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Background The COVID-19 pandemic is a widespread source of stress with adverse mental health impacts. Meaning in life, both as a trait and as momentary awareness of what is personally meaningful (meaning salience), is associated with positive health outcomes and may buffer against the deleterious effects of stress. Purpose This project examines prospective associations between baseline meaning salience (daily, post-laboratory stressor) and meaning in life with perceived stress during COVID-19. Methods A community sample of healthy adults (n = 147) completed a laboratory stress protocol in 2018–2019, where perceived stress, meaning in life, and meaning salience (daily, post-stressor) were assessed. During April and July 2020 (n = 95, and 97, respectively), participants were re-contacted and reported perceived stress. General linear mixed-effects models accounting for repeated measures of stress during COVID-19 were conducted. Results Partial correlations holding constant baseline perceived stress showed that COVID-19 perceived stress was correlated with daily meaning salience (r = –.28), post-stressor meaning salience (r = –.20), and meaning in life (r = –.22). In mixed-effects models, daily and post-stressor meaning salience and higher meaning in life, respectively, predicted lower perceived stress during COVID-19, controlling for age, gender, and baseline perceived stress. Conclusions Individuals more capable of accessing meaning when exposed to laboratory stress reported lower perceived stress during a global health crisis. Despite study limitations concerning generalizability, results support meaning in life and meaning salience as important aspects of psychological functioning that may promote well-being by affecting stress appraisals and available resources for coping.

We examined prospective associations between religiousness/spirituality (R/S; i.e., service attendance, R/S identity, R/S coping, spirituality) and all-cause mortality in the Midlife in the United States (MIDUS) sample, including whether having a purpose in life and positive social support are indirect pathways through which R/S predicts mortality. We examined service attendance and a composite of R/S identity, R/S coping, and spirituality from the baseline wave (1995–1996; n = 6120 with complete data), purpose in life and positive social support from the second wave (2004–2006), and vital status through 2020 (n = 1711 decedents). Cox regression models showed that attending religious services more than weekly and approximately weekly was associated with a lower mortality risk compared to never attending in the adjusted models (>weekly vs. never, HR (95% CI) = 0.72 (0.61, 0.85); weekly vs. never, HR (95% CI) = 0.76 (0.66, 0.88)). The R/S composite was also associated with lower mortality risk in the adjusted models (HR (95% CI) = 0.92 (0.87, 0.97)). Indirect effects from R/S to mortality via purpose in life and positive social support were significantly different from zero. These findings highlight the importance of multidimensional aspects of R/S for population health and point to purpose in life and positive social support as underlying pathways between R/S and mortality.

OBJECTIVES: Black adults in the United States have shorter sleep durations and poorer sleep efficiency relative to White adults, yet reasons for these disparities are not well explicated. The objective of this study was to examine neighborhood safety in childhood as a mediator of subsequent racial disparities in sleep. METHODS: Data were from Black and White young adults attending a large, predominantly White university in the Southeastern United States (N = 263; 52% Black, 53% female; Mean age = 19.21 years, SD = 1.01). Sleep parameters were assessed from 8 nights of wrist actigraphy (time in bed, sleep duration, and efficiency) and an established self-report measure of daytime sleepiness. Residential histories from birth through age 18 were documented, and retrospective self-reports of neighborhood safety in childhood were assessed. RESULTS: Black participants had less time in bed (p < 0.001), shorter sleep duration (p < 0.001), poorer sleep efficiency (p < 0.001), and more daytime sleepiness (p = 0.009) than White participants. Neighborhood safety mediated race differences in time in bed (p = 0.028), sleep duration (p = 0.033), and daytime sleepiness (p = 0.048), but not sleep efficiency. Findings were substantively unchanged after adjustment for family socioeconomic status, BMI, and substance use. CONCLUSIONS: Findings support the hypothesis that neighborhood safety in childhood may partially account for race differences in subsequent sleep duration and daytime sleepiness. Addressing racial inequities in childhood neighborhood safety may be an important step toward reducing racial disparities in sleep health.

Objectives Cardiovascular health (CVH) is associated with reductions in age-related disease and later-life mortality. Black adults, particularly Black women, are less likely to achieve ideal CVH. Guided by intersectionality and life-course approaches, we examine to what degree (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. Methods We used biomarker subsamples from the Midlife in the United States Core and Refresher studies (N = 1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or midlife socioeconomic status (SES) between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. Results White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs would reduce the disparities: White men versus Black women (30% reduction) and White women versus Black women (15%). Intervening on perceived discrimination would not substantially change initial disparities. Intervening on midlife SES would yield large disparity reductions: White men versus Black men (64%), White men versus Black women (60%), and White women versus Black women (27%). These reductions are robust to unmeasured confounders. Discussion Providing economic security in adulthood for Blacks may help reduce racial disparities in CVH. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to White adults.

