A Longitudinal Investigation of Race, Socioeconomic Status, and Psychosocial Mediators of Allostatic Load in Midlife Women

Abstract

Objectives This research sought to assess racial and SES differences in level and change in allostatic load (AL) over time in midlife women and to test whether psychosocial factors mediate these relationships. These factors were: discrimination, perceived stress, and hostility. Methods Longitudinal data obtained from the Study of Women’s Health Across the Nation SWAN were used (n = 2063; mean age at baseline = 46.0). Latent growth curve (LGC) models evaluated the impact of demographic, menopausal, and psychosocial variables on level and change in AL over 8 years. Results Direct effects: High levels of discrimination and hostility significantly predicted higher AL (path coefficients 0.05, 0.05 respectively). High perceived stress significantly predicted a faster rate of increase of AL (path coefficient 0.06). Racial and socioeconomic status (SES) differentials were present, with African American race (path coefficient 0.23), low income (path coefficient −0.15), and low education (path coefficient −0.08) significantly predicted high AL level. Indirect effects: Significant indirect effects were found for African American race, less income, and lower education through higher discrimination, perceived stress, and hostility on level and rate of AL. Conclusion This was one of the first studies that investigated AL over multiple time periods and results supported AL as a cumulative phenomenon, affected by multiple psychosocial and demographic factors. The results suggest the complex ways in which race, SES, and psychosocial factors operate to influence AL.

Allostatic load and biological anthropology

“…In addition, with increasing age, most individuals likely experience more stressful events than those of younger ages. Expectedly, positive relationships of age with allostatic load are observed across samples (Crimmins et al, 2003;Crimmins, Kim, & Seeman, 2009;Dich et al, 2015b;Doamekpor & Dinwiddie, 2015;Karlamangla et al, 2006;McClure et al, 2015;Riva et al, 2014;Robertson & Watts, 2016;Rosenberg et al, 2014;Schnorpfeil et al, 2003;Seeman, Epel, Gruenewald, Karlamangla, & McEwen, 2010;Seeman et al, 2008;Seeman, Merkin, Karlamangla, Koretz, & Seeman, 2014;Upchurch, Rainisch, & Chyu, 2015;Upchurch, Stein, et al, 2015;Vie et al, 2014;Zilioli, Slatcher, Ong, & Gruenewald, 2015). Within age cohorts, however, substantial variation in allostatic load may be observed.…”

“…For example, socioeconomic status (SES; McEwen & Seeman, 1999;Seeman et al, 2008Seeman et al, , 2010 and lifestyle choices (e.g., physical activity and smoking; Gay et al, 2015;Kusano et al, 2016;Lipowicz et al, 2014;McEwen, 1998aMcEwen, , 1998bMcEwen, , 2001McEwen, , 2004bSeeman et al, 2010) reported for "nonwhite" study participants, a difference that may be driven by discrimination and race-related hostility (Upchurch, Rainisch, et al, 2015;Upchurch, Stein, et al, 2015). When foreign-born and US-born "blacks" were compared, foreign-born "blacks" were observed to have lower allostatic load at adulthood (Doamekpor & Dinwiddie, 2015).…”

Community-based participatory research to design a faith-enhanced diabetes prevention program: The Better Me Within randomized trial

“…For example, allostatic load, a composite of several biological measures representing dysregulation due to prolonged exposure to stress, has been shown to increase the “wear and tear” on the body [14], with data showing allostatic load is higher in AA as compared to White females [14, 15]. Further, the influence of sex hormones such as estradiol on stress responses are not fully understood and could alter responses to intervention [16–18].…”

Origins of heath inequalities: the case for Allostatic Load

“…As we have discussed, it will be interesting to see what happens to the AL score in the era of systems medicine based on big data. But whatever algorithms are used, it takes more than de--contextualised measurements to appreciate the balance between gaining and draining factors in a clinically meaningful and ethically responsible way (Evans, 2003;Juster et al, 2015;Repetti, Robles, & Reynolds, 2011;Upchurch et al, 2015). From the clinical viewpoint we might speak of a capacity for integrative perception that might at some point become conceptually linked to professional empathy (Ferrari, 2014).…”