Higher economic status reduces stress but increases heart health risks


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Researchers say people moving up or down the economic ladder may face higher heart health risks than those whose status remains more constant. Getty Images
  • Researchers report that people who move up the economic ladder tend to have better mental health, but also higher risks of cardiovascular disease.
  • They say that many people who improve their socioeconomic status still have childhood health issues.
  • They add that sometimes people who are evolving are so focused on their work that they do not maintain good health habits.

Advancement in socioeconomic status can improve some areas of life, but when it comes to heart health, it’s not that simple.

Research published today in the Journal of the American Heart Association found that while upward income mobility improved a person’s mental health, their cardiometabolic health was worse.

“Upward mobility is not always beneficial for cardiometabolic health, although it improves economic conditions and mental health,” said Greg miller, PhD, research author and co-director of the Foundations of Health Research Center at Northwestern University in Illinois.

“Most of the time, higher socioeconomic status means better health. But not in everyone, not in all diseases, ”Miller told Healthline. “And as our work shows, the health benefits of high socioeconomic status somehow depend on how one becomes high socioeconomic status.”

In undertaking the research, Miller, working with researchers at Northwestern and the University of Georgia, analyzed data from two studies spanning several decades.

The 7,542 participants in the National Longitudinal Study of Adolescent Health and 1,877 participants in the Midlife in the United States Study entered the studies when they were young and were followed into adulthood.

The researchers classified the participants into groups based on their family’s income during childhood and adulthood.

The four groups were those who suffered constant disadvantage; those who have enjoyed a constant advantage; those who were upwardly mobile (meaning an increase in socio-economic status compared to childhood); and those who have experienced downward mobility.

The researchers said they found that those who were mobile upward had less perceived stress and fewer symptoms of depression. But they have experienced higher rates of metabolic syndrome, a set of conditions that increase the risk of heart attack, stroke, and diabetes.

Higher socioeconomic status is generally associated with fewer health problems. However, the study suggests that an improvement in financial conditions does not necessarily equate to an improvement in cardiometabolic health.

“Many of us would have intuitively thought that if we improved our financial situation, we would be able to reap the health benefits associated with that financial improvement, and that could include less diabetes, less obesity, less of poor cardiometabolic health… in this regard, it’s surprising, ”said Dr Robert Harrington, interventional cardiologist and chairman of the department of medicine at Stanford University in California.

“What’s not surprising, and perhaps what’s consistent with other things we know, is that lifelong cardiovascular health dates back to the peripartum period,” Harrington told Healthline.

“In other words, we know that the cardiovascular and cardiometabolic health of the mother play a role in the life of the cardiovascular health of the child,” he said.

Cardiometabolic syndrome includes conditions such as high blood sugar, high blood pressure, higher levels of body fat around the waist, and abnormal levels of cholesterol.

Dr Nieca Goldberg, medical director of the NYU Langone Women’s Heart Attack Program and volunteer expert for the American Heart Association, says those trying to improve their socioeconomic status may have a lifestyle that contributes to these risk factors.

“People who are trying to be financially successful often focus on the work or jobs they need to do to be economically successful at the expense of cardiometabolic risk,” she told Healthline.

“Cardiometabolic risk factors which include high blood pressure, central obesity (abdominal fat), high blood sugar, low HDL (good cholesterol) and high triglycerides depend on lifestyle, and people with mobility ascendant may find it difficult to fit exercise into their already busy schedule. , eat prepared meals or processed foods because they are pressed for time, ”she added.

Miller notes that people whose status remains constant tend to have better health outcomes.

Dr Michelle J. Ko, an assistant professor in the division of health policy and management at the University of California at Davis, says those who fall into the consistent category may not experience the same stressors as those who are mobile upward .

“Those who have a consistent benefit throughout their lives are likely to face a lot less stressors to maintain their status,” Ko told Healthline. “As children, they have received social, educational, cultural and social benefits, which allow them both to remain advantaged and to navigate that social status. Those with upward mobility face multiple stressors: how to get there, how to stay there, how to balance the needs of family and friends who are not doing as well. ”

On top of that, Ko says an increase in income doesn’t guarantee you can live in an area that promotes healthy living.

“Those with upward mobility don’t necessarily have the wealth to settle in neighborhoods with factors that promote good cardiovascular health, such as clean air, lower levels of environmental contamination, better options for shopping. healthy foods or an open, safe space for exercise. and recreation, ”she said.

The Northwestern study found that those who were upwardly mobile and those who were consistently disadvantaged fared the worst when it came to their cardiometabolic health.

Harrington says that a person’s socioeconomic status can influence their cardiovascular health in several ways.

“We know that people with higher socioeconomic status generally have better cardiovascular health than people with lower socioeconomic status,” he said.

“In other words, an individual of lower socioeconomic status with cardiovascular disease will fare worse on average than an individual of higher socioeconomic status when associated with the same cardiovascular disease. .

“There’s also an interplay between the socio-economy and access to adequate medical care… which includes things like blood pressure monitoring, diabetes screening, cholesterol screening, the kinds of things that are. readily available as preventative health measures for those of a certain socioeconomic class, but not all, ”said Harrington.

Harrington says that when people are trying to improve their socioeconomic status, attention should also be paid to improving their cardiovascular health.

“As people evolve and improve their socio-economic status, there is also a need to pay increased attention to lifestyle issues that portend better cardiovascular health: quitting or avoiding smoking, taking care of blood pressure, control blood sugar. , control your weight, have a lifestyle that includes regular physical activity, ”he said.

“Everyone we know of is associated with good long-term cardiovascular health, and that’s what we need to aim for,” said Harrington.

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