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For example, home foreclosures have been associated with weight gain Arcaya et al. Of importance is testing whether more widespread recession hardship is associated with more widespread health problems. Emerging research conducted in the United States and Europe have linked the Great Recession with a diverse set of health outcomes such as increased suicide rates Chang et al. Based on findings from prior recession research, this study examined the association between recession-related hardships and health using a diverse set of indicators, including self-rated health, waist circumference, acute symptoms e.

We predicted that a greater number of hardships would be linked with poorer self-rated health, an unhealthy waist circumference and more chronic and acute health problems. The recent recession has influenced, to differing degrees, the lives of many Americans, although the impact of pre-existing vulnerabilities on health has not been carefully elaborated.

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National studies show that less educated adults experienced more economic hardships and had more difficulty recovering from the recent recession than their higher educated counterparts Hoynes et al. Furthermore, educational attainment has become an ever stronger predictor of health and longevity in recent decades, raising concerns about widening inequalities across educational levels Case and Deaton, ; Hayward et al.

Based on these findings, this study focused on educational status as a key pre-existing vulnerability factor. Educational status is an indicator of socioeconomic standing SES that remains relatively stable in adulthood Krieger et al. Previous research has established strong and consistent relationships between educational status and health.

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At every level of the education gradient, lower ranking individuals show higher rates of morbidity and mortality than their more advantaged counterparts Adler et al. Educational attainment, compared to other markers of SES e. Lower educational status may also foster less healthy behaviors e. On a daily basis, lower educated adults are known to experience more severe stressors and appraise such events as posing greater threats to financial stability and self-concept Almeida, Educational status may modify associations between recession hardships and health by altering emotional and physiological responses to stress.

In contrast to other SES indicators e. Recession-related hardships may also amplify the negative health consequences of low educational attainment and possibly worsen social inequalities in health. In a review of prior recession findings see Glonti et al. Additionally, Cutler et al. That is, educationally disadvantaged who entered the labor market during economic downturns were most likely to suffer poorer health.

Applying these prior findings to the Great Recession, we hypothesized that lower educated adults represent a pre-existing vulnerable subgroup that would experience more widespread hardship and, relatedly, worse health. It is expected that individuals will show variability in how they respond to hardships of the Great Recession. To understand these differences, it is useful to examine risk and protective factors that modify the associations between recession hardships and health.

To date, few studies in the recession and health literature have tested the role of psychological factors in modifying health outcomes Glonti et al. Outside the recession context, however, research on social disadvantage and health inequalities has found strong and consistent evidence for the health-protective role of psychological resources. According to the reserve capacity model, the presence of psychological resources contributes to more positive heath outcomes and can buffer the effects of social disadvantage Gallo et al. We examined three psychological resources—perceived control, purpose in life, and conscientiousness—as potential moderators of the health impacts of the Great Recession.

The health-protective role of these psychological resources for the lower SES has been documented in prior work. A generalized sense of control i. Although higher SES is associated with a greater perceived control Lachman and Weaver, , there is individual variation in control beliefs within SES strata. Among low SES groups, those with high perceived control showed similar levels of health and well-being and mortality rates to their higher SES counterparts Lachman and Weaver, ; Turiano et al. Perceived control may therefore be an important buffer against life adversity.

Research has linked purpose in life with reduced risk of morbidity and mortality Boyle et al. Regarding educational gradients in health, higher purpose in life was associated with reduced inflammation among lower but not higher educated adults Morozink et al. In summary, the health-modifying roles of purpose in life may be particularly important to assess during times of heightened adversity, such as the Great Recession. Finally, personality traits have been studied as mediators of SES gradients in health, although recent findings suggest that SES and personality traits independently predict mortality, and therefore explain not only between-strata variation but also within-strata variation in health Chapman et al.

Conscientiousness reflects a disposition of being responsible, organized, and hardworking. Decades of research show this trait to be an important predictor of health and well-being Bogg and Roberts, and greater longevity Kern and Friedman, ; Jokela et al. Lower levels of conscientiousness also predict engagement in health-compromising behaviors such as smoking, heavy alcohol use, and unhealthy eating e. Together, these findings suggest that some individuals may offset the adverse health effects of economic adversity through being conscientious.

Respondents from a national sample of US adults answered multiple questions about recession experiences job insecurity, housing instability, and financial strain as well as diverse indicators of health and psychological resources. The key objectives of this study were to examine links between recession hardship and health and to identify risk and protective factors that contribute to subgroup differences in these associations. We sharpened our focus on educational status as a pre-existing vulnerability factor and psychological resources sense of control, purpose in life, and conscientiousness as protective factors.

