Socioeconomic status, stress and mortality: A life course approach.

摘要

The link between socioeconomic status (SES) and health and mortality has been well-established, but evidence continues to suggest that this relationship begins in early life with parental SES. There is evidence that allostatic load (AL) mediates the relationship between SES and mortality, and SES is inversely associated with AL across the life course (Seeman et al. 2004; Seeman et al. 2008; Hawkley et al. 2011; Evans & Kim, 2012). Existing longitudinal studies using biologically objective health outcomes are limited, and this study incorporates measures of both perceived stress and the body's physiological response to stress, observed over time, in older adults. Using the National Social Life, Health, and Aging Project (NSHAP), this dissertation aims to fill gaps in the literature by exploring the associations between socioeconomic status across the life course, allostatic load, and mortality. I examine 1) how SES in childhood affects SES, perceived stress, and allostatic load in older adults; 2) how childhood SES affects change in allostatic load over 5 years; and 3) if childhood SES indirectly impacts mortality risk through SES and stress in late adulthood.;Results add to existing findings by showing significant relationships between SES and mortality in late adulthood, with allostatic load and perceived stress partially explaining this relationship. Results also contribute to the field showing an indirect relationship between childhood SES and allostatic load in late life. Individuals who grew up in low SES households show significantly higher allostatic load scores in late adulthood. This association is mediated mostly by educational attainment, but wealth also plays a role. This study also provides two examples for studying allostatic load across two time points, and results show that childhood SES affects allostatic load change in a similar manner to a singular measure. The findings highlight the importance of the association between childhood SES and adult educational attainment, as the effects carry over into many adult outcomes.