are also more likely than non-Hispanic
white adolescents to experience family violence, child abuse and
neglect (Straus, Hamby, Finkelhor, Moore, & Runyan, 1998).
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Such problems are also more common in Native American fami-
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lies (Sarche & Spicer, 2008). Currently, there is scant research on
relations between family connectedness and general health status
among ethnic/racial minority adolescents; thus, a primary focus of
this study is to examine such relations. It is done in the context of
also considering physical environmental conditions so as to pro-
vide a more inclusive understanding of the role of proximal home
environmental conditions on physical health among U.S. ethnic/
racial minority adolescents. Considering physical and social as-
pects of home experience simultaneously, while controlling for
gender, reduces the likelihood of drawing inaccurate conclusions
regarding any one factor given that health is a complex derivative
of multiple, often co-occurring, factors (Currie et al., 2012).
The purpose of the study is to document how two home condi-
tions (physical environment, and companionship and investment)
are associated with two different indicators of physical health
(perceived endurance, number of health problems) for Native
American, African American, and Latino adolescents. These
groups were selected because they face considerable adversity and
adults from these groups tend to show higher levels of health
problems than is the case for the U.S. population generally (Wen,
2007). These two broad markers of health status were selected for
three reasons: (a) there is limited evidence for racial/ethnic differ-
ences pertaining to most discrete health problems during adoles-
cence (Harris, Gordon-Larsen, Chantala, & Udry, 2006; Starfield,
Riley, Witt, & Robertson, 2002); (b) systems theory suggests that
the same environmental condition is likely to impact different
individuals in different ways, depending on other biological and
contextual conditions (Repetti, Taylor, & Seeman, 2002; Viner et
al., 2012); and (c) the experience of a particular illness or health
problem could reflect exposure to a specific environmental condi-
tion, whereas perceived endurance (vitality) may reflect the overall
quality of the physical and social environment (Ferguson et al.,
2013; Williams et al., 2016). Thus, the more holistic approach to
health seemed more useful given the goal of explicating how social
and physical conditions connected to home life were associated
with health during adolescence within each group. The primary
hypothesis is that family connectedness (operationalized using the
Companionship and Investment score from the Late Adolescence
HOME Inventory; Caldwell & Bradley, 2016) is related to both
indicators of adolescent health status. By comparison, scores on
the Physical Environment domain from LA-HOME are expected
to show less consistent relations with adolescent health— even
granting the generally negative impact of low family income (Lee
et al., 2013).
Method
Participants
The sample includes 53 Native American families, 132 African
American families, and 155 Latino families, each with a child
between 16 and 20 years old. Families were recruited in 2014 from
four states (Arizona, Arkansas, California, and Oklahoma) as part
of a larger study on measuring family environments (Bradley,
Pennar, Fuligni, & Whiteside-Mansell, 2019). The data collection
sites were selected because the institutions at each site were highly
experienced in collecting data from the populations of interest.
Only participants fluent in either English or Spanish were enrolled
because of limitations in the measures available.
Recruitment procedures. Somewhat different approaches were
used to obtain samples at each site; and there was variation within
sites as well. In Arizona a multiplicity of procedures were used.
They included (a) passing out flyers in select neighborhoods and
events, (b) using established processes to recruit participants at
Arizona State University, (c) personal presentations during classes
at ASU, (d) a web site and a Facebook page, (e) having research
assistants provide information on site at health facilities and public
organizations such as Boys and Girls Clubs, (f) use of mass
emailing lists, and (g) word of mouth. In Arkansas, (a) flyers were
distributed throughout the community; (b) personal connections at
University of Arkansas for Medical Sciences, University of Ar-
kansas at Little Rock, and various community agencies in both
urban and rural areas were enlisted; and (c) professional data
collectors in rural communities who had assisted with prior proj-
ects were enlisted. At Cherokee Nation in Oklahoma recruitment
was (a) by means of personal communication and (b) by placement
of announcements in local public service agencies. In California
families were recruited (a) by means of personal contacts by
personnel at the Family Resiliency Center at UCLA and (b) by
snowball sampling.