We hypothesized that educational status would moderate relationships between recession hardship and health. Tests of two-way interactions were predicted to show that more widespread recession hardship would be more strongly associated with worse physical health among the educationally disadvantaged. For the educationally advantaged , we predicted that the relationship between recession hardship and negative health outcomes would be attenuated.


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These findings would extend prior literature that has shown that individuals with lower levels of education experienced greater depressive symptoms following job loss compared to individuals with higher levels of education Berchick et al. Consistent with the reserve capacity model Matthews et al. Studies have demonstrated that psychological resources can protect against the negative health impacts of educational disadvantage, but few published studies have tested hypotheses involving the health returns of psychological resources in broader socioeconomic contexts.

Tests of two-way interactions were expected to show that psychological resources would moderate the associations between recession hardship and health. For respondents who rate themselves higher in perceived control, purpose in life, and conscientiousness, we predicted that the associations between more widespread recession hardship and poor health would be attenuated compared to respondents who might lack these psychological resources. Few studies have examined the interactions between pre-existing vulnerabilities low educational status and psychological resources in investigating health impacts of the Great Recession.

How these factors come together could, however, take different forms Shanahan et al. Alternatively, the resource accumulation and positive amplification hypothesis propose that protective factors may be amplified by supportive and stable socioeconomic contexts.

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Support for the disabling hypothesis comes from observations made in the Terman Sample of Gifted Children. Such work revealed that psychological strengths could be weakened in contexts of economic decline. High conscientiousness in adolescence was not beneficial for social or psychological well-being among adults who later entered workforce during the Great Depression, but was beneficial for adults who entered the workforce after World War II Shanahan et al.

Two directional hypotheses were considered for tests of three-way interactions among educational status, psychological resources, and recession hardship. One from the reserve capacity model predicts that less educated adults with high levels of psychological resources would be protected against risk of poorer health outcomes associated with more widespread economic hardship.

To summarize, the overarching predictions were as follows: The cross-sectional limitations of the study are noted and examined in discussing the findings. Data were collected from adults recruited into the Midlife in the United States MIDUS study, a national longitudinal study of health and well-being http: MIDUS began in with the purpose of understanding the bio—psycho—social processes of aging and is a major forum for investigating health of US adults.

Data from the main survey project were currently available for reporting for this study, as sampling and data collection for the other protocols are still ongoing. Respondents were selected from the 48 contiguous states using random digit dialing RDD of numbers with age and sex information about household composition. However, the sample was more highly educated relative to the national population.

For this study, data are reported for a sample of respondents that completed both the phone interview and the SAQ portions and had complete data for all dependent variables tested in the analyses. This subset of respondents was comparable to the larger refresher sample on sociodemographic factors age, gender, marital status, and education.

A composite measure of recession-related hardships was assessed with 18 items, derived from a national survey of unemployed adults conducted by the Heidrich Center for Workforce Development, Rutgers Borie-Holtz et al. Four items assessed job impact e. Self-reported health is a single global question. Although subjective, this item has consistently predicted mortality, frequently better than physician-rated health Benyamini and Idler, ; DeSalvo et al.

Chronic conditions were measured with 39 items in the SAQ. They indicated whether they had experienced any chronic health issues e. Using the same procedures as Piazza et al. Conditions related to emotional distress e. Appendix 2 lists the 19 chronic conditions included in the analysis and the percentage of respondents reporting each of these conditions.

A total score was computed based on the number of chronic conditions respondents endorsed.


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  • Higher values indicate a greater number of chronic conditions possible range 0— Frequency of acute somatic symptoms consisted of 11 items that assessed the occurrence of minor health symptoms e. The scores ranged from 1 almost every day to 6 not at all. The items were reverse scored and averaged. Waist circumference was used to assess overweight status because it is a strong predictor of morbidity and mortality risk Bigaard et al. In prior population research, intraclass correlations have demonstrated high concordance between measured and self-reported values for waist circumference Dekkers et al.

    Three psychological factors were tested as moderators of the health impacts of the recession. Perceived control was assessed with a item composite with an internal consistency of. The measure assesses perceived control over outcomes in life and consists of two subscales from the MIDUS sense of control scale: I can do just about anything I really set my mind to and perceived constraints e. What happens in my life is often beyond my control; Lachman and Weaver, To create the scale, the items for personal mastery were reverse coded such that higher values indicated a higher sense of control, and all 12 items were averaged.