OBJECTIVE The current study examined race differences in how childhood socioeconomic status (SES) predicted midlife inflammation. It also tested psychological resources (purpose in life, optimism, and conscientiousness) as moderators of the association between childhood SES and inflammation among Black and White adults. METHOD Data came from the biomarker subsamples of the Midlife in the United States Core and Refresher studies (n = 1,578 White and n = 395 Black participants). Childhood SES was operationalized as a composite of parental education, perceived financial status, and welfare status. Outcomes included circulating IL-6 and CRP. RESULTS Childhood SES did not predict IL-6 or CRP among Black or White adults in fully adjusted models. Among Black adults with low optimism, lower childhood SES predicted higher IL-6 and CRP. Among Black adults with low purpose in life, lower childhood SES predicted higher CRP (but not IL-6). Conscientiousness did not moderate childhood SES-inflammation associations among Black adults. Among White adults with low conscientiousness or low optimism, lower childhood SES predicted higher IL-6 (but not CRP). Purpose in life did not moderate associations among White adults. Effect sizes were small (≤1% variance explained) and comparable to effects of clinical risk factors in this sample (e.g., age, chronic conditions). CONCLUSIONS Race differences in the childhood SES and inflammation association were not apparent. Childhood SES was linked to inflammation more strongly among those with fewer psychological resources across both racial groups. Psychological resources may be important moderators of inflammation in the context of early life SES disadvantage. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Stress is often invoked as a potential contributor to disparities in physical health as a function of social status. Although there is good reason to believe that stress exposure and stress responses may be an important pathway linking lower social status to poor health, direct evidence is lacking. We summarize the evidence for this pathway and limitations of that evidence, focusing particularly on how stress is conceptualized and measured. We argue that in addition to more direct tests of mediation, the measurement of the mediator—stress—could also be improved. We also propose that measuring theory-specific stress exposures may be more fruitful than assessing general stress exposures (e.g., life events, global perceived stress) by increasing theoretical clarity and predictive utility of stress in this context.

OBJECTIVES. Research on older adults often focuses on mitigating health risks, and less is known about protective factors that contribute to longer, healthier lives. We examine longitudinal associations between psychological well-being and mortality among a national sample of older adults and test competing hypotheses about whether the education/mortality association depends on the level of psychological well-being. METHODS. We use six waves (2006–2016) of the Health and Retirement Study, a national sample of adults over age 50 (n = 21,172), with 14 years of mortality follow-up. Psychological well-being is measured up to three times and includes positive affect, life satisfaction, purpose in life, social support, and optimism. Discrete-time survival models examine (1) the association between time-varying psychological well-being and mortality, and (2) interactions between psychological well-being and education on mortality. RESULTS. Higher purpose in life, positive affect, optimism, social support, and life satisfaction predicted lower mortality. A one standard deviation increase in most measures of psychological well-being was associated with a 2–4 year increase in life expectancy at age 50. Positive affect and purpose in life moderated the education/mortality association —the inverse association between education and mortality was stronger for those with high psychological well-being. CONCLUSIONS. We find strong evidence that psychological well-being predicts lower mortality risk and modifies the association between education and mortality. The inverse association between education and mortality becomes stronger at higher levels of purpose in life and positive affect. Therefore, efforts to promote life satisfaction, social support, and optimism may support longer lives without widening education disparities.

Background Macroeconomic crises can exaggerate existing educational disparities in health. Few studies, however, have examined whether macroeconomic crises get under the skin to affect educational disparities in health-related biological processes. Purpose This study aimed to examine the effect of the economic recession of 2008 (i.e., Great Recession) on educational disparities in cardiometabolic risk and self-reported psychological distress. Methods Data were drawn from two subsamples of the Midlife in the United States (MIDUS) study: the second wave of the MIDUS sample (pre-recession cohort, N = 985) and the refresher sample (post-recession cohort, N = 863). Educational attainment was categorized into high school education or less, some college, and bachelor’s degree or higher. Outcomes included metabolic syndrome, C-reactive protein, and interleukin-6, as well as self-reported perceived stress, depressive symptoms, and financial distress. Results Results showed that having a bachelor’s degree or higher (compared to having a high school education or less) was more strongly associated with decreased metabolic syndrome symptoms in the post-recession cohort than the pre-recession cohort, above and beyond demographic, health, and behavioral covariates. These findings did not extend to systemic inflammation or psychological distress. Conclusions Our findings suggest that chronic macroeconomic stressors may widen the educational gap in physical health, particularly cardiometabolic health, by modifying biological and anthropometric risk factors implicated in metabolic syndrome.

This chapter provides an overview of hedonic and eudaimonic approaches to well-being, both with roots traceable to the ancient Greeks. The authors examine the history of each approach and describe scientific endeavors seeking to translate the ideas to empirical assessment tools. They review how these two varieties of well-being are distributed in the general population by attending to their associations with major demographic factors (age, socioeconomic status, gender, race) as well as the interplay (intersectionality) of such factors. Such information contextualizes what is known about who reports they are or are not experiencing various aspects of well-being. The authors then examine how hedonic and eudaimonic well-being are linked with multiple indicators of health (self-reported, morbidity, mortality, biological systems). There is a paucity of studies that have jointly examined both types of well-being. The authors then draw attention to changing historical conditions and what this means for the future study of well-being and health.

