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Social Disparities, Stress & Health

College Graduation Helps and Hurts Disadvantaged Minorities’ Health

College graduates live longer, healthier lives than people who do not graduate from college, but the effects are not the same across races. In Proceedings of the National Academy of Sciences, IPR health psychologists Edith Chen and Greg Miller outline the differential returns to educational attainment for American minorities. They find that college completion predicts lower rates of depression for all racial groups, as well as lower rates of metabolic syndrome—a group of risk factors that predict diabetes, stroke, and heart disease—among whites. However, African Americans and Hispanics from disadvantaged backgrounds who graduated college had higher rates of metabolic syndrome. The results suggest that upward mobility has negative effects on physical health for young minorities in the United States. Chen is the John D. and Catherine T. MacArthur Professor of Psychology, and Miller is the Louis W. Menk Professor of Psychology.

Discrimination Affects Stress, Health

IPR psychobiologist Emma Adam has found that discrimination is associated with chronic stress, with adolescent experiences having particularly strong effects on adult stress biology.

Does being exposed to discrimination affect health? IPR developmental psychobiologist Emma Adam and her colleagues are examining 20 years of data, gathered from adolescence through young adulthood, in a project with funding from the National Institutes of Health (NIH). The data include exposure to race-related stressors, as well as measures of family functioning, racial and ethnic identity, and coping. Adam is examining this data with a wide range of stress-sensitive biological measures in young adulthood, including gene expression relevant to the regulation of biological stress. Results indicate that participants with higher perceived discrimination have lower overall cortisol levels and flatter cortisol diurnal rhythms, which are associated with chronic stress. Experiences of discrimination during adolescence have particularly strong effects on adult stress biology. Adam also finds that histories of discrimination help to explain racial and ethnic differences in cortisol rhythms. However, the presence of a strong ethnic and racial identity in adolescence, and particularly in early adulthood, is associated with better-regulated stress biology and higher levels of academic attainment. Adam is the Edwina S. Tarry Professor of Human Development and Social Policy.

The Health Costs of Family Stress

Family stress can lead to worse health outcomes, including for adolescents who experience many demands in their family life. Chen investigates under what circumstances family demands might have a physiological cost. In Health Psychology, she looks at two potential moderators between frequency of family demands and adolescents’ inflammatory profiles: the closeness of the teens’ relationships with their families and how often teens provided help to their families, such as doing chores or caring for siblings. For the study, 234 youth aged 13–16 filled out a daily diary and were interviewed about their family relationships. Chen finds that more frequent demands from family predicted higher levels of inflammation. Family closeness moderated this relationship, as frequent demands proved to be more physiologically detrimental when adolescents were close to their families. How frequently the teens provided help also moderated the relationship, with more frequent demands predicting worse inflammatory profiles when adolescents helped out more with the family. The results build on previous work to show how family pressures can affect health.

The Impact of Health on Academic Disparities Between Boys and Girls 

In the United States, girls have been outperforming boys academically, with most girls earning higher scores on standardized tests. In a study, ChenMiller, and former IPR postdoctoral fellow Cynthia Levine, now at the University of Washington, examine the relationship between gender disparities in academic performance and students’ health outcomes. To understand the relationship between the two, they took various measures of metabolic syndrome, which is a cluster of risk factors associated with cardiovascular disease and diabetes, in 240 healthy eighth grade boys and girls in the Chicago area. In another group of 275 eighth graders with asthma, they looked at their immune function using blood samples. Then using the students’ standardized test scores of the schools the children attended, the researchers calculated that the average difference between the girls’ and boys’ performance in a school was 11%. They find that across the two studies, when boys attend schools where there is a greater disparity between boys’ and girls’ academic performance (in the direction of boys performing worse than girls), the boys have worse health (that is, higher metabolic syndrome scores and worse immune function). The researchers note that while their work establishes a relationship between gender disparities in academic outcomes and boys’ health, an important next step should be to test what the cause-and-effect relationship might be between the two, especially before making policy proposals to improve boys’ health. 

Metabolic Health Disparities

IPR health psychologists Greg Miller and Edith Chen, shown here in their lab, are investigating how socioeconomic status affects health, including the risk for cardiovascular disease and metabolic syndrome.

A quarter of the world’s population has metabolic syndrome, which includes high blood pressure, high blood sugar, and high cholesterol. Researchers have shown that being lower on the socioeconomic ladder is associated with a higher risk for metabolic syndrome. In Psychosomatic MedicineMiller and Chen examine how economic disadvantage early in life—even if an individual later moves up the socioeconomic ladder—is related to a higher risk of metabolic syndrome in mid-adulthood. They determine that early-life SES affects risk. On average, individuals with low childhood SES were nearly twice as likely to meet the criteria for metabolic syndrome at midlife than those with high childhood SES. However, the researchers do not find a significant effect for SES at the time when metabolic syndrome is measured. Miller and Chen suggest that early childhood might be an opportune time to target interventions aiming to reduce the risk of metabolic syndrome across a person’s lifespan.


Childhood Adversity and the Onset of Chronic Disease in Young Adults 

Research has continued to show a strong link between adverse childhood experiences and poor health and behavioral outcomes in adulthood. Research professor and IPR associate Joe Feinglass and his colleagues examine the connection between adverse childhood experiences and chronic disease in young adulthood in a study published in Preventive Medicine. The researchers looked at Center for Disease Control data between 2011 and 2012, where nearly 87,000 participants from nine states answered questions about child abuse and household stressors, as well as chronic health conditions. Even though rates of chronic disease were low among young adults, the researchers find those between 18 and 34 years old who had higher levels of adverse childhood experiences were at much greater risk reporting chronic conditions and more likely to report that their health was fair or poor. Feinglass and his colleagues point out that the prevalence of ACEs and the relative health risks associated with ACEs were highest among young adults as compared to middle age or older respondents.

Newborn Health and Childhood Disabilities New

About 6.4 million public school students receive special education services for disabilities at a cost of almost $40 billion annually. Scholars searching for the causes of childhood disability have found it hard to disentangle the roles of children’s health from their family socioeconomic status (SES). IPR education economist David Figlio, former IPR graduate research assistant Claudia Persico (PhD 2016), and their colleagues are able to separate newborn health from SES and trace the role of neonatal health in childhood disability. They use a large dataset that links K–12 education records to birth certificates of children born in Florida who attended public schools there from kindergarten through fourth grade. In the American Journal of Health Economics, the researchers find that birthweight was by far the most significant measured health issue of all neonatal metrics in its impact on childhood disability. They discover that children with lower birthweights were much more likely to be diagnosed with disabilities in elementary school. They find that a 10% increase in birthweight reduced disability rates in fourth grade by 1.2 percentage points. In addition, they learn that SES did not matter in this case: Low-birthweight, economically disadvantaged children are not more likely than advantaged ones to end up with disabilities. Figlio is the Orrington Lunt Professor of Education and Social Policy and Dean of the School of Education and Social Policy.