    To create the scale, the items that were negatively worded were reverse coded to reflect higher standing in the scale, and the seven items were summed. Internal consistency for these items is. Respondents were asked how much each of the five adjectives responsible, hardworking, organized, thorough, and careless described themselves on a scale ranging from 1 not at all to 4 a lot. Conscientiousness was calculated by first reverse-scoring careless and then averaging the five adjectives.

    Internal consistency for these items was. Respondents were asked to report how many years of school or college they had completed. The 12 response categories ranged from no schooling to completion of a professional degree. Education was treated as a continuous variable in the analyses. All models for were adjusted for age, sex, race, and marital status. A dummy code was constructed for both race and marital status. Caucasians were contrasted against all other races, and those married were contrasted against those who were unmarried. Table 1 lists the descriptive statistics for all variables included in the analyses.

    To test the impact of recession hardships on health and the moderating role of educational status and psychosocial variables, a series of general linear models was estimated with the statistical program R. Differences in recession hardships were examined as a function of sociodemographic factors, with a primary focus on educational standing, although age, gender, race, and marital status were also examined. The purpose of these initial analyses was to provide a descriptive look at subgroup differences in recession hardship. To test the main hypotheses, separate multiple regression analyses were run for each health outcome.

    All continuous predictors were standardized. Case analyses did not reveal statistical outliers or influential data points. Tests of model assumptions suggested violations of normality and homogeneity of variance for models predicting chronic conditions. These models were reanalyzed with a square root transformation of chronic conditions and yielded similar results as untransformed analyses. Therefore, original, untransformed models are reported in the final results.

    Age, gender, race, and marital status have been associated with number of chronic conditions, and other health outcomes and were therefore included as covariates in the analyses. To reduce multicollinearity, separate hierarchical regression models were run for each psychological moderating factor. A set of hierarchical regression models was estimated to first test the hypothesis that educational status would moderate the relationships between recession hardships and health.

    The first model included sociodemographic covariates age, sex, marital status, and race. The second model included education, with sociodemographic covariates. The third model incorporated recession hardships, and the fourth model included the two-way interaction between educational status and recession hardships.

    A second set of hierarchical regression models was estimated to test hypotheses that psychological resources would modify the effects of the recession on health. The first step included sociodemographic variables, including education and recession hardships.

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    The second step included the psychological variable, and a third step tested two-way interactions, one set between the psychological variable and recession experiences and the second set between education and psychological factors. Of primary interest, per the guiding hypotheses, were the tests of the three-way interactions among education, recession experience, and psychological factors. Preliminary analyses revealed that education, recession hardships, and psychological factors were moderately correlated with each other.

    To test whether multicollinearity was an issue, the variance inflation factor VIF for each of the predictors in the regression models was calculated. VIFs indicate how much the standard error of the parameter estimate increases as a result of redundancy among the predictor variables, where VIFs greater than 5 are considered problematic. None of the VIFs calculated exceeded a value of 2, indicating that multicollinearity was not problematic for the tested models. Sociodemographic differences were examined by regressing the composite measure of recession hardships on each variable and comparing estimated group mean differences.

    Educational status was of primary interest, although subgroup differences in gender, age, race, and marital status were also examined. As predicted, respondents without a 4-year college degree reported more recession events high school or lower: Age did not significantly predict differences in number of recession hardships reported. A set of hierarchical regression models tested the prediction that less educated adults would be more vulnerable to the health impacts of the Great Recession i.

    The top portion of Table 2 illustrates the results of these regression models. Step 2 shows that educational status was a significant predictor of all four health outcomes: Lower educated individuals showed more negative health outcomes such as more chronic conditions, more frequent somatic symptoms, worse self-rated health, and larger waist circumference. In step 3, recession hardships explained a significant additional proportion of variance for each health outcome. Individuals who reported more recession hardships also reported more chronic conditions, more acute somatic symptoms, lower self-rated health, and larger waist circumference.

    All models included the lower order predictors: The key test of hypothesis 1 was examined in step 4, which probed the interaction of educational status with recession hardships. These interactions indicate that, as predicted, lower educated adults showed a stronger and significantly more positive relationship between recession hardships and number of chronic conditions and waist circumference than their higher educated counterparts. No other health outcomes were significantly moderated by education.

