Women's Health Over the Lifecourse: Social, Psychosocial, and Biological Intersections

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Principal Investigator: Dawn Upchurch

Midlife is a pivotal stage in women’s lifecourse marked by significant physiological changes and social transitions. This study employed a dynamic biopsychosocial model to examine racial and SES effects on allostatic load (AL) over time and to estimate the extent to which discrimination, perceived stress, and hostility mediate their effects. AL is conceptualized as a multi-system, cumulative burden of physiological dysregulation. We used latent growth models to capture level and change in AL among a cohort of midlife women over 8 years of observation (Study of Women’s Health Across the Nation). African American race and lower income were predictive of higher discrimination (p<.001); higher discrimination was predictive of higher level of AL (p<.05). African American race, lower income, and lower education were predictive of higher hostility (p<.001); higher hostility was predictive of higher level of AL (p<.05). Lower income was predictive of higher perceived stress (p<.001); higher perceived stress was predictive of faster increase in AL (p<.05). The findings are the first to assess AL accumulation over time and demonstrate the complex ways race, SES, and psychosocial factors operate on AL. Additionally, the findings suggest possible clinical and public health intervention strategies to improve women’s health during midlife and beyond.