We question use of the term “well-being” to encompass notably distinct phenomena (objective indicators of socioeconomic status and health, subjective indicators of psychological experience) and dispute characterization of the field of well-being as relatively new. We also call for greater interplay between government surveys and multiuse cohort studies, both of which increasingly focus on well-being. The MIDUS study is presented as an example of how to negotiate distinct disciplinary priorities in broad-based studies of well-being and health, including those that take context seriously. We conclude with explanations for why we do not endorse any of the measurement recommendations (single-item measures, 4- to 6-item measures, multi-item assessments) put forth in the preceding chapter, arguing that the ultra-short assessments ignore extensive prior science documenting the complex, multifaceted nature of well-being, while the proposed longer assessment (Comprehensive Inventory of Thriving) suffers from multiple problems including a questionable conceptual foundation, inadequate evidence of validity and reliability, and highly redundant items.

We challenge the view that “one is better than none” on grounds that single-item assessments perpetuate a simplistic view of well-being, which is out of touch with how the field has progressed over recent decades. We also question blanket advocacy for measures in the absence of substantive scientific questions that require thoughtful engagement with the prior literature to make sound measurement choices. Substantive illustrations, invoking research on well-being and health in different cultural and socioeconomic contexts, are provided. Quality control is also essential in making sound measurement choices. Numerous contenders fail at this juncture because they have no conceptual foundation and also lack rigorous psychometric analyses documenting their empirical credibility. Another critical element in adjudicating measurement quality is extent of prior usage: evidence that the measures have taken hold in the scientific community, indicated by citation counts and number of published studies. We conclude that all such quality control criteria were inadequately addressed or missing in the measurement recommendations put forth in Chapter 17.

We investigate whether socioeconomic status (SES) in childhood shapes adult health lifestyles in domains of physical activity (leisure, work, chores) and diet (servings of healthy [i.e., nutrient-dense] vs. unhealthy [energy-dense] foods). Physical activity and food choices vary by gender and are key factors in the development of metabolic syndrome (MetS). Thus, we examined gender differences in the intervening role of these behaviors in linking early-life SES and MetS in adulthood. We used survey data (n = 1054) from two waves of the Midlife in the U.S. Study (MIDUS 1 and 2) and biomarker data collected at MIDUS 2. Results show that individuals who were disadvantaged in early life are more likely to participate in physical activity related to work or chores, but less likely to participate in leisure-time physical activity, the domain most consistently linked with health benefits. Women from low SES families were exceedingly less likely to complete recommended amounts of physical activity through leisure. Men from low SES consumed more servings of unhealthy foods and fewer servings of healthy foods. The observed associations between childhood SES and health lifestyles in adulthood persist even after controlling for adult SES. For men, lack of leisure-time physical activity and unhealthy food consumption largely explained the association between early-life disadvantage and MetS. For women, leisure-time physical activity partially accounted for the association, with the direct effect of childhood SES remaining significant. Evidence that material deprivation in early life compromises metabolic health in adulthood calls for policy attention to improve economic conditions for disadvantaged families with young children where behavioral pathways (including gender differences therein) may be shaped. The findings also underscore the need to develop gender-specific interventions in adulthood., Highlights • Physical activity and healthy diet have been recommended to prevent/treat metabolic syndrome (MetS). • Childhood SES is associated with development of MetS via physical activity and diet. • Gender is key to understanding the behavioral pathways linking childhood SES and MetS. • Low childhood SES is associated with unhealthy diet for men and insufficient leisure-time activity for both genders. • Leisure-time activity and unhealthy diet mediate the effect of childhood SES on MetS, particularly for men.

Objective: Higher cardiovascular health (CVH) scores are significantly associated with reductions in aging-related disease and mortality but racial minorities exhibit poor CVH. We examine the degree to which (a) disparities in CVH exist at the intersection of race and gender and (b) CVH disparities would be reduced if marginalized groups had the same levels of resources and adversities as privileged groups. Methods: We used biomarker subsamples from the Midlife in the United States (MIDUS) core study and Refresher studies (N=1,948). Causal decomposition analysis was implemented to test hypothetical interventions to equalize the distribution of early-life adversities (ELAs), perceived discrimination, or adult SES between marginalized and privileged groups. We conducted sensitivity analyses to determine to what degree unmeasured confounders would invalidate our findings. Results: White women have the highest CVH score, followed by White men, Black men, and Black women. Intervening on ELAs reduces the disparities: White men vs. Black women (30% of reduction) and White women vs. Black women (15%). Intervening on adult SES provides large disparity reductions: White men vs. Black men (79%), White men vs. Black women (70%), White women vs. Black men (25%), and White women vs. Black women (32%). Among these combinations, interventions on ELAs and adult SES are robust to unmeasured confounders. However, intervening on discrimination makes little change in initial disparities. Discussion: Economic security in midlife for Blacks helps reduce racial disparities in cardiovascular health. Preventing exposure to ELAs among Black women may reduce their vulnerability to cardiovascular disease, compared to Whites.