    A set of hierarchical regression models tested perceived control as a moderator of recession hardships on health outcomes. The second portion of Table 2 illustrates the results of these regression models. The first model tested the main effect of perceived control separate from other psychological factors and included the lower order effects of age, gender, marital status, race, education, and recession experiences.

    The main effect of perceived control for each of the four health outcomes was statistically significant. The second model tested perceived control as a moderator of educational status and health relationships. The positive coefficient for the interaction term of. In other words, sense of control was more strongly and negatively associated with chronic conditions among the lower educated relative to the higher educated. Perceived control did not moderate relationships between recession hardships and health outcomes.

    Purpose in life was tested as a moderator of recession hardships and health outcomes in separate regression models see Table 2. Purpose in life significantly predicted each of the four health outcomes. In other words, purpose in life was more strongly and negatively associated with chronic conditions among the lower educated relative to the higher educated. Purpose in life did not moderate relationships between recession hardships and health outcomes.

    In other words, conscientiousness was more strongly and negatively associated with acute somatic symptoms among the lower educated relative to the higher educated. Of primary interest was the test of three-way interaction among education, recession hardships, and perceived control. Figure 1 a , top two panels, illustrates the significant three-way interaction by depicting the two-way interaction between recession hardships and perceived control by educational status.

    Overall, perceived control predicted higher levels of self-rated health, but was a weaker predictor of self-rated health for low-educated individuals who reported more recession hardships left panel of the figures, dotted line. A different pattern emerged among high-educated individuals. Recession hardship was more strongly negatively associated with self-rated health among individuals who reported 1 standard deviation SD below the mean in perceived control.

    No other significant interactions were evident in analyses for perceived control. The left panel represents model predictions for self-rated health graphed at 1 standard deviation SD below the mean for education.

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    The right panel represents model predictions for self-rated health graphed at 1 SD above the mean for education. Solid lines represent model predictions by perceived control 1 SD below the mean and dotted lines represent model predictions by high perceived control 1 SD above the mean. The left panel represents model predictions for self-rated health graphed at 1 SD below the mean for education. Solid lines represent model predictions by low purpose in life 1 SD below the mean and dotted lines represent model predictions by high purpose in life 1 SD above the mean.

    Figure 1 b , bottom two panels, illustrates the significant three-way interaction for self-rated health. Overall, purpose in life predicted better self-rated health, but less so for low-educated individuals who reported more recession hardships left panel of the figures, dotted line. Recession hardship was more strongly negatively associated with self-rated health among individuals who reported 1 SD below the mean in purpose in life.

    Figure 2 a , top two panels, illustrates the significant three-way interaction for chronic conditions. Overall, high purpose in life predicted fewer chronic conditions, but less so for low-educated individuals who reported more recession hardships left panel of the figures, dotted line. This interaction between recession hardship and purpose in life was not observed among high-educated individuals. The left panel represents model predictions for chronic conditions graphed at 1 standard deviation SD below the mean for education.

    The right panel represents model predictions for chronic conditions graphed at 1 SD above the mean for education. The left panel represents model predictions for chronic conditions graphed at 1 SD below the mean for education. Solid lines represent model predictions by low conscientiousness 1 SD below the mean and dotted lines represent model predictions by high conscientiousness 1 SD above the mean.

    Figure 2 b , bottom two panels, shows that conscientiousness predicted fewer chronic conditions, but less so for low-educated individuals who reported more recession hardships left panel of the figures, dotted line. This interaction between recession hardships and conscientiousness was not observed among high-educated individuals. This study investigated links between reported hardships from the Great Recession and physical health in a nationally representative study of US midlife adults.

    Findings supported the hypothesis that low educational status is key pre-existing vulnerability factor: In addition, educational status moderated the relationship between recession impact and two indicators of health chronic conditions and waist circumference , revealing that lower educated adults were more likely to show heightened chronic conditions and a larger waist circumference in the face of high recession impact compared to higher educated adults. Consistent with the prior literature, purpose in life and perceived control moderated educational gradients in chronic conditions, whereas conscientiousness moderated educational gradients in acute somatic symptoms.

    In support of prior work by Lachman and Weaver and Morozink et al. Conscientiousness also interacted with educational status to predict acute somatic symptoms, suggesting that it was more health protective among the lower educated relative to the higher educated. Would you like to tell us about a lower price? If you are a seller for this product, would you like to suggest updates through seller support?

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