As Table 1 shows, there is considerable variability within each
racial/ethnic group. Native Americans varied with respect to ma-
ternal education and household income (about 30% had a high
school degree or less but about 30% had a college degree or more;
more than one-third had household incomes ⬍$30,000 but 17%
had incomes ⬎$70,000). Latino families were also diverse by
educational status (about one-fourth had a high school degree or
less but 40% had a college degree or more; 40% of households had
incomes under $40,000 but nearly 15% had incomes greater than
$80,000). About 25% of African American mothers had a high
school degree or less but 40% had a college degree or more; and
about 40% of African American families had incomes under
$30,000 but 15% had incomes $80,000 or higher. There was also
substantial variability within each group with respect to household
size, with more than 15% of both Native American and Latino
households having at least nine people in residence. As expected,
a very high percentage of African American households had only
one parent (60%), but over 35% of Native American households
had only one parent as well.
Measures
Preliminary evaluation of measures. A multistage process
for selecting the measures used for the study was followed given
 HOME LIFE AND ADOLESCENT HEALTH 741

Table 1 partment of Commerce, U.S. Census Bureau, 2010). It includes

Demographic Characteristics of Sample information on (a) gender, age and racial/ethnic group membership
of household residents, (b) marital, educational and employment
Number of participants status of parents, (c) household income, (d) country of origin and
Native African language spoken in the home, and (e) health status of family
American American Latino members. Using data from ACS, we constructed a four-indicator
Adolescent gender index of family risk: (a) households in which parents had a high
Female 33 68 87 school degree or less; (b) households that met criteria for poverty
Male 20 64 68 (income-to-needs ⬍1.0); (c) households with only a single parent
Mother’s marital status present; and (d) households with less than 150 square feet of space
Married (or lives with partner) 33 50 124
Single (no partner) 19 80 37
per resident. Scores could range from 0 ⫽ no risks present to 4 ⫽
Other (or incomplete data) 1 2 0 all risks present.
Mother’s level of education HOME Inventory. Each family was administered the Late
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Less than high school 3 9 31 Adolescence version of the Home Observation for Measurement of
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High school degree 13 22 34 the Environment (HOME) Inventory (Caldwell & Bradley, 2016).
Some postsecondary school 22 47 59
College degree 11 27 29 LA-HOME contains 59 items representing six aspects of the home
Master’s degree or more 4 27 8 environment. It was administered in the adolescent’s primary place
Household income of residence when both the adolescent and the primary parent were
Less than $20,000 8 39 18 present (other family members were welcome to take part, but not
$20,000–$39,999 20 36 53
$40,000–$59,999 11 24 28
required). Data collectors were trained to be nonintrusive and to
$60,000–$79,999 5 14 23 make the family comfortable. LA-HOME was administered in
$80,000–$99,999 2 6 19 either Spanish or English based on the wishes of the participants.
$100,000 or more 7 13 17 Scores on two of the six LA-HOME dimensions were used for the
Incomplete data 0 0 3 study: (a) Physical Environment (9 items), and (b) Companionship
Household size
2 4 23 8 and Investment (10 items). The Physical Environment items ad-
3–4 16 72 51 dressed issues related to safety, crowdedness, esthetics, noise, and
5–6 13 27 64 cleanliness. The Companionship and Investment items included
7–8 7 8 19 consideration of joint activities, expectations, planning, and
9⫹ 3 1 5
Incomplete data 0 0 14
encouragement of the adolescent’s involvement in enriching
activities—this dimension was used as a reflection of family
connectedness. Interrater agreement based on 123 home visits
was 94% (␬ ⫽ .81).
