Social class stigma and poorer health behaviors: Evidence from the eating in America study.

Although the association between objective markers of low socioeconomic status (SES) and poor health is well established, one underexamined possibility is that over and above objective SES, social class stigma-experiences and anticipation of discrimination based on social class-might undermine people's ability to engage in healthy behaviors. Participants (N = 2022) were recruited between December 2019 and January 2020 via a national Qualtrics panel that was census-matched to the U.S. population in age, gender, income, race/ethnicity, and census region. Participants completed measures of class stigma, alcohol use, disordered eating, comfort eating, sleep disturbance, physical activity, and demographics. Controlling for objective SES and demographics, generalized linear regression models indicated that class stigma was associated with significantly greater alcohol use, disordered eating, greater comfort eating, and sleep disturbance but not less physical activity. Class stigma was not associated with health behaviors after full adjustment for weight/racial discrimination and psychological factors. Results from this investigation suggest that beyond one's objective SES, the stigma associated with having low class may also contribute to poorer health behaviors.

What Does the MacArthur Scale of Subjective Social Status Measure? Separating Economic Circumstances and Social Status to Predict Health.

BACKGROUND: Subjective socioeconomic status is robustly associated with many measures of health and well-being. The MacArthur Scale of Subjective Social Status (i.e., the MacArthur ladder) is the most widely used measure of this construct, but it remains unclear what exactly the MacArthur ladder measures. PURPOSE: The present research sought to explore the social and economic factors that underlie responses to the MacArthur ladder and its relationship to health. METHODS: We investigated this issue by examining the relationship between scores on the MacArthur ladder and measures of economic circumstances and noneconomic social status, as well as health and well-being measures, in healthy adults in the USA. RESULTS: In three studies (total N = 1,310) we found evidence that economic circumstances and social status are distinct constructs that have distinct associations with scores on the MacArthur ladder. We found that both factors exhibit distinct associations with measures of health and well-being and accounted for the association between the MacArthur ladder and each measure of health and well-being. CONCLUSIONS: Our findings suggest that the MacArthur ladder's robust predictive validity may result from the fact that it measures two factors-economic circumstances and social status-that are each independently associated with health outcomes. These findings provide a novel perspective on the large body of literature that uses the MacArthur ladder and suggests health researchers should do more to disentangle the social and economic aspects of subjective socioeconomic status.

Past research has found that people's subjective perception of their own socioeconomic status (SES) is associated with their health and well-being, even after controlling for traditional measures of SES such as income. But researchers still do not know why. One possibility is that subjective SES is simply a different measure of SES. Another is that it measures social status, separate from economic circumstances. We investigated this question using the MacArthur Scale of Subjective Social Status, which measures how people see their place in society. Across three studies using 1,300 adults in the USA, we found that the MacArthur Ladder measures two distinct factors: (i) economic circumstances, as measured by their income, education, housing, etc. and (ii) social status as measured by relative judgements of power, control, social influence, and their standing in their community and society. Both of these aspects of SES uniquely predict health and well-being. Our investigation demonstrates that the MacArthur ladder is good at predicting health outcomes because it measures both economic circumstances and social status. This new insight can help health researchers better understand the effects of social and economic factors on health, and to measure them more precisely.

Lower Socioeconomic Position Is Associated with Greater Activity in and Integration within an Allostatic-Interoceptive Brain Network in Response to Affective Stimuli.