Background:Regular physical activity is a key way to prevent disease. However, we have a limited understanding of the socioeconomic precursors and glucoregulatory sequelae of engaging in physical activity in different domains.Methods:We examined the associations among life course socioeconomic disadvantage; meeting the physical activity guidelines with leisure-time physical activity, occupational physical activity, or household physical activity; and prediabetes and diabetes in the Midlife in the United States national study (N = 986).Results:Childhood disadvantage was associated with lower odds of meeting the guidelines with leisure-time physical activity (odds ratio = 0.75; 95% confidence interval, 0.65–0.86). Adulthood disadvantage was associated with higher odds of meeting the guidelines with occupational physical activity (odds ratio = 1.94; 95% confidence interval, 1.49–2.53). Importantly, while meeting the guidelines with leisure-time physical activity was associated with lower odds of prediabetes and diabetes, we found no evidence for associations among occupational physical activity, household physical activity, and glucoregulation.Conclusion:Current US physical activity guidelines do not differentiate between physical activity for leisure or work, assuming that physical activity in any domain confers comparable health benefits. We documented important differences in the associations among lifetime socioeconomic disadvantage, physical activity domain, and diabetes, suggesting that physical activity domain potentially belongs in the guidelines, similar to other characteristics of activity (eg, type, intensity).

Rationale Health disparities defined by neighborhood socioeconomic status (SES) are well established; it is less well understood whether neighborhood SES is differentially associated with health depending on one's own SES. Objective The double jeopardy hypothesis, collective resources model, fundamental cause theory, and relative deprivation hypothesis support differential patterns of association between neighborhood and individual SES with health. The first three models suggest that higher neighborhood SES predicts health more strongly among lower, as compared to higher, SES individuals. The relative deprivation hypothesis suggests that higher SES neighborhoods bring no extra health benefit to low SES individuals and could even bring a health deficit. This study examined competing hypotheses with prospective associations between cardiovascular (CV) health and individual SES, neighborhood SES, and their interaction. Method Data were from two waves of the Midlife in the United States (MIDUS) Study (N = 1012), a national survey of adults ages 25 and older at baseline. Neighborhood SES was a composite of five census tract-level SES indicators from the 1990 census. Individual SES was a composite of educational attainment and household income at wave one (1995–1996). CV health at wave two (2004–2008), was computed as a composite based on smoking status, body mass index, physical activity, diet, total cholesterol, blood pressure, and glucose. Results Individual and neighborhood SES were each associated with CV health net of baseline health status and other covariates. Interactions between individual and neighborhood SES showed that higher neighborhood SES was associated with better CV health for those of lower, not higher, individual SES. Conclusion Results are consistent with the double jeopardy hypothesis, the collective resources model, and the fundamental cause theory, but not with a relative deprivation hypothesis. Results suggest that additional attention to the neighborhood socioeconomic context of lower SES individuals may reduce SES disparities in cardiovascular health.

Objective American Heart Association (AHA) developed a new metric to evaluate ideal cardiovascular health based on optimal levels of 7 cardiovascular risk factors and health behaviors. We evaluated the relationships of parenting characteristics and academic achievement in adolescence in relation to ideal cardiovascular health in midlife men. Method We measured cardiovascular risk factors in 171 Black and 136 White men and their ideal cardiovascular health score was constructed based on AHA guidelines. When the participants were 13-16 years old, annual measures of parent-child communication, positive relationship, parental monitoring, family cohesion, boys' involvement in family activities, and academic achievement were recorded and averaged. Results Confirmatory factor analysis of adolescent parenting measures revealed a single Parenting Composite. Multiple linear regressions showed a significant Race by Parenting Composite interaction term, β = -.19, p = .03; better parenting was significantly related to more ideal cardiovascular health in Blacks only, β = -.23, p = .004, which remained after adjustments for adolescent and adult socioeconomic status (SES). Academic achievement was related to ideal cardiovascular health, β = -.13, but was no longer significant after controls for adult SES. Adult SES was a strong correlate of ideal cardiovascular health in Black and White men. Conclusions Black men exposed to positive parenting during adolescence had more ideal cardiovascular health based on AHA guidelines. Improving academic achievement in adolescence may indirectly benefit adult cardiovascular health through improving adult SES. This is the first study of adolescent family predictors of the extent of ideal cardiovascular health. (PsycINFO Database Record

Disparities in sleep duration and efficiency between Black/African American (AA) and White/European American (EA) adults are well-documented. The objective of this study was to examine neighborhood disadvantage as an explanation for race differences in objectively measured sleep.Data were from 133 AA and 293 EA adults who participated in the sleep assessment protocol of the Midlife in the United States (MIDUS) study (57% female; Mean Age = 56.8 years, SD = 11.4). Sleep minutes, onset latency, and waking after sleep onset (WASO) were assessed over seven nights using wrist actigraphy. Neighborhood characteristics were assessed by linking home addresses to tract-level socioeconomic data from the 2000 US Census. Multilevel models estimated associations between neighborhood disadvantage and sleep, and the degree to which neighborhood disadvantage mediated race differences in sleep controlling for family socioeconomic position and demographic variables.AAs had shorter sleep duration, greater onset latency, and higher WASO than EAs (ps 0.001). Neighborhood disadvantage was significantly associated with WASO (B = 3.54, p = 0.028), but not sleep minutes (B = -2.21, p = 0.60) or latency (B = 1.55, p = 0.38). Furthermore, race was indirectly associated with WASO via neighborhood disadvantage (B = 4.63, p = 0.035), which explained 24% of the race difference. When measures of depression, health behaviors, and obesity were added to the model, the association between neighborhood disadvantage and WASO was attenuated by 11% but remained significant.Findings suggest that neighborhood disadvantage mediates a portion of race differences in WASO, an important indicator of sleep efficiency.