variations in cultural values and language spoken by the constit- Adolescent health. Adolescents completed a 22-item survey
uent racial/ethnic groups involved in the study. First, only mea- dealing with health and quality of life. Items were taken from the
sures that were already available in English and Spanish and Child Health and Illness Profile-Adolescent Edition (CHIP-AE;
measures with a prior history of use with the constituent popula- Starfield et al., 1995). Included in this survey is an item that
tions were selected—the exception was the LA-HOME that un- captures the adolescent’s perception of endurance (“I can be phys-
derwent extensive prior field testing and vetting by experts before ically active for long periods of time without getting overly tired”;
implementation of the study (see Bradley et al., 2019). Second, the rated on a 6-point scale). There were also 13 items dealing with
planned measures were vetted by experts familiar with each racial/ health problems, each rated on a 5-point scale based on number of
ethnic group, experts who had engaged in multiple studies on those days in the past month the adolescent had experienced a particular
groups. Third, the planned measures were vetted by supervisors condition (no days to 15⫹ days). These last 13 were summarized
and data collectors at all sites; and only those approved by all were to produce an overall health problems score. Adolescents com-
used. Fourth, data collectors kept records of each data collection, pleted the survey in private while the parents completed surveys
with comments made pertaining to possible difficulties pertaining pertaining to family background.
to misinterpretation of measures by participants. When difficulties
were identified—there were very few—the data were recorded as
Statistical Analysis
missing.
Data collection procedures. Before collecting data, the pro- Descriptive statistics were computed for the four primary mea-
cedures for data collection were fully explained to all participants. sures used in the study (two dimensions from LA-HOME, per-
Signed written consents were obtained from all Participants 18 ceived endurance, recent health problems). Bivariate correlations
years of age and older, in accordance with procedures approved by were performed between scores on the two LA-HOME dimensions
the institutional review board (IRB) at all four collaborating insti- for each group; and bivariate correlations were also performed
tutions (Arizona State University, University of California—Los between scores on the two health outcomes. Bivariate correlations
Angeles, University of Arkansas for Medical Sciences, Cherokee were also performed between scores in the overall index of family
Nation). Those under the age of 18 provided assent, as approved risk and scores from the two LA-HOME dimensions and two
by the IRBs. health outcomes. Based on preliminary analyses described below,
Family background. Parents completed a 23-item survey, two multiple regression analyses were run for each racial/ethnic
adapted from the American Community Survey (ACS; U.S. De- group, one using perceived endurance as the outcome and the
 742 BRADLEY

second using health problems as the outcome. Each regression
model included the two LA-HOME dimension scores and gender.
Results
Preliminary Analyses
As Table 2 shows, most adolescents reported reasonably high
levels of endurance. Specifically, less than 10% responded “false”
or “mostly false” to the item pertaining to endurance. Correspond-
ingly, few reported having a significant health problem. Scores for
most families on the two LA-HOME dimensions were also rea-
sonably high, with less than 10% scoring below 5 on the Physical
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correlation between Physical Environment and health problems
was significant for Latinos (r ⫽ ⫺.19). By contrast, bivariate
correlations between scores on Companionship and Investment
and endurance were significant in all three groups (r ⫽ .21 to .41).
In addition, correlations between Companionship and Investment
and health problems were significant for Native Americans
(r ⫽ ⫺.24) and African Americans (r ⫽ ⫺.31); not quite signif-
icant for Latinos.