Socioeconomic inequities shape physical health and emotional well-being. As such, recent work has examined the neural mechanisms through which socioeconomic position (SEP) may influence health. However, there remain critical gaps in knowledge regarding the relationships between SEP and brain function. These gaps include a lack of research on: (1) the association between SEP and brain functioning in later life, (2) relationships between SEP and functioning of the whole brain beyond specific regions of interest, and (3) how neural responses to positive affective stimuli differ by SEP. The current study addressed these gaps by examining the association between SEP (i.e., education, income) and neural responses to affective stimuli among 122 mid- to late-life adults. During MRI scanning, participants viewed 30 positive, 30 negative, and 30 neutral images; activation and network connectivity analyses explored associations between SEP and neural responses to these affective stimuli. Analyses revealed that those with lower SEP showed greater neural activity to both positive and negative images in regions within the allostatic-interoceptive network, a system of regions implicated in representing and regulating physiological states of the body and the external environment. There were no positive associations between SEP and neural responses to negative or positive images. In addition, graph-theory network analyses showed that individuals with lower SEP demonstrated greater global efficiency within the allostatic-interoceptive network and executive control network, across all task conditions. The findings suggest that lower SEP is associated with enhanced neural sensitivity to affective cues that may be metabolically costly to maintain over time and suggest a mechanism by which SEP might get "under the skull" to influence mental and physical well-being.

Brain-body pathways linking racism and health.

Racial disparities in health are a major public health problem in the United States, especially when comparing chronic disease morbidity and mortality for Black versus White Americans. These health disparities are primarily due to insidious anti-Black racism that permeates American history, current culture and institutions, and interpersonal interactions. But how does racism get under the skull and the skin to influence brain and bodily processes that impact the health of Black Americans? In the present article, we present a model describing the possible neural and inflammatory mechanisms linking racism and health. We hypothesize that racism influences neural activity and connectivity in the salience and default mode networks of the brain and disrupts interactions between these networks and the executive control network. This pattern of neural functioning in turn leads to greater sympathetic nervous system signaling, hypothalamic-pituitary-adrenal axis activation, and increased expression of genes involved in inflammation, ultimately leading to higher levels of proinflammatory cytokines in the body and brain. Over time, these neural and physiological responses can lead to chronic physical and mental health conditions, disrupt well-being, and cause premature mortality. Given that research in this area is underdeveloped to date, we emphasize opportunities for future research that are needed to build a comprehensive mechanistic understanding of the brain-body pathways linking anti-Black racism and health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Socioeconomic status and inflammation: a meta-analysis.

Socioeconomic status (SES), often conceptualized as income, education, or occupation, is associated with risk for disease morbidity and psychopathology. Recent research has focused on the potential biological mechanisms linking lower SES and poor outcomes; much of this work has examined the relationship between SES and markers of systemic inflammation. The strength of the estimated association between SES and inflammatory markers varies widely across individual studies. Thus, we used meta-analytic techniques to quantify the magnitude of this relationship. To accomplish this, PubMed and PsycINFO were searched for papers that reported on SES and two commonly measured systemic inflammatory markers, C-reactive protein (CRP) and interleukin-6 (IL-6). Peer-reviewed, empirical papers conducted in non-patient populations were included. Data from 43 papers (N = 111,156) reporting a total of 63 relevant effect sizes were included in analyses. SES, broadly defined, was significantly associated with both levels of CRP (Z = 0.12; 95% CI, 0.09-0.16) and IL-6 (Z = 0.15; 95% CI, 0.12-0.18); individuals with lower SES showed higher levels of systemic inflammation. Subanalyses demonstrated that studies operationalizing SES as either levels of income or educational attainment also found significant associations with both CRP and IL-6. Moderator analyses revealed that effect sizes varied based on sample characteristics and analysis approaches. Lower SES is associated with significantly elevated levels of inflammatory markers of disease risk. Thus, pro-inflammatory pathways are likely an important mechanism translating socioeconomic inequalities into mental and physical health disparities.

Subjective social status and neural processing of race in Mexican American adolescents.

