Youth Who Achieve Upward Socioeconomic Mobility Display Lower Psychological Distress But Higher Metabolic Syndrome Rates as Adults: Prospective Evidence From Add Health and MIDUS

Abstract

Background People with higher socioeconomic status generally enjoy better cardiovascular health across the life course than those with lower status. However, recent studies of upward mobility, where a child goes on to achieve higher socioeconomic status than his or her parents, suggest that it entails a tradeoff between better psychological well-being and worse cardiometabolic health. In this study, we consider further evidence of this tradeoff in 2 multidecade studies, asking how upward income mobility relates to subsequent perceived stress, depressive symptoms, and metabolic syndrome. We ask parallel questions about downward mobility. Finally, given shifting patterns of mobility in recent generations, we also consider whether mobility's association with health outcomes differs for individuals born in the middle and later parts of the 20th century. Methods and Results We analyzed prospective data from Add Health (National Longitudinal Study of Adolescent Health; N=7542) and MIDUS (Midlife in the United States Study; N=1877). In both studies, evidence of the tradeoff was observed. Upward mobility presaged lower perceived stress and fewer depressive symptoms, in combination with higher metabolic syndrome rates. In contrast, downward mobility presaged worse outcomes on all health indicators. The magnitude of the mobility-health associations was similar across cohorts. Conclusions These findings provide evidence that upward income mobility is associated with a tradeoff between well-being and cardiometabolic health. The similarity of the findings across cohorts suggests that this tradeoff is a generalized consequence of ascending the socioeconomic hierarchy, at least for Americans born in the middle and later parts of the 20th century.

Keywords: depression; metabolic syndrome; socioeconomic position.

Figure 1. Adult health outcomes in each study as a function of life‐course socioeconomic group.

Outcomes depicted include psychological stress (A), depression (B and C), and metabolic syndrome (MetS; D and E). Values are adjusted for age, sex, race, and ethnicity. Add Health indicates National Longitudinal Study of Adolescent Health; and MIDUS, Midlife in the United States Study.

Figure 2. Proportion of participants in each study who display presumptive tradeoff as a function of life‐course socioeconomic group.

Tradeoff is defined as the absence of significant depression coupled with the presence of metabolic syndrome. Add Health indicates National Longitudinal Study of Adolescent Health; and MIDUS, Midlife in the United States Study.