Healthy eating is important for physical health. Using large probability samples of middle-aged adults in the United States and Japan, we show that fitting with the culturally normative way of being predicts healthy eating. In the United States, a culture that prioritizes and emphasizes independence, being independent predicts eating a healthy diet (an index of fish, protein, fruit, vegetables, reverse-coded sugared beverages, and reverse-coded high fat meat consumption; Study 1) and not using nonmeat food as a way to cope with stress (Study 2a). In Japan, a culture that prioritizes and emphasizes interdependence, being interdependent predicts eating a healthy diet (Studies 1 and 2b). Furthermore, reflecting the types of agency that are prevalent in each context, these relationships are mediated by autonomy in the United States and positive relations with others in Japan. These findings highlight the importance of understanding cultural differences in shaping healthy behavior and have implications for designing health-promoting interventions.

Epidemiological evidence from the Midlife in the United States and other studies shows robust socioeconomic disparities in mental and physical health outcomes. Considerable heterogeneity exists in health within socioeconomic strata; not all socioeconomically disadvantaged individuals exhibit poor health. Evidence is presented supporting an integrative conceptual framework wherein psychological factors moderate the association between socioeconomic status and health, illuminating unique risk and resilience profiles. Regarding protective factors, distinctions between hedonic well-being and eudaimonic well-being are highlighted. Regarding psychological risk factors, the focus is on the experience and expression of anger. Several pathways through which socioeconomic and psychological factors may affect health, including health behaviors, emotion regulation, and physiological responses to stress are considered. The chapter concludes with directions for future research, including efforts to integrate psychological strengths and risk factors and the need for longitudinal and intervention approaches to address the public health issue of health disparities from a biopsychosocial perspective.

Current theorizing on socioeconomic status (SES) focuses on the availability of resources and the freedom they afford as a key determinant of the association between high SES and stronger orientation toward the self and, by implication, weaker orientation toward others. However, this work relies nearly exclusively on data from Western countries where self-orientation is strongly sanctioned. In the present work, we predicted and found that especially in East Asian countries, where other-orientation is strongly sanctioned, high SES is associated with stronger other-orientation as well as with self-orientation. We first examined both psychological attributes (Study 1, N = 2,832) and socialization values (Study 2a, N = 4,675) in Japan and the United States. In line with the existent evidence, SES was associated with greater self-oriented psychological attributes and socialization values in both the U.S. and Japan. Importantly, however, higher SES was associated with greater other orientation in Japan, whereas this association was weaker or even reversed in the United States. Study 2b (N = 85,296) indicated that the positive association between SES and self-orientation is found, overall, across 60 nations. Further, Study 2b showed that the positive association between SES and other-orientation in Japan can be generalized to other Confucian cultures, whereas the negative association between SES and other-orientation in the U.S. can be generalized to other Frontier cultures. Implications of the current findings for modernization and globalization are discussed. (PsycINFO Database Record

Background Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health. Purpose In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources. Methods Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32). Results Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups. Conclusions Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.

Objective Disparities in cardiovascular health by socioeconomic status (SES) are a pressing public health concern. Hypothesized mechanisms linking low SES to poor health are large cardiovascular responses to and delayed recovery from psychological stress. The current study presents a meta-analysis of the literature on the association of SES with blood pressure and heart rate reactivity to and recovery from acute stress tasks. Methods The PubMed database was searched, and 26 unique studies with relevant data were identified (k = 25 reactivity [n = 14,617], k = 6 recovery [n = 1,324]). Results Using random-effects models, no significant association between SES and cardiovascular reactivity to stress emerged (r = .008, 95% confidence interval = -.02 to .04), although higher SES was associated with better recovery from stress (r = -.14, 95% confidence interval -.23 to -.05). Stressor type moderated the reactivity effect, wherein higher SES was associated with greater reactivity to cognitive stressors (r = .036, p = .024), not with reactivity to interpersonal stressors (r = -.02, p = .62), but was associated with lower reactivity to tasks with combinations of cognitive, interpersonal, and physical challenges (r = -.12, p = .029). Accounting for publication bias revealed a significant association between SES and reactivity in the opposite direction of hypotheses. Conclusions Cardiovascular recovery from acute stress, but not reactivity to stress, may be a key pathway between low SES and risk for cardiovascular diseases. Heterogeneity in effect size and direction, challenges related to working across temporal dynamics, and recommendations for future research are discussed.