Regression Analyses
To further the goal of better characterizing the interplay of
social and physical determinants of adolescent health in the three

Environment dimension (out of nine items) and less than 15% groups being examined, each health outcome was regressed on
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scoring below 5 on the Companionship dimension (out of 10 both LA-HOME dimensions while also considering gender. The
items). Correlations between scores on Physical Environment and cumulative household risk index was not included in the models
scores on Companionship and Investment for the three groups based on preliminary analyses showing that scores on the index
were moderate (r ⫽ .19 to .48). Correlations between the two were not related to the two health outcomes being examined. We
health indicators were also moderate in strength (r ⫽ ⫺.25 executed these three-variable models given limitations in the sam-
to ⫺.42). ple sizes available— especially for Native Americans—and based
Because contextual factors can make it more difficult for parents on information from prior research showing that both of the home
to engage their children in supportive ways and evidence showing environment dimensions included in the models were related to
the cumulative household risk predicts poor health during adoles- household socioeconomic status (Bradley et al., 2019). The com-
cence (Adler & Newman, 2002; Cabrera et al., 2013; Lin & Seo, bined set of findings reduced concerns about spuriousness that
2017), we wanted to determine how contextual risk was associated might result from executing the three-variable regression models
with both family environment dimensions and both health out- used in this study. What emerged from the six regression analyses
comes being examined. As expected, scores on four-indicator run (2 outcomes ⫻ 3 racial/ethnic groups) can be seen in Tables 3
index of family risk described above were significantly related to and 4. Specifically, Companionship and Investment was a signif-
both the Physical Environment LA-HOME dimension score icant predictor of health outcomes in four of the six models
(r ⫽ ⫺.44 to ⫺.73) and the Companionship and Investment run—and nearly significant in a fifth. By contrast, scores on
dimension score (r ⫽ ⫺.16 to ⫺.35) in all three groups. However, Physical Environment were only significant for Native Americans
scores on the risk index were not significantly related to either for endurance (see Table 3) and for Latino adolescents for health
perceived endurance or to number of recent health problems in any problems (see Table 4).
group.
Bivariate correlations between gender and the two health out-
Discussion
comes were also computed. Correlations were significant in all
three ethnic/racial groups for recent health problems (r ⫽ .20 to Researchers, policymakers, and philanthropic organizations
r ⫽ .26); and they were significant for all three groups for continue to express interest in better understanding environmental
perceived endurance (r ⫽ ⫺.22 to r ⫽ ⫺.28). factors responsible for poor health, including social determinants
Bivariate correlations between scores on Physical Environment of health disparities (Adler & Newman, 2002; Centers for Disease
and endurance were nonsignificant for all groups. However, the Control and Prevention, 2018; Newman et al., 2008; Viner et al.,
2012). Williams and colleagues (2016) make the case for more
fully delineating the factors implicated in health, especially for
Table 2 members of minority groups that face discrimination and higher
Descriptive Statistics for Home Environment and Health than ordinary levels of adversity, as such information can help
Status Measures inform interventions that may help moderate negative impacts on
health. This recommendation seems useful given earlier findings
Minority group showing substantial residual variance in health status even ac-
Native African counting for socioeconomic conditions for Native American, Af-
American American Latino rican American, and Latino youth (Wen, 2007). Findings from this
Measures M SD M SD M SD study are fairly clear in pointing to one aspect of family life that
appears important for Native American, African American and
Health Latino adolescents, family connectedness. This aspect of family
Endurance 3.24 1.16 3.48 1.32 3.25 1.36
Health problems .06 .23 .07 .25 .09 .29
life, measured using Companionship and Investment from LA-
Home environment HOME, was significantly related to perceived endurance in all
Physical environment 7.30 1.91 7.56 1.73 7.91 1.45 three groups and to health problems in two of the three. Moreover,
Companionship 6.91 2.09 6.88 1.96 6.47 2.11 it was a significant predictor in four of the six regression models,
Note. Latino families had higher scores on physical environment than even with Physical Environment and gender included in the mod-
Native American and African American families. els. Broadly speaking, these findings correspond to the idea that
 HOME LIFE AND ADOLESCENT HEALTH 743

Table 3
Regression Analyses Involving Dimensions of Home Environment and Endurance by
Race/Ethnicity

Native American African American Latino

Predictors B SE B ␤ B SE B ␤ B SE B ␤
ⴱ
Physical environment ⫺.22 .08 ⫺.36 .04 .08 .05 .02 .06 .02
Companionship and investment .31 .07 .55ⴱ .12 .06 .17 (.07) .21 .06 .33ⴱ
Gender ⫺.59 .28 ⫺.25ⴱ ⫺.85 .23 ⫺.32ⴱ ⫺.90 .26 ⫺.33ⴱ
R2 .33 .15 .14
F 7.94ⴱ 6.66ⴱ 6.78ⴱ
ⴱ
p ⬍ .05.
