January 19, 2022
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Women who rated themselves as having lower socioeconomic status experienced higher allostatic stress at 1 year postpartum, which may lead to poorer health outcomes in the future, according to results published in Health Psychology.
In light of the current pandemic, increased stress for financial, health or other reasons could exacerbate this inequality, the study authors said.
“Data collection for this study occurred between 2008 and 2012, which coincided with the Great Recession.” Christina Guardino, MA, PhD, an assistant professor of psychology at Dickinson College, Healio said. “We found that subjective and objective markers of socioeconomic status predicted higher allostatic loading in this sample. Job losses, financial instability, home insecurity and other disruptions during the COVID-19 pandemic can affect both actual and perceived socioeconomic status, which in turn can impact physical and mental health.”
They watched and Christine Dark Schetter, doctor, a psychology professor and associate vice chancellor for faculty development at UCLA, used data from the Community Child Health Network to follow 1,168 women through their postpartum year. The researchers conducted home visits at 1, 6, and 12 months after delivery to assess 10 biomarkers of allostatic stress, including the participants’ BMI, BP, cholesterol, and cortisol levels. To calculate the allostatic load, the researchers assigned a point to each of the biomarkers when the values exceeded the clinical cut-off points. Researchers also collected information about participants’ household income, years of education, and perceived social status.
Subjective social status (SSS) scores were reported using the SSS MacArthur scale at 6 and 12 months postpartum; On a 10-point scale, scores of one to three were considered low SSS, while scores of eight to 10 were considered high SSS.
Christina Guardino
cohort demographics
Overall, 43% of the participants lived at or below the federal poverty line and 27% had incomes between 100% and 200% of the federal poverty line, the researchers said. In addition, the participants had completed an average of 13 years of schooling.
Approximately 53% of the women were Black, with a mean SSS of 5.26 (95% CI, 5.11-5.4); 23.2% were non-Hispanic whites with a mean SSS of 6.15 (95% CI, 5.93-6.37); and 23.2% were Hispanic, with a mean SSS of 4.84 (95% CI, 4.62-5.06). According to Guardino and Schetter, about 15% of the cohort reported low SSS and 12% high SSS.
Differences between racial groups are partly due to higher levels of stress and inequalities in the participants’ neighborhoods, Guardino said. This is consistent with a growing body of research showing that social determinants such as economic stability, educational opportunities and neighborhood environments contribute to health disparities, she added.
Allostatic load associations
The researchers reported that the participants had an average of 3.01 markers of allostatic stress that were above clinical cutoffs.
“These results point to an increased health risk in this sample of women and suggest that attention needs to be given to women’s health after childbirth,” Guardino said.
Additionally, higher SSS was correlated with higher income and more years of education completed, and was significantly associated with lower allostatic load, according to the researchers. When adjusted for race or ethnicity, SSS remained significantly associated with allostatic loading. The association persisted after additional adjustments for relationship status, geographic location, maternal age, and weeks since delivery at the time of biomarker assessment.
The strength of the association between SSS and allostatic load was stronger than the association between income and allostatic load (P=0.02), according to Guardino and Schetter. However, the association between SSS and allostatic load may vary based on income and education.
“In the United States, standard medical care after childbirth typically focuses almost entirely on the infant,” Guardino said. “Maternal postpartum health is rarely emphasized, leading to a missed opportunity to support women’s health and well-being. This research arose out of our interest in developing a better understanding of the predictors of women’s health in the year after childbirth.”
Exposure to financial pressures and other chronic stressors causes “wear and tear” on body systems, which can contribute to greater allostatic stress, she added.
“[Allostatic load] may contribute to adverse outcomes in later pregnancies and influence health outcomes for women throughout the lifespan,” wrote Guardino and Schetter.
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