Growing research addresses the salubrious health effects of positive psychological functioning, which converges with the World Health Organization's view of health as a state of well-being and more than the absence of disease [1]. Evidence supports independent health benefits of psychological well-being, which is more than the absence of negative psychological functioning, such as depression, anxiety, or anger [2]. Indeed, well-being is a multidimensional domain that has been differentiated into related, but distinct, components. Hedonic well-being typically encompasses constructs such as positive affect, happiness, and life satisfaction. Eudaimonic well-being, in contrast, refers to evaluative judgments about people's lives, such as their sense of purpose and meaning and whether they perceive that personal talents and abilities are being realized [3,4]. Major reviews have synthesized the wealth of evidence linking both hedonic and eudaimonic well-being to optimal health, including in the realm of cardiovascular risk, morbidity, and mortality [5,6]. For example, purpose in life, a key component of eudaimonic well-being, has been found to prospectively predict both reduced risk of myocardial infarction [7] as well as reduced risk of stroke [8], independent of traditional cardiovascular risk factors. This work suggests that well-being predicts lower cardiovascular morbidity and mortality in both healthy and patient populations, independent of health behaviors and traditional risk factors. Identifying links between well-being and reduced cardiovascular morbidity and mortality invites inquiry into the biological processes mediating such associations. Hypothesized mediators include autonomic and neuroendocrine regulation (hypothalamic pituitary adrenal axis and sympathetic nervous system activation), inflammation, and cardiometabolic functioning (e.g., obesity, blood pressure, cholesterol, and glucose regulation). In the current report, we focus on cardiometabolic functioning, assessed via metabolic syndrome, using a large sample of adults across five decades of age. Metabolic syndrome is a constellation of central obesity, hypertension, dysregulated lipids, and insulin resistance or hyperglycemia. Individuals with metabolic syndrome have increased risk for cardiovascular disease, stroke, and type II diabetes [9]. Metabolic syndrome has a high prevalence rate (over 30%) among US adults, with rates increasing in recent years [10]. There are several definitions of metabolic syndrome in the literature, including the National Cholesterol Education Program's Adult Treatment Panel III (ATP III), the World Health Organization, and the International Diabetes Foundation, which vary somewhat in the clinical cut points defining risk [9]. In the current study, our primary outcome was based on ATP III criteria given that this is the definition most commonly used for studies of psychological factors and metabolic syndrome [11]. Although no prior studies have examined links among hedonic or eudaimonic well-being with diagnostic metabolic syndrome, several have documented associations among well-being and individual components comprising metabolic syndrome. For example, HDL cholesterol has been linked with greater optimism in the present sample [12] as well as with greater positive affect, personal growth, and purpose in life in a sample of older women [13]. In the same sample of older women, positive affect further predicted lower levels of glycated hemoglobin over time [14]. Positive emotions were associated with lower rates of hypertension in a sample of older Mexican Americans [15], and happiness was inversely related to ambulatory blood pressure in the Whitehall psychobiology study [16]. A related positive psychological construct, perceived control, was cross-sectionally associated with higher HDL cholesterol and lower glycated hemoglobin and waist circumference in a national sample of middle aged and older Americans [17]. Finally, life satisfaction was inversely associated with excess weight in a community sample of adolescents and young adults [18]. In a recent review, emerging evidence supported associations among well-being and metabolic function, although limited evidence precluded drawing meaningful distinctions among different types of well-being [6]. Findings were also less consistent regarding associations among eudaimonic well-being and glucose regulation and body composition. Few studies have incorporated both hedonic and eudaimonic well-being measures, which is essential to empirically test their comparative effects [cf., 12,18–22]. Although hedonic and eudaimonic well-being measures are moderately correlated, they have previously demonstrated unique associations with central and peripheral health outcomes [4,6,13,23]. The aim of the current study was thus to examine associations between both hedonic and eudaimonic well-being with metabolic syndrome in a national sample of adults known as MIDUS (Midlife in the U.S.). In line with prior evidence, we hypothesized that both types of well-being, although capturing distinct components of positive psychological experience, would be associated with lower risk of metabolic syndrome. That is, both feeling good and being actively engaged in life, may predict reduced risk for cardiometabolic factors implicated in multiple disease outcomes. Our initial analyses focused on cross-sectional associations, but we augment the analyses with longitudinal associations between a subset of well-being assessments, measured 9-10 years earlier, and currently assessed metabolic syndrome.

Racial differences in anger frequency and expression styles have been found. Further, African Americans receive fewer health benefits from higher education than Whites.This study seeks to investigate racial differences in how anger moderates the association between education and inflammation.Midlife in the US participants (n = 1,200; 43.0 % male; 18.5 % African American) provided education and anger data via survey assessments. Interleukin-6 (IL-6) and fibrinogen were determined from a fasting blood sample following an overnight clinic visit.African Americans reported higher anger-out, IL-6, and fibrinogen and lower anger-control than Whites. Anger-out predicted higher IL-6 and fibrinogen among African Americans with higher education; whereas, trait anger and anger-out predicted lower fibrinogen among Whites with higher education. Anger-out marginally predicted higher IL-6 in less educated Whites.Findings underscore racial differences in the benefits and consequences of educational attainment, and how social inequities and anger are manifested in inflammatory physiology.

Expression of anger is associated with biological health risk (BHR) in Western cultures. However, recent evidence documenting culturally divergent functions of the expression of anger suggests that its link with BHR may be moderated by culture. To test this prediction, we examined large probability samples of both Japanese and Americans using multiple measures of BHR, including pro-inflammatory markers (interleukin-6 and C-reactive protein) and indices of cardiovascular malfunction (systolic blood pressure and ratio of total to HDL cholesterol). We found that the link between greater expression of anger and increased BHR was robust for Americans. As predicted, however, this association was diametrically reversed for Japanese, among whom greater expression of anger predicted reduced BHR. These patterns were unique to the expressive facet of anger and remained after we controlled for age, gender, health status, health behaviors, social status, and reported experience of negative emotions. Implications for sociocultural modulation of bio-physiological responses are discussed.

