- Researchers report that people moving up the economic ladder tend to have improved mental health but also higher risks for cardiovascular-related disease.
- They say many people who improve their socioeconomic status still have childhood-related health issues.
- They add that sometimes people moving up are so focused on their jobs that they don’t maintain good health habits.
Moving up in socioeconomic status may improve some areas of life, but when it comes to heart health, it’s not as simple.
Research published today in the Journal of the American Heart Association found that though upward income mobility improved a person’s mental health, their cardiometabolic health was worse.
“Upward mobility is not always beneficial for cardiometabolic health, even if it improves economic standing and mental health,” said Greg Miller, PhD, an author of the research and co-director of the Foundations of Health Research Center at Northwestern University in Illinois.
“Most of the time, higher socioeconomic status forecasts better health. But not in everyone, not for all diseases,” Miller told Healthline. “And as our work shows, the health benefits of being higher socioeconomic status depend somewhat on how one becomes high socioeconomic status.”
In undertaking the research, Miller, together with researchers from Northwestern and the University of Georgia, analyzed data from two studies spanning multiple decades.
The 7,542 participants in the National Longitudinal Study of Adolescent Health and the 1,877 participants in the Midlife in the United States Study entered the studies as youth and were followed into adulthood.
The researchers categorized the participants into groups based on their family’s income during childhood and adulthood.
The four groups were those who experienced consistent disadvantage; those who experienced consistent advantage; those who were upwardly mobile (meaning an increase in socioeconomic status compared with childhood); and those who experienced downward mobility.
The researchers said they found that those who were upwardly mobile had lower perceived stress and less symptoms of depression. But they experienced higher rates of metabolic syndrome, a collection of conditions that increases the risk of heart attack, stroke, and diabetes.
High socioeconomic status is generally associated with fewer health problems. However, the study suggests an improvement in financial conditions doesn’t necessarily equate to an improvement in cardiometabolic health.
“Many of us would have thought intuitively that if one improved one’s financial situation, one would be able to reap the health benefits associated with that financial improvement, and that might include less diabetes, less obesity, less bad cardiometabolic health… in that regard, it’s surprising,” said Dr. Robert Harrington, an interventional cardiologist and chair of the department of medicine at Stanford University in California.
“What’s not surprising, and perhaps what’s consistent with other things we know, is that lifelong cardiovascular health goes all the way back to the peripartum time frame,” Harrington told Healthline.
“In other words, we know the cardiovascular and cardiometabolic health of the mother plays a role in the lifetime of the cardiovascular health of the child,” he said.
Cardiometabolic syndrome includes conditions such as high blood sugar, high blood pressure, higher levels of body fat around the waist, and abnormal levels of cholesterol.
Dr. Nieca Goldberg, medical director of the NYU Langone Women’s Heart Attack Program and volunteer expert for the American Heart Association, says those who are trying to improve their socioeconomic status may have a lifestyle that contributes to these risk factors.
“People who are trying to succeed at financial success are often focused on the job or jobs they must do for economic success at the expense of cardiometabolic risk,” she told Healthline.
“Cardiometabolic risk factors that include high blood pressure, central obesity (belly fat), elevated glucose, low HDL (good cholesterol), and elevated triglycerides are lifestyle-dependent, and the upwardly mobile individuals may have trouble fitting exercise into their already busy schedule, eat prepared meals or processed foods because they are time-pressed,” she added.
Miller notes that people whose status remains consistent tend to have better health outcomes.
Dr. Michelle J. Ko, an assistant professor in the division of health policy and management at the University of California, Davis, says those who fall into the consistent category may not experience the same stressors as those who are upwardly mobile.
“Those with consistent advantage throughout life presumably face far fewer stressors to maintain their status,” Ko told Healthline. “They have been granted income, educational, cultural, and social benefits as children, which makes it easier to both stay advantaged and navigate that social status. Those with upward mobility must contend with multiple stressors: how to get there, how to stay there, how to balance the needs of family and friends who are not as successful.”
In addition to this, Ko says an increase in income doesn’t guarantee being able to live in an area that promotes healthy living.
“Those with upward mobility do not necessarily have the wealth to move into neighborhoods with factors that lead to good cardiovascular health, such as clean air, lower levels of environmental contamination, better options for purchasing healthy food, or having open and safe space for exercise and recreation,” she said.
The Northwestern study found that those who were upwardly mobile and those who were consistently disadvantaged fared the worst when it came to their cardiometabolic health.
Harrington says a person’s socioeconomic status can influence their cardiovascular health in many ways.
“We know that people who have a higher socioeconomic status in general have better cardiovascular health than people at a lower socioeconomic level,” he said.
“In other words, an individual of lower socioeconomic status with cardiovascular disease is going to fare worse on average than an individual with higher socioeconomic status when matched with the same cardiovascular disease.
“There is also an interplay of socioeconomics with access to adequate medical care… that includes things like blood pressure monitoring, diabetes screening, cholesterol screening, the kind of things that are readily available as preventative healthcare measures to those of a certain socioeconomic class, but not to all,” Harrington said.
Harrington says that as people attempt to improve their socioeconomic status, attention also needs to be paid to improving their cardiovascular health.
“As people move up and improve their socioeconomic status, one needs to be mindful of also making sure that one improves one’s attention to lifestyle issues which portend better cardiovascular health: smoking cessation or avoidance, taking care of one’s blood pressure, controlling one’s blood sugar, controlling one’s weight, having a lifestyle that includes physical activity on a regular basis,” he said.
“All of those we know are associated with good cardiovascular health over the long term, and that’s what should be strived for,” Harrington said.