Abstract P652: Higher Self-Perceived Financial Stress is Associated With Increased Allostatic Load Among African American Women: The Jackson Heart Study

Abstract

Introduction: African American women have higher rates of financial stress as well as higher allostatic load compared to non-Hispanic White women. Financial stress is the psychological, subjective perception of hardship, experienced with limited access to material resources and an inability to meet financial obligations. Differences in financial stress have been observed between sexes, as women are more likely to report experiencing this stressor as compared to men. Allostatic load has been used to quantify the effects of chronic stress on the body. Among those with higher allostatic load, there is an increased risk for cardiovascular disease and mortality. The purpose of this study was to assess the association between financial stress and allostatic load among African American women in the Jackson Heart Study. Hypothesis: We hypothesized that the composite score of allostatic load would be positively associated with self-reported financial stress. Methods: Data were included from African American women within Exam 1 of the Jackson Heart Study, a longitudinal observational cohort study of African Americans in the Jackson, Mississippi metropolitan area. Financial stress, the exposure variable, was based on participants’ self-reported experiences, rated as “ did not experience stress,”” no stress,” “mild stress,” and “moderate to high stress .” The survey questions were gathered from the Weekly Stress Index which is a self-reported measure developed to estimate the overall stressfulness of distinct individual financial stressors experienced throughout the past week. Allostatic load, the outcome variable, was calculated using the following measures: cortisol, glycosylated hemoglobin A1c, total cholesterol, waist circumference, systolic blood pressure, diastolic blood pressure, heart rate, C-reactive protein, and white blood cell count. The composite measure of allostatic load consisted of the sum of the total number of biomarkers that were found to be within high-risk quartiles. Logistic regression models with relevant covariates were used to estimate the association. Results: Among the total sample of 1,867, 15% reported moderate to high financial stress and 37.17% had a composite measure indicative of high allostatic load. After controlling for social economic status, access to care, health behaviors, and psychosocial variables, those who reported moderate to high financial stress were 1.85 (95% CI 1.32, 2.59) times more likely to have high allostatic load. Conclusions: Financial stress may be one mechanism contributing to increased production of physiological biomarkers of stress in the body. Further analysis should be conducted on financial stress and the incidence of cardiovascular disease among African American women.