Socioeconomic status (SES) is an important predictor of a range of health and illness outcomes. Research seeking to identify the extent to which this often-reported effect is due to protective benefits of higher SES or to toxic elements of lower social status has not yielded consistent or conclusive findings. A relatively novel hypothesis is that these effects are due to chronic stress that is associated with SES; lower SES is reliably associated with a number of important social and environmental conditions that contribute to chronic stress burden, including crowding, crime, noise pollution, discrimination, and other hazards or stressors. In other words, chronic stress may capture much of the variance in health and social outcomes associated with harmful aspects of lower social status. Low SES is generally associated with distress, prevalence of mental health problems, and with health-impairing behaviors that are also related to stress. Research targeting this hypothesis is needed to determine the extent to which stress is a pathway linking SES and health.

This article describes a 6-item scale, the Life Engagement Test, designed to measure purpose in life, defined in terms of the extent to which a person engages in activities that are personally valued. Psychometric data are presented including information about the scale's factor structure, internal consistency, test-retest reliability, convergent validity, discriminant predictive validity, and norms. The data suggest that the Life Engagement Test is psychometrically sound across different gender, age, and ethnic groups and is appropriate for wider use. Discussion centers on the use of the Life Engagement Test in behavioral medicine and health psychology research and recent associations that have begun to emerge between the scale and health-relevant outcomes.

Lower SES was associated in a graded fashion with higher basal levels of cortisol and catecholamines. These associations occurred independent of race, and the data were consistent with mediation by health practices and social factors.