Socioeconomic position, social mobility, and health selection effects on allostatic load in the United States

Abstract

The contemporaneous association between higher socioeconomic position and better health is well established. Life course research has also demonstrated a lasting effect of childhood socioeconomic conditions on adult health and well-being. Yet, little is known about the separate health effects of intergenerational mobility—moving into a different socioeconomic position than one’s parents—among early adults in the United States. Most studies on the health implications of mobility rely on cross-sectional datasets, which makes it impossible to differentiate between health selection and social causation effects. In addition, understanding the effects of social mobility on health at a relatively young age has been hampered by the paucity of health measures that reliably predict disease onset. Analysing 4,713 respondents aged 25 to 32 from the National Longitudinal Study of Adolescent Health’s Waves I and IV, we use diagonal reference models to separately identify the effects of socioeconomic origin and destination, as well as social mobility on allostatic load among individuals in the United States. Using a combined measure of educational and occupational attainment, and accounting for individuals’ initial health, we demonstrate that in addition to health gradient among the socially immobile, individuals’ socioeconomic origin and destination are equally important for multi-system physiological dysregulation. Short-range upward mobility also has a positive and significant association with health. After mitigating health selection concerns in our observational data, this effect is observed only among those reporting poor health before experiencing social mobility. Our findings move towards the reconciliation of two theoretical perspectives, confirming the positive effect of upward mobility as predicted by the “rags to riches” perspective, while not contradicting potential costs associated with more extensive upward mobility experiences as predicted by the dissociative thesis.

Pathways from Childhood Economic Conditions to Adult Mortality in a 1953 Stockholm Cohort: The Intermediate Role of Personal Attributes and Socioeconomic Career

“…Individuals who moved down in the income distribution compared to their parents, had a tendency towards lower mortality risk compared to those with low income in both childhood and adulthood. These results for downward mobility are consistent with most of the social mobility literature to date [ 6 , 25 , 27 ]. However, we did not find any indication that were in line with the recent findings suggesting that upward mobility may have a detrimental effect on health [ 28 , 29 , 30 ].…”

“…Social mobility refers to the change between status of origin and destination. Most studies on this topic tend to find that upwardly mobile individuals have worse health than those they join and better health than those they leave behind, while the downwardly mobile have better health than those they join and worse health than those they leave behind [ 6 , 8 , 24 , 25 , 26 , 27 ]. Whether these patterns can be simply attributed to the sum of the different positions that are held by an individual across the life course or if the mobility process in itself is related to health remains unclear.…”

“…The vast majority of studies on the health-related consequences of social mobility are based on occupational status [ 6 , 8 , 24 , 25 , 26 , 29 ] or educational attainment [ 27 , 28 ]. Yet, education, occupation, and income are independently associated with health [ 31 , 32 , 33 ], in part through different processes [ 34 , 35 ].…”

Social Mobility, Health and Wellbeing in Poland

“…To understand the effect of intergenerational occupational mobility on individuals’ health and psychological wellbeing, we employed diagonal reference models (DRM) ( Sobel, 1981 ). Widely used in social mobility research ( Houle and Martin, 2011 ; Billingsley et al, 2018 ; Gugushvili et al, 2021 ), DRMs allow disentangling of the effects of mobility on the impact of origin and destination positions. DRM first estimates intercepts for immobile individuals whose social origin position equals their destination position.…”

Early life adversity and adult social relationships have independent effects on survival in a wild animal model of aging

“…At the same time, understanding the causes of variation in health and mortality can inform investment in public health interventions and policy. However, despite extensive research on the pathways linking early experience and adult life outcomes, the relative importance of health selection versus social causation in explaining social environmental effects on adult survival is widely debated (13,(20)(21)(22)(23)(24).…”