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social support can lead to the perception that one has control over
one’s life, a factor that has been theoretically and empirically
linked to better health (Thoits, 2011).
It would appear worth noting that gender emerged as a signif-
icant factor in almost every analysis conducted as part of the study,
with adolescent females reporting both lower levels of endurance
and higher levels of health problems than adolescent males. That
said, the gender differences were small, with few adolescents of
either gender reporting significant issues pertaining to endurance
or a recent health problem. Because few adolescents reported high
levels of health problems, the exact meaning of the findings
pertaining to gender is difficult to discern. It would seem useful to
note that adolescents served as reporters for both endurance and
recent health problems. Prior research suggests that the gender
differences in these reports may reflect gender differences in
coping style rather than poorer health among Native American,
Latino, and African American adolescent females per se (Wilson,
Pritchard, & Revalee, 2005). There is evidence that adolescent
females more often use emotion-focused coping strategies; and,
specifically that they report more health problems and anxiety than
do males. By contrast, adolescent males are more likely to report
that they engage in risky behavior (Wilson et al., 2005). Critically,
when gender was included in the regression models, significant
associations were observed between home environment factors
and adolescent health. Thus, it would appear worthwhile for schol-
ars to examine how coping strategies might fit into the equation.
Among Native Americans, scores on the Companionship and
Investment dimension of LA-HOME were significantly related to
perceived endurance and almost significantly related to number of
health problems. By contrast, findings pertaining to the Physical
Environment dimension appear to be something of an anomaly.
The findings pertaining to Physical Environment scores among
Native Americans appear to be a classic suppressor effect (Smith,
Ager, & Williams, 1992). More specifically, relations between
scores on the Physical Environment dimension of LA-HOME and
endurance were nonsignificant, whereas relations between scores
on the Physical Environment and Companionship dimensions of
LA-HOME were strong (r ⫽ .46). This, in concert with the
significant negative beta for Physical Environment in the regres-
sion equation, indicates that scores on the Physical Environment
domain help reduce problems in the measurement of endurance;
thus, allowing the relation between Companionship and endurance
to become more fully evident. These findings appear consistent
with ideas from Self-Determination Theory; specifically, when an
individual’s needs for relatedness and autonomy are met (that
would be more likely when scores on Companionship and Invest-
ment are high), then the individual is likely to have greater vitality
(Joussemet et al., 2008).
Matthews and colleagues (2017) found that a good overall
parenting environment during adolescence was associated with
better cardio-metabolic health in adulthood for African American
males. Findings from this study indicate that the positive impacts
on health status for African Americans begin even earlier. Scores
on Companionship and Investment were significantly related to
both outcomes examined for African American adolescents—al-
beit, only marginally so for perceived endurance. These results for
African American adolescents are not surprising in light of re-
search in Australia showing that positive parenting during encoun-
ters between parents and adolescents that could induce stress were
associated with lower levels of inflammatory markers in adoles-
cents (Byrne et al., 2017). It is also consistent with research
showing how joint planning, good communication and connected-

Table 4
Regression Analyses Involving Dimensions of Home Environment and Health Problems by
Race/Ethnicity

Native American African American Latino

Predictors B SE B ␤ B SE B ␤ B SE B ␤

Physical environment .67 .63 .17 .29 .38 .07 ⫺.73 .38 ⫺.15ⴱ
Companionship and investment ⫺1.08 .57 ⫺.30 (.06) ⫺1.17 .33 ⫺.33ⴱ ⫺.67 .27 ⫺.20ⴱ
Gender 2.57 2.21 .16 2.56 1.15 .19ⴱ 4.57 1.14 .32ⴱ
R2 .11 .13 .14
F 1.88 6.44ⴱ 8.09ⴱ
ⴱ
p ⬍ .05.
