This study was designed to determine whether black adolescents from disadvantaged backgrounds who have an unrelenting determination to succeed would, as adults, show “skin-deep resilience” by faring well in psychosocial domains but also show a heightened chance of having a chronic disease, specifically type 2 diabetes.


Secondary data analyses were executed with the use of waves 1 and 4 of the US Longitudinal Study of Adolescent to Adult Health (Add Health). At wave 1, when participants were age 16, data were obtained on a behavioral style termed “striving.” Striving includes high aspirations, unwavering persistence, investment in education, and avoidance of activities that sidetrack success. At wave 4, when participants were age 29, college graduation, personal income, symptoms of depression, and type 2 diabetes status were assessed.


Black and non-Hispanic white youth who displayed striving during adolescence evinced, at age 29, a higher likelihood of college graduation, greater personal income, and fewer symptoms of depression than did nonstrivers. Among black participants, the findings were consistent with the “skin-deep resilience” pattern for type 2 diabetes. High-striving black adolescents in the most disadvantaged families had a greater likelihood of developing type 2 diabetes during adulthood than did similar high-striving black adolescents living in more privileged families. The skin-deep resilience pattern did not emerge among non-Hispanic white participants.


This study is the first to show that an unrelenting determination to succeed among black adolescents from disadvantaged backgrounds forecasts an elevated risk of developing type 2 diabetes during adulthood.

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