Linking Cardiac Psychology and Cardiovascular Medicine via Self-Determination Theory and Shared Decision-Making.

Despite considerable progress in recent years, research in cardiac psychology is not widely translated into routine practice by clinical cardiologists or clinical health psychologists. Self-determination theory (SDT), which addresses how basic psychological needs of autonomy, competence, and relatedness contribute to the internalization of motivation, may help bridge this research-practice gap through its application to shared decision-making (SDM). This narrative review discusses the following: (a) brief background information on SDT and SDM, (b) the application of SDT to health behavior change and cardiology interventions, and (c) how SDT and SDM may be merged using a dissemination and implementation (D&I) framework. We address barriers to implementing SDM in cardiology, how SDM and SDT address the need for respect of patient autonomy, and how SDT can enhance D&I of SDM interventions through its focus on autonomy, competence, and relatedness and its consideration of other constructs that facilitate the internalization of motivation.

Meaning Salience and Meaning in Life Prospectively Predict Lower Distress During the COVID-19 Pandemic.

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.

The COVID-19 pandemic is a widespread source of stress. Having a sense of meaning in life, or that you have goals in life and a sense that the things you do are worthwhile and significant, is an important part of psychological well-being and might help reduce stress. We collected data on 147 healthy adults in 2018­2019 regarding their stress levels, sense of meaning in life, and how often they were aware of their life's meaning on daily basis and after a stress task in the laboratory. We re-contacted these adults in both April and July 2020 to ask about their stress, and 95 adults responded. Adults who had higher meaning in life in 2018­2019 experienced less stress during the early months of the COVID-19 pandemic. Adults who were more aware of their life's meaning each day and immediately after a stress task in the laboratory also experienced less stress during the COVID-19 pandemic. Results from this study provide evidence that having a strong sense of meaning in life overall and being aware of your life's meaning each day and during times of stress, may promote psychological well-being and reduce stress during times when stress is widespread and abundant.

Effects of the Great Recession on Educational Disparities in Cardiometabolic Health.

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.

Socioeconomic Status and Cardiovascular Responses to Standardized Stressors: A Systematic Review and Meta-Analysis.

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.

Pathways Linking Childhood SES and Adult Health Behaviors and Psychological Resources in Black and White Men.

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.

Psychological well-being and metabolic syndrome: findings from the midlife in the United States national sample.

OBJECTIVES: Psychological well-being predicts favorable cardiovascular outcomes, but less evidence addresses biological mediators underlying these effects. Therefore, associations among well-being and metabolic syndrome (MetSyn) were examined in a national sample. METHODS: Survey of Midlife in the US participants (MIDUS; n = 1205) provided survey assessments of hedonic (positive affect, life satisfaction) and eudaimonic well-being (e.g., personal growth and purpose in life) at two waves 9 to 10 years apart. MetSyn components were measured during an overnight clinic visit at Time 2 only. Outcomes included the number of MetSyn risk factors and a binary outcome reflective of MetSyn status. RESULTS: The unadjusted prevalence of MetSyn was 36.6%. Life satisfaction (B [standard error {SE}] = -0.12 [0.04], p = .005), positive affect (B [SE] = -0.10 [0.04], p = .009), and personal growth (B [SE] = -0.10 [0.04], p = .012) predicted fewer MetSyn components and lower risk of meeting diagnostic criteria in fully adjusted models. Results were unchanged by adjustments for depressive symptoms, and were not moderated by age, sex, race, or socioeconomic status. Life satisfaction (B [SE] = -0.11 [0.05], p = .023) and a eudaimonic well-being composite (B [SE] = -0.11 [0.05], p = .045) also predicted fewer components and lower risk of meeting diagnostic criteria in longitudinal models. CONCLUSIONS: Psychosocial resources, including positive affect, life satisfaction, and personal growth, predicted reduced risk for MetSyn both cross sectionally and longitudinally. Further work should examine consequences of these linkages for cardiovascular outcomes in intervention contexts.

Expression of anger and ill health in two cultures: an examination of inflammation and cardiovascular risk.

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.

Educational Status, Anger, and Inflammation in the MIDUS National Sample: Does Race Matter?

BACKGROUND: Racial differences in anger frequency and expression styles have been found. Further, African Americans receive fewer health benefits from higher education than Whites. PURPOSE: This study seeks to investigate racial differences in how anger moderates the association between education and inflammation. METHODS: 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. RESULTS: 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. CONCLUSIONS: Findings underscore racial differences in the benefits and consequences of educational attainment, and how social inequities and anger are manifested in inflammatory physiology.

Varieties of anger and the inverse link between education and inflammation: toward an integrative framework.

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 <.004) and between anger control and IL-6 and CRP (r values = -0.07, p values < .03). Controlling for demographic and health status covariates, anger-in predicted lower fibrinogen (p = .03). Interactions between education and anger measures were significant for education and trait anger as related to fibrinogen (p = .02) and education and anger-out as related to IL-6 (p = .05) and fibrinogen (p = .05). As predicted, the inverse relationships between education and IL-6 and fibrinogen were stronger among individuals reporting high anger. Anger control also moderated the association of education with IL-6 in women (p = .026), such that the link between education and IL-6 was attenuated among women with high anger control. CONCLUSIONS: Varieties of anger moderated educational gradients in inflammation: The inverse relationships between education and inflammation markers were strongest among individuals with high anger and were attenuated among those with high anger control.

Negative emotions predict elevated interleukin-6 in the United States but not in Japan.

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.

Do Purpose in Life and Social Support Mediate the Association between Religiousness/Spirituality and Mortality? Evidence from the MIDUS National Sample.

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.

Psychological well-being, education, and mortality.

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. METHOD: 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 (a) the association between time-varying psychological well-being and mortality, and (b) 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 1 SD 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. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Racial disparities in sleep health between Black and White young adults: The role of neighborhood safety in childhood.

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 eight 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.

Childhood socioeconomic status and inflammation: Psychological moderators among Black and White Americans.

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).

Behavioral Adjustment Moderates the Link Between Neuroticism and Biological Health Risk: A U.S.-Japan Comparison Study.

Neuroticism, a broad personality trait linked to negative emotions, is consistently linked to ill health when self-report is used to assess health. However, when health risk is assessed with biomarkers, the evidence is inconsistent. Here, we tested the hypothesis that the association between neuroticism and biological health risk is moderated by behavioral adjustment, a propensity to flexibly adjust behaviors to environmental contingencies. Using a U.S.-Japan cross-cultural survey, we found that neuroticism was linked to lower biological health risk for those who are high, but not low, in behavioral adjustment. Importantly, Japanese were higher in behavioral adjustment than European Americans, and as predicted by this cultural difference, neuroticism was linked to lower biological health risk for Japanese but not for European Americans. Finally, consistent with prior evidence, neuroticism was associated with worse self-reported health regardless of behavioral adjustment or culture. Discussion focused on the significance of identifying sociocultural correlates of biological health.

Culture and social hierarchy: Self- and other-oriented correlates of socioeconomic status across cultures.

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

Neighborhood SES is particularly important to the cardiovascular health of low SES individuals.

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.

Childhood Socioeconomic Disadvantage, Occupational, Leisure-Time, and Household Physical Activity, and Diabetes in Adulthood.

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).

Moving up matters: Socioeconomic mobility prospectively predicts better physical health.

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