Objectives To test whether napping was associated with 2 inflammatory markers with known relationships to cardiovascular disease: high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6). Because IL-6 is known to impact central inflammatory processes that relate to sleep regulation, including subjective fatigue, we tested whether this relationship was moderated by sleep duration, sleep efficiency, and self-reported sleep quality. Design Cross-sectional. Participants A community sample of Black and White men (N=253) completed a week of actigraphy and diary measures of sleep and napping and provided a fasting blood sample. Measurements/analysis Napping was measured as the proportion of days with at least 30 minutes napped and the average minutes napped per day. Linear regressions adjusted for race, socioeconomic status, employment, body mass index, smoking, medications that affect sleep or inflammation, working the nightshift, and day-sleeping status, followed by interaction terms between napping and sleep duration, efficiency, and quality, respectively. Results There were no significant main effects of actigraphy- or diary-measured napping on IL-6 or hsCRP. Moderation analyses indicated elevated IL-6 values among men who napped more days (by actigraphy) and demonstrated short sleep duration ( P =.03). Moderation analyses also indicated elevated IL-6 among men who demonstrated greater average minutes napped (by actigraphy) and short sleep duration ( P P =.03), and poor quality ( P =.03). Moderation analyses involving diary napping or hsCRP were not significant. Conclusions Actigraphy-assessed daytime napping is related to higher IL-6 in men who demonstrate worse sleep characteristics. Daytime napping may pose additional risk for inflammation beyond the known risk conferred by short sleep.

Objective Low socioeconomic status (SES) in childhood confers risk for poor physical health later in life. This study prospectively examines whether improvements in family SES protect youth from developing physical health problems by adulthood and whether such effects differ by race or age. Method Participants are a school-based sample of urban Black (53%) and White (47%) men (N = 311). Using latent growth curve modeling, we prospectively examined whether changes in family SES measured annually between Ages 7 and 16 predicted physical health diagnoses in adulthood (Age 32). Family SES was assessed as a weighted composite of parental education and occupational status. Physical health diagnoses were assessed as a count of self-reported medical conditions from a health history interview. Results Consistent with macroeconomic trends, on average, family SES increased until the early 1990s, then remained flat until rising again in the mid-1990s. During each of 3 independent developmental periods, boys raised in families who experienced more positive changes in SES reported fewer physical health diagnoses in adulthood. These effects did not vary significantly by race and remained after controlling for initial childhood SES, childhood health problems, concurrent adult SES, and weight (Body Mass Index or reported overweight). Conclusions Initial childhood SES did not predict physical health, whereas relative improvements in SES over a 10-year period did. If the families of Black and White boys were upwardly mobile, it appeared to protect them from developing physical disease, and upward mobility was additively protective across developmental periods examined here. (PsycINFO Database Record

Individuals with lower social status have been reported to express more anger, but this evidence comes mostly from Western cultures. Here, we used representative samples of American and Japanese adults and tested the hypothesis that the association between social status and anger expression depends on whether anger serves primarily to vent frustration, as in the United States, or to display authority, as in Japan. Consistent with the assumption that lower social standing is associated with greater frustration stemming from life adversities and blocked goals, Americans with lower social status expressed more anger, with the relationship mediated by the extent of frustration. In contrast, consistent with the assumption that higher social standing affords a privilege to display anger, Japanese with higher social status expressed more anger, with the relationship mediated by decision-making authority. As expected, anger expression was predicted by subjective social status among Americans and by objective social status among Japanese. Implications for the dynamic construction of anger and anger expression are discussed.

Previous studies conducted in Western cultures have shown that negative emotions predict higher levels of pro-inflammatory biomarkers, specifically interleukin-6 (IL-6). This link between negative emotions and IL-6 may be specific to Western cultures where negative emotions are perceived to be problematic and thus may not extend to Eastern cultures where negative emotions are seen as acceptable and normal. Using samples of 1044 American and 382 Japanese middle-aged and older adults, we investigated whether the relationship between negative emotions and IL-6 varies by cultural context. Negative emotions predicted higher IL-6 among American adults, whereas no association was evident among Japanese adults. Furthermore, the interaction between culture and negative emotions remained even after controlling for demographic variables, psychological factors (positive emotions, neuroticism, extraversion), health behaviors (smoking status, alcohol consumption), and health status (chronic conditions, BMI). These findings highlight the role of cultural context in shaping how negative emotions affect inflammatory physiology and underscore the importance of cultural ideas and practices relevant to negative emotions for understanding of the interplay between psychology, physiology, and health.

OBJECTIVE Building on prior work linking high anger expression to poor health, this cross-sectional study addressed whether anger expression exacerbated age-related risk for metabolic syndrome in a national sample of adults, known as MIDUS (Midlife in the United States). METHOD Respondents reported anger expression via survey assessments and completed an overnight clinic visit. RESULTS Unadjusted metabolic syndrome prevalence was 40.6%. Men, less educated individuals, and those who reported not getting regular physical activity were at significantly higher risk for metabolic syndrome. Anger expression did not predict higher risk for metabolic syndrome in main effects models, but it moderated the relationship between age and metabolic syndrome. Age-associated risk for metabolic syndrome was significant only for adults with high anger expression. DISCUSSION Among older adults, anger expression predicted higher prevalence of metabolic syndrome. Older adults reporting low anger expression had metabolic syndrome rates comparable to younger adults. Results highlight that failing to show the frequently observed decline in anger expression with age may have pernicious health concomitants.

