title: A Longitudinal Investigation of Race, Socioeconomic Status, and Psychosocial Mediators of Allostatic Load in Midlife Women: Findings From the Study of Women's Health Across the Nation.
abstract: OBJECTIVE
  This research sought to assess racial and socioeconomic status (SES) differences in level and change in allostatic load (AL) over time in midlife women and to test whether psychosocial factors mediate these relationships. These factors were discrimination, perceived stress, and hostility.
  
  
  METHODS
  Longitudinal data obtained from the Study of Women's Health Across the Nation were used (n = 2063; mean age at baseline = 46.0 years). Latent growth curve models evaluated the impact of demographic, menopausal, and psychosocial variables on level and change in AL for 8 years.
  
  
  RESULTS
  Direct effects: high levels of discrimination and hostility significantly predicted higher AL (path coefficients = 0.05 and 0.05, respectively). High perceived stress significantly predicted a faster rate of increase of AL (path coefficient = 0.06). Racial and SES differentials were present, with African American race (path coefficient = 0.23), low income (path coefficient = -0.15), and low education (path coefficient = -0.08) significantly predicting high AL level. Indirect effects: significant indirect effects were found for African American race, less income, and lower education through higher discrimination, perceived stress, and hostility on level and rate of AL.
  
  
  CONCLUSIONS
  This was one of the first studies that investigated AL over multiple periods, and results supported AL as a cumulative phenomenon, affected by multiple psychosocial and demographic factors. The results suggest the complex ways in which race, SES, and psychosocial factors operate to influence AL.
authors.affiliation: From the Department of Community Health Sciences (Upchurch), UCLA Fielding School of Public Health, Los Angeles, California; UCLA Department of Psychology (Stein), Los Angeles, California; Division of Geriatrics (Greendale, Huang, Seeman), David Geffen School of Medicine at UCLA, Los Angeles, California; Public Health Sciences Program (Chyu), Santa Clara University, Santa Clara, California; Division of General Internal Medicine and Health Services Research (Tseng), Department of Medicine, UCLA, Los Angeles, California; Department of Epidemiology (Lewis), Rollins School of Public Health, Emory University, Atlanta, Georgia; and Department of Psychiatry and Department of Preventive Medicine (Kravitz), Rush University Medical Center, Chicago, Illinois.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Upchurch
authors.forename: Judith
authors.initials: J
authors.lastname: Stein
authors.forename: Gail A
authors.initials: GA
authors.lastname: Greendale
authors.forename: Laura
authors.initials: L
authors.lastname: Chyu
authors.forename: Chi-Hong
authors.initials: CH
authors.lastname: Tseng
authors.forename: Mei-Hua
authors.initials: MH
authors.lastname: Huang
authors.forename: Tené T
authors.initials: TT
authors.lastname: Lewis
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.forename: Teresa
authors.initials: T
authors.lastname: Seeman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000208:ethnology; D052636:Allostasis / Q000502:physiology*; D001213:Asian / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000208:ethnology; D006791:Hostility; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D011287:Prejudice; D012923:Social Class; D013315:Stress, Psychological / Q000208:ethnology*; D014481:United States / Q000208:ethnology; D044465:White People / Q000208:ethnology; D016387:Women's Health / Q000208:ethnology*