 744 BRADLEY
ness between parents and children tends to increase attachment
security and reduce psychological complaints (Moreno et al.,
2009; Resnick et al., 1997; Ruhl, Dolan, & Buhrmester, 2015;
Viner et al., 2012). Pietromonaco et al. (2013) have argued that a
secure attachment can serve to protect health under conditions of
challenge because attachment processes help determine how peo-
ple regulate their emotions and behavior. Thus, those with a secure
attachment are both more likely to engage in productive health
behaviors and to avoid behaviors that can be harmful to health. The
findings would seem to have particular relevance for African
American adolescents given that many face discrimination and
many experience high rates of adversity during childhood (Slopen
et al., 2016). Spending time together and engaging in productive
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
communications may help foster resilience in African American
This document is copyrighted by the American Psychological Association or one of its allied publishers.
youth, particularly if the communications include racial socializa-
tion (Brown & Tylka, 2011).
It can be challenging to study Latino youth in that they come
from families that vary considerably by country of origin; and the
children vary considerably with respect to nativity and accultura-
tion (Murphey, Guzman, & Torres, 2014). Even so, in the current
study sample of Latino families from the greater Los Angeles, CA
and greater Phoenix, AZ areas, scores on Companionship and
Investment were significantly associated with both perceived en-
durance and number of recent health problems, even with Physical
Environment included in the models. The latter is consequential, in
that Latino families often live in conditions of poverty; and many
reside in multigenerational households and homes where family
members share bedrooms with several other family members (Ev-
ans, 2006; Murphey et al., 2014). The findings are consistent with
research showing that family cohesion reduced the likelihood
Latino youth would engage in violent behavior, a potential source
of injury; and it is consonant with the idea of familism as a
protective factor in Latino communities (Estrada-Martínez et al.,
2011). The findings are also consistent research showing that
family cohesion and parent– child communication reduced mari-
juana use in Latino youth (Lac et al., 2011).
Adler and Newman (2002) identified isolation, low social co-
hesion, and lack of engagement in social networks as major path-
ways through which low SES impacts health among adults. Find-
ings from this study suggest that such processes begin before
adulthood, as appears to be the case for many of the environmental
hazards that are implicated in disease (Centers for Disease Control
and Prevention, 2018; Currie et al., 2012). Maintaining strong
family bonds may be particularly valuable for adolescents from
minority groups that face adversity, given that such families are
less likely to have good health and dental care (Dye et al., 2012;
Flores & Lin, 2013; Guarnizo-Herreño & Wehby, 2012; U.S.
Department of Health and Human Services, Indian Health Service,
2017). Ongoing communications may increase the likelihood that
parents will invest the energy needed to acquire such care. Ongo-
ing communications also increases the likelihood parents can
monitor the activities of children, including those like use of
alcohol and drugs that are inimical to good health (Lac & Crano,
2009).
Findings from this study pertaining to the physical accouter-
ments of the home environment stand somewhat in contrast to the
findings pertaining to parent– child communication. Few statisti-
cally significant associations between scores on the HOME Phys-
ical Environment dimension and adolescent health emerged. That
said, the findings are consistent with prior research showing that
most negative of impacts of low quality housing were in the areas
of adaptive behavior and competence (Ferguson et al., 2013). Our
findings should be viewed with some caution, nonetheless, given
that most study families did not live in seriously dilapidated homes
or in highly dangerous neighborhoods. On the other hand, it should
be noted that Latino adolescents in the current study reported
fewer health problems if they lived in homes with better physical
accouterments.
Limitations
This study, like most others, has limitations. Measures used in
the study do not capture either the home environment or the health
constructs in their full extensity. In addition, the sample is not fully
representative of the three ethnic/racial minority groups examined,
even granting that there was diversity by geography, social status,
and family configuration. A third limitation pertains to fact that
most of the participants did not live in seriously dilapidated hous-
ing or residences lacking basic amenities like electricity and indoor
plumbing; thus, reducing the likelihood of finding significant
relations between scores on the Physical Environment dimension
of LA-HOME and adolescent health. Fourth, all the data were
collected at a single time point making causal attributions about
observed relations problematic. Finally, the study was not struc-
tured in a way that controlled for potential genetic or epigenetic
influences on the relations examined. This fifth limitation connects
to broader concerns pertaining to potential omitted variables or
selection biases. When Fomby and Cherlin (2007) looked at the
literature on relations between family instability and child well-
being, they found substantial support for the idea that maternal
characteristics accounted for many of the observed relations. Ac-
cordingly, it is not appropriate to interpret the associations ob-
served in this study as representing causal connections. These
limitations granted, the findings appear to offer more details about
the landscape of adolescent health. What remains striking about
the findings is the seeming value of family connectedness with
respect to adolescent health status in all groups.
Conclusions
Physical health does not appear to be a simple derivative of
living in conditions of poverty but appears to reflect the interplay
of a more diverse set of factors connected to adolescent life.
Bannink, Broeren, Joosten-van Zwananburg, de Looij-Jansen, and
Ratt (2014) found that the quality of parent-adolescent relation-
ships was related to adolescent mental health; and Hair, Moore,
Hadley, Kaye, Day, and Orthner (2009) found that the quality of
parent–adolescent relationships was related to overall health in
early adulthood. However, in both studies there were interactions
with other family conditions (e.g., marital quality, number of
negative life events). Findings from this study (along with findings
from those two studies) suggest that practitioners and policymak-
ers concerned with adolescent health would benefit from taking a
more nuanced view of family life among ethnic/racial minority
families.
The findings from this study, together with the larger canon of
studies about family life and adolescent development, suggest that
additional efforts be made by those in the health, human services,
 HOME LIFE AND ADOLESCENT HEALTH
and juvenile justice industries to promote productive communica-
tion between adolescents and members of their families (i.e.,
respectful exchanges dealing with planning and problem solving).
Additional efforts by personnel in these industries should also be
directed toward encouraging engagement between parents and
offspring in mutually enjoyable and enriching activities, activities
that by their nature foster family cohesion. Although it was not the
aim of this study to consider all the mechanisms that might be
involved in relations between aspects of home life and adolescent
health, the findings from this study, together with findings from
other studies suggest that having a strong bond with parents enables
adolescents to build a sense of personal identity and agency (Klimstra,
Hale, Raaijmakers, Branje, & Meeus, 2010; Koepke & Denissen,
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
2012). Having a positive sense of identity and agency, in turn, helps
This document is copyrighted by the American Psychological Association or one of its allied publishers.
promote good health (Currie et al., 2012). Currently, there are not
many evidence-based programs that address these issues, particularly
programs that have been successful when used with the three racial/
ethnic groups examined in this study. Terzian and MBwana (2009)
reviewed parenting programs aimed at improving outcomes for ado-
lescents and observed mixed, often weak impacts on outcomes. Many
models would seem worth considering, including those that utilize
cell phones or computers as the delivery system, particularly since it
can be difficult to engage parents and adolescents in programs that
require visits to offices or agency settings (Terzian & MBwana, 2009;
Toombs, Unruh, & McGrath, 2018). To make it easier for parents to
attend, programs at the parents’ worksite would also seem to have
potential (Eastman, Corona, & Schuster, 2006). In mounting pro-
grams, thought needs to be given to cultural differences in beliefs
(e.g., familism, respect for elders) and practices that may affect
parent-adolescent relationships (Gutman et al., 2017). A good exam-
ple is the Talking Circle program designed for use in Native American
communities (Hodge & Nandy, 2011). All this said, efforts to im-
prove communications and joint activities between ethnic/racial mi-
nority parents and their children should be approached with care and
with attention to adult needs as well, given the stresses and resource
limitations that often permeate ethnic/racial minority households in
the United States. Moreover, future research should consider even
more nuanced examinations of relations between family conditions
and adolescent health, particularly with respect to adolescent gender,
family composition, and key adolescent conditions (e.g., presence of
disability, attention-deficit-hyperactivity disorder (ADHD), bipolar
illness, and schizophrenia).
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Received April 6, 2018
Revision received April 4, 2019
Accepted April 28, 2019 䡲