Allostatic Load and Exposure Histories of Disadvantage

Lucy Prior

doi:10.3390/ijerph18147222

Abstract

The stress pathway posits that those in disadvantaged circumstances are exposed to a higher degree of stressful experiences over time resulting in an accumulated biological burden which subsequently relates to poorer health. Trajectories of disadvantage, in the form of neighbourhood deprivation and structural social capital, are evaluated in their relation to allostatic load representing the cumulative “wear and tear” of chronic stress. This paper uses data from the British Household Panel Survey and Understanding Society in a latent class growth analysis. We identify groups of exposure trajectories over time using these classes to predict allostatic load at the final wave. The results show that persistent exposure to higher deprivation is related to worse allostatic load. High structural social capital over time relates to lower allostatic load, in line with a stress buffering effect, though this relationship is not robust to controlling for individual sociodemographic characteristics. By demonstrating a gradient in allostatic load by histories of deprivation, this analysis supports a biological embedding of disadvantage through chronic exposure to stressful environments as an explanation for social health inequalities.

Highlights

In line with expectations from the literature on the stress pathway hypothesis, this study aims to address the following research questions: does greater exposure to deprived neighbourhoods over time relate to higher allostatic load, and does experiencing higher social capital over time relate to lower allostatic load?
Though the sample-size adjusted Bayesian Information Criteria (SSABIC) is smallest for the 6-class model, indicated a better fitting model, for social capital a three-class solution is deemed most appropriate as maintaining a larger sample size (>50) for each exposure trajectory is desirable
The second stage of the analysis examined the relationship of allostatic load to the exposure histories of disadvantage and social capital

Summary

Introduction

The stress pathway has long been posited as a critical element of individual outcomes in social health research. This tended to be implicit, with a stress mechanism acting as an underlying theoretical proposal for explaining associations. Dowd et al [27] reviewed studies examining associations of socioeconomic status with cortisol and allostatic load. Overall, they found inconsistent evidence for associations with different cortisol measures. More agreement was found in relationships of socioeconomic status and allostatic load, which summarizes a long-term, accumulative response to stress [13,27]

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