OBJECTIVE To examine multiple aspects of anger experience and expression (frequency, outward expression, suppression, and control) as moderators of the association of social inequality, as measured by educational status, with inflammation and coagulation markers. METHODS After survey assessments via telephone and mail, Midlife in the United States respondents (N = 1054) participated in an overnight clinic visit, where they completed anger questionnaires and provided a fasting blood sample to measure interleukin-6 (IL-6), C-reactive protein (CRP), and fibrinogen. RESULTS Educational status was linked to higher anger control among men (B = 0.14, p = .001). Significant inverse correlations emerged between education and IL-6, CRP, and fibrinogen (r values ≥ -0.09, p values

This chapter reviews the philosophical and conceptual foundations of two types of happiness: hedonic well-being and eudaimonic well-being. Both are increasingly the focus of scientific research, including studies of health. We summarize extant evidence linking both types of well-being to health, broadly defined to include self-reported health, disease states and severity, functional capacities and biological risk factors. For eudaimonic well-being, links to brain-based assessments have also been conducted. The overarching message from this literature is that well-being, whether framed as life contentment or life engagement, appears to be protective of good health, and further that health problems appear to compromise well-being. More research is needed, particularly longitudinal studies that can more clearly delineate the direction of causal influences as well as the biological and brain-based mechanisms that account for connections between well-being and health. We conclude with consideration of how studies of well-being might fruitfully intersect with studies of quality of life. A further priority for future work pertains to interventions designed to promote greater experiences of life contentment and life engagement for greater segments of society, which may also be beneficial for health.

OBJECTIVE To evaluate a possible physiological mechanism underlying links between low childhood socioeconomic status (SES) and poor adult health by (a) testing whether childhood SES is prospectively related to cardiovascular responses to laboratory stress in adulthood, and (b) by determining whether psychological resources buffer cardiovascular reactivity and promote better recovery from stress. METHOD Participants (n = 246; 55% Black; mean age = 32 years) were from a population-based sample of men in Pittsburgh, PA. Childhood SES was measured through the Hollingshead index (parental education and occupation) across 10 waves between the ages of 6 and 16. In adulthood, cardiovascular measures, including systolic and diastolic blood pressure (SBP, DBP), heart rate (HR), and high-frequency heart rate variability (HF-HRV), were taken during and following standardized laboratory psychological stressors. Participants completed measures of optimism, purpose in life, self-esteem, positive affect, and self-mastery, which were combined into a psychological resource factor. RESULTS Lower childhood SES predicted higher HR and SBP at recovery, independent of age, race, body mass index, current smoking, task demand, and current SES. Psychological resources moderated the association between childhood SES and SBP. Lower childhood SES predicted SBP recovery only among men with fewer psychological resources. CONCLUSIONS Psychological resources may buffer the relation between low childhood SES and cardiovascular recovery from stress. This buffering may improve adult health to the extent that cardiovascular recovery contributes to the risk of low childhood SES for subsequent disease. (PsycINFO Database Record

Objectives: We investigate (a) the extent to which healthy lifestyles (physical activity and diet) explain the association between childhood disadvantage and metabolic syndrome (MetS) in midlife, and (b) whether there are gender differences in the associations.

Purpose in life predicts both health and longevity suggesting that the ability to find meaning from life's experiences, especially when confronting life's challenges, may be a mechanism underlying resilience. Having purpose in life may motivate reframing stressful situations to deal with them more productively, thereby facilitating recovery from stress and trauma. In turn, enhanced ability to recover from negative events may allow a person to achieve or maintain a feeling of greater purpose in life over time. In a large sample of adults (aged 36-84 years) from the MIDUS study (Midlife in the U.S., http://www.midus.wisc.edu/), we tested whether purpose in life was associated with better emotional recovery following exposure to negative picture stimuli indexed by the magnitude of the eyeblink startle reflex (EBR), a measure sensitive to emotional state. We differentiated between initial emotional reactivity (during stimulus presentation) and emotional recovery (occurring after stimulus offset). Greater purpose in life, assessed over two years prior, predicted better recovery from negative stimuli indexed by a smaller eyeblink after negative pictures offset, even after controlling for initial reactivity to the stimuli during the picture presentation, gender, age, trait affect, and other well-being dimensions. These data suggest a proximal mechanism by which purpose in life may afford protection from negative events and confer resilience is through enhanced automatic emotion regulation after negative emotional provocation.

This article seeks to forge scientific connections between three overarching themes (culture, inequality, health). Although the influence of cultural context on human experience has gained notable research prominence, it has rarely embraced another large arena of science focused on the influence social hierarchies have on how well and how long people live. That literature is increasingly focused psychosocial factors, working interactively with biological and brain-based mechanisms, to account for why those with low socioeconomic standing have poorer health. Our central question is whether and how these processes might vary by cultural context. We draw on emerging findings from two parallel studies, Midlife in the U.S. and Midlife in Japan, to illustrate the cultural specificity evident in how psychosocial and neurobiological factors are linked with each other as well as how position in social hierarchies matters for psychological experience and biology. We conclude with suggestions for future multidisciplinary research seeking to understand how social hierarchies matter for people’s health, albeit in ways that may possibly differ across cultural contexts.