Socioeconomic gradients of early pubertal development and menarche across racial/ethnic groups: Findings from a nationally representative sample of adolescent girls in the US

In recent decades, the trend towards earlier ages at menarche and pubertal development among girls in the US has become a growing concern. Evidence suggests that early-maturing girls are at higher risk for negative physical and mental health outcomes and behaviors in adolescence as well as later in life, including early sexual initiation and pregnancy, substance abuse, depression, obesity, cardiovascular disease, and breast cancer. While pubertal development is in part determined by various endogenous factors, socioenvironmental factors also play significant roles in influencing timing of pubertal development. Racial/ethnic differences in pubertal development have been found among girls in the US, with African American girls experiencing earlier development than white girls, and Mexican American girls showing intermediate patterns. To better understand these racial/ethnic differences and parse out socioeconomic influences, this study uses data from the National Longitudinal Study of Adolescent Health to examine socioeconomic gradients of early pubertal development among a nationally representative sample of white, African American, and Hispanic adolescent girls in the US. We specifically examine how age at menarche and breast development are associated with parental education, and how these patterns may vary across racial/ethnic groups. We use multivariate regression models stratified by race/ethnicity and account for other factors such as body mass index, diet, birthweight, family structure, and physical and sexual abuse. Information on groups at high risk for early pubertal development is useful for effectively targeting health and policy interventions aimed at disease prevention and elimination of health disparities.