Adolescence is a sensitive period for sociocultural development in which facets of social identity, including social status and race, become especially salient. Despite the heightened importance of both social status and race during this developmental period, no known work has examined how individual differences in social status influence perceptions of race in adolescents. Thus, in the present study, we investigated how both subjective social status and objective socioeconomic status (SES) influence neural responses to race. Twenty-three Mexican American adolescents (15 females; mean age = 17.22 years) were scanned using functional magnetic resonance imaging while they viewed Black and White faces in a standard labeling task. Adolescents rated their subjective social status in US society, while their parents responded to questions about their educational background, occupation, and economic strain (objective SES). Results demonstrated a negative association between subjective social status and neural responses in the amygdala, fusiform face area, and medial prefrontal cortex when adolescents viewed Black (relative to White) faces. In other words, adolescents with lower subjective social status showed greater activity in neural regions involved in processing salience, perceptual expertise, and thinking about the minds of others when they viewed images of Black faces, suggesting enhanced salience of race for these youth. There was no relationship between objective SES and neural responses to the faces. Moreover, instructing participants to focus on the gender or emotion expression on the face attenuated the relationship between subjective social status and neural processing of race. Together, these results demonstrate that subjective social status shapes the way the brain responds to race, which may have implications for psychopathology.

Socioeconomic influences on brain function: implications for health.

Socioeconomic-based disparities in physical health outcomes are well established, with individuals from lower socioeconomic status (SES) backgrounds being more likely to experience chronic disease morbidity and early mortality compared to those from higher SES strata. While numerous studies in recent decades have focused on understanding the contextual, psychosocial, and biological mechanisms linking SES and health, the neural pathways that contribute to this relationship are currently underinvestigated. The present paper reviews and synthesizes the small number of published studies that have explored links between SES and health-relevant neural functioning. Specifically, current knowledge of the relationship between socioeconomic factors and neural systems that may be affected by low SES contexts, including those related to processing threat and stress, responding to reward, and engaging in emotion regulation, is reviewed. Gaps in our knowledge that could be filled by health neuroscience research are emphasized, in an effort to catalyze future studies in this area. Understanding the neural mechanisms linking SES and health is crucial for building comprehensive models of the pathways by which social inequalities become health inequalities and may help identify novel targets for intervention to prevent health disparities. Health neuroscience research has a critical role to play in this important area of research.

Neural mechanisms linking social status and inflammatory responses to social stress.

Social stratification has important implications for health and well-being, with individuals lower in standing in a hierarchy experiencing worse outcomes than those higher up the social ladder. Separate lines of past research suggest that alterations in inflammatory processes and neural responses to threat may link lower social status with poorer outcomes. This study was designed to bridge these literatures to investigate the neurocognitive mechanisms linking subjective social status and inflammation. Thirty-one participants reported their subjective social status, and underwent a functional magnetic resonance imaging scan while they were socially evaluated. Participants also provided blood samples before and after the stressor, which were analysed for changes in inflammation. Results showed that lower subjective social status was associated with greater increases in inflammation. Neuroimaging data revealed lower subjective social status was associated with greater neural activity in the dorsomedial prefrontal cortex (DMPFC) in response to negative feedback. Finally, results indicated that activation in the DMPFC in response to negative feedback mediated the relation between social status and increases in inflammatory activity. This study provides the first evidence of a neurocognitive pathway linking subjective social status and inflammation, thus furthering our understanding of how social hierarchies shape neural and physiological responses to social interactions.

Social status modulates neural activity in the mentalizing network.

The current research explored the neural mechanisms linking social status to perceptions of the social world. Two fMRI studies provide converging evidence that individuals lower in social status are more likely to engage neural circuitry often involved in 'mentalizing' or thinking about others' thoughts and feelings. Study 1 found that college students' perception of their social status in the university community was related to neural activity in the mentalizing network (e.g., DMPFC, MPFC, precuneus/PCC) while encoding social information, with lower social status predicting greater neural activity in this network. Study 2 demonstrated that socioeconomic status, an objective indicator of global standing, predicted adolescents' neural activity during the processing of threatening faces, with individuals lower in social status displaying greater activity in the DMPFC, previously associated with mentalizing, and the amygdala, previously associated with emotion/salience processing. These studies demonstrate that social status is fundamentally and neurocognitively linked to how people process and navigate their social worlds.