Navigating the minority grief paradox: racial-ethnic differences on parental death, social ties and early-midlife psychological distress in the United States

The death of a parent can profoundly impact psychological and social functioning, particularly among racial-ethnic minority groups. Using data from the National Longitudinal Study of Adolescent to Adult Health (N = 9,508), the current study compared the association between parental death timing during different life stages and early-midlife depressive and perceived stress symptoms ('psychological distress') across racial-ethnic identities, while accounting for early-midlife social support and strain. We also investigated the mediating effects of cumulative social support and strain between life course timing of first parental death and midlife psychological distress using the Karlson-Holm-Breen (KHB) method. We found that Black individuals experienced the highest frequency of parental death beginning earlier in life. Stepwise linear regression models showed that parental death during young adulthood and early midlife is associated with early-midlife psychological distress among White individuals, net of covariates. Our results among Black and Hispanic adults indicate that the life course timing of parental death was unrelated to early-midlife psychological distress, exposing an understudied area of the 'Minority Mental Health Paradox'. Early-midlife social support and strain were strongly associated with early-midlife psychological distress across racial-ethnic identities. The KHB mediation analysis further revealed that cumulative social support in midlife independently accounted for approximately 16 per cent and 20 per cent of the association between parental death in young adulthood and midlife stress and depressive symptoms, respectively. Our study highlights that bereavement programmes could tailor interventions to address variations in midlife social support and strain across different racial-ethnic groups to mitigate psychological distress.