PERCEPTION of SOCIAL STATUS INFLUENCES
ABDOMINAL FAT IN WHITE WOMEN
By Nancy E. Adler, M.D., Elissa S. Espel, Ph.D.,
University of California, San Francisco;
Grace Castellazzo, B.S.N., and Jeannette R. Ickovics,
The American Psychological Association has announced research
showing that the perception of stress can affect a white woman's
overall health as much as already known stressors like poverty.
"It is not simply the effects of income or education that are
linked to better health, but also the perception that one is
higher on the social hierarchy," said lead author Nancy Adler,
M.D., and University of California at San Francisco professor of
Researchers found that women who placed themselves higher on
the social ladder reported better physical health, took less time
to fall asleep at night, had lower resting physiological arousal
and less abdominal fat, a key indicator for stress adaptation,
said Dr. Adler. Perceptions of lower social standing were also
associated with likelihood of greater chronic stress, pessimism
and lower perceived control of life.
The researchers studied a sample of nearly 160 healthy white
women age 30-46. In addition to reporting on their income and
education, the women completed a new measure of subjective
status. They were shown a drawing of a ladder with ten rungs and
told to think of the ladder as representing where people stand in
society. At the top of the ladder are people who are best off -
those who have the most money, education, and best jobs. At the
bottom are people who are the worst off - who have the least
money, least education and worst jobs. Participants were then
asked to place an "X" on the rung which best represented where
they think they stood on the ladder.
The women, who had varying socio-economic backgrounds, were
evaluated for psychological indicators, including negative
affectivity (how much they generally tend to feel negative
emotions), pessimism, perceived control over life, coping style,
self-defined stress levels, and chronic stress levels.
Participants were also evaluated for sleep patterns, resting
physiological response, and fat distribution. A sub-sample of 59
women took part in a laboratory stress study that examined their
cortisol response to stress over a three day period. Cortisol is
a stress hormone that may play a role in the accumulation of
abdominal fat, explained Dr. Adler.
Fat deposit, in turn, is linked to metabolic and
cardiovascular disease. "With repeated experiences of the stress,
the body has greater exposure to cortisol. Abdominal fat has a
relatively greater sensitivity to cortisol than peripheral fat,
so individuals with higher cortisol reactivity, high resting
levels of cortisol and /or great exposure to events that evoke
stress response accumulate greater abdominal fat," said Dr.
Adler. Researchers analyzed the accumulation of body fat by
measuring body mass index (BMI) and waist-to-hip ratios.
"These findings suggest that women who perceive themselves to
be lower on the SES ladder, regardless of their actual placement,
had more stress than their SES peers who did not have low
perceptions of their SES status," said Dr. Adler. In order to
make this determination, the authors controlled for the effects
of objective SES in their statistical analysis before looking at
the additional effect of subjective status. Therefore, their
finding that subjective SES status is linked to physical and
mental health outcomes is shown to be occurring above and beyond
the direct impact of socioeconomic status.
Low subjective SES may either increase stress directly or make
women more vulnerable to the affects of stress," said Dr. Adler.
Lower ladder rankings are linked to increased stress even when
researchers controlled for an objective evaluation of SES
(education, occupation, income) and how much participants say
they tend to feel negative emotions, explained Adler.
This research serves as a human analog to studies of social
ordering and health among , plained Dr. Adler.
Subordinate primates have higher cortisol, higher blood pressure,
and worse health than dominant animals in stable social
environments, according to previous research. "The ladder
rankings may reflect direct social comparisons of social rank
that are more similar to dominance hierarchies than are
traditional measures of SES (education, occupation, income)," she
"Relationship of Subjective and Objective Social Status With
Psychological and Physiological Functioning: Preliminary Data in
Healthy White Women," Nancy E. Adler, M.D., Elissa S. Espel,
Ph.D., University of California, San Francisco; Grace
Castellazzo, B.S.N., and Jeannette R. Ickovics, Ph.D., Yale
University; Health Psychology, Vol. 19, No. 6
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