Social class is a robust predictor of health, with risk for disease and mortality increasing towards the lower end of the socioeconomic (SES) spectrum. While certain psychological characteristics, such as high sense of control, can protect low-SES individuals from adverse health outcomes, very few studies have investigated the biological mechanisms underlying these relationships. In this study, we tested whether sense of control mitigated the associations between SES and cortisol activity, and SES and physical health in daily life (i.e., number and severity of physical symptoms). Next, we tested whether individual differences in cortisol secretion would act as a mechanism by which SES and perceived control influenced physical health. In a large national sample from the Midlife in the United States (MIDUS) survey, we found that SES interacted with perceived control in predicting morning cortisol levels, cortisol slopes, number of physical symptoms, and severity of physical symptoms. Specifically, SES disparities in these health outcomes were more pronounced among individuals reporting low levels of perceived control than among individuals endorsing high levels of perceived control. Further, we found that a flatter cortisol slope mediated the link between lower SES and greater number and severity of physical symptoms for those individuals who reported lower levels of perceived control, but not for individuals reporting higher levels of perceived control. These findings suggest that perception of greater control may act as a buffer of against the effect of low SES on health-related physiological processes.

The association between SES and health is well established; however, only a handful of studies have investigated the relationship between SES and daily cortisol parameters. Further, within this small literature, virtually no studies have looked at psychological factors that might mitigate this relationship. In this study, we tested whether life satisfaction—the overall subjective affective assessment of one’s own life—acts as a protective factor against cortisol dysregulation driven by low-SES. Among a large sample (N = 1,325) of individuals from the Midlife in the United States (MIDUS) survey, we found that low-SES individuals with high levels of life satisfaction had a cortisol circadian profile similar to those of high-SES individuals. In contrast, low-SES individuals reporting low life satisfaction experienced attenuated morning cortisol concentrations and a flatter (“less healthy”) diurnal cortisol slope. Although more studies are needed to investigate the constellation of psychological resources and processes through which life satisfaction exerts its effects, the current work shows that the general affective evaluation of one’s own life acts as a buffer against the detrimental effect of low-SES on health-related physiological processes.

Close relationships are known to predict physical health outcomes. The time has come for a shift toward achieving a better understanding of the underlying mechanisms. One promising group of psychological mechanisms is affective processes, such as discrete emotions, emotion regulation, and affect reactivity. In this paper, we discuss the evidence linking relationship functioning with both the positive and negative valences of each affective process, considering the contributions of different types of close relationships across the lifespan, and the evidence for each affective process impacting physical health. We note evidence suggesting that affective processes may also have a causal impact on relationship function. When available, we review literature testing full mediational pathways, from relationship functioning to affective processes to physical health, as the ideal methodology for testing these links. Finally, we identify core themes and propose key future directions for this research.

Perceived partner responsiveness (PPR)—the extent to which people feel understood, cared for, and appreciated—has been identified as an organizing principle in the study of close relationships. Previous work indicates that PPR may benefit physical health and well-being, but how PPR is associated with personal benefits is less clear. One cognitive mechanism that may help to explain these associations is perceived control. Here we tested two competing models (moderation vs. mediation) in which we assessed whether perceived control might explain how PPR impacts health, well-being, and mortality in a 20-year longitudinal study of adults ( N = 1,186). We found that PPR has a long-term positive association with health, well-being, and mortality via increased perceived control and, in turn, decreased negative affect reactivity to daily stressors. These findings have important implications for understanding the cognitive mechanisms that link